Parâmetros espirométricos e níveis de citocinas, cortisol e complemento séricos em pacientes submetidos a reabilitação respiratória pós-infecção por SARS-Cov-2

Abstract

SARS-CoV-2 is the etiological agent of Covid-19, which during the pandemic had an impact on the lives of millions of people around the world, thousands of deaths, respiratory and social consequences and pulmonary sequelae with immunological and hormonal changes. Pulmonary impairment was the main factor responsible for hospitalizations and the greater severity of the respiratory disease represented a greater risk for the development of pulmonary sequelae. In this sense, respiratory physiotherapy rehabilitation plays an important role in the prevention of sequelae and recovery from ADLs. It is possible that pulmonary physical therapy may act on immunological and hormonal parameters. Thus, the objective of this study was to evaluate the spirometric result (pulmonary function test) and the levels of cortisol, cytokines and complement system proteins in patients admitted to respiratory breathing, with follow-up for 18 to 24 months after Covid-19. Serum samples were collected from 23 individuals, aged between 30 and 75 years, as well as spirometric tests carried out after a period of 18 to 24 months after infection. Patients were admitted to a respiratory physiotherapeutic rehabilitation program from the moment of admission until a period of 3 months after hospital discharge. Individuals were divided into three groups: individuals not infected by Covid-19 (GC), individuals infected and with pulmonary disease by Covid-19 with lung impairment of up to 40%, and individuals with pulmonary disease with impairment greater than 70% and hospitalized in UTI. Blood samples were collected to determine C-Reactive Protein (us-CRP), cortisol and complement dosage (CH50, C3 and C4). Spirometric evaluation was performed 18 to 24 months after infection. Note that, despite the permanence of pulmonary interstitial sequelae, there was no change in spirometric development. There was maintenance of normal levels of cortisol, hs-CRP and the complementary system after a period of up to 2 years after infection by Covid-19. These data suggest that physiotherapeutic rehabilitation promotes the maintenance of an adequate pulmonary ventilatory pattern, even in patients who evolved with severe pulmonary impairment and with interstitial pulmonary sequelae, had spirometric success and with full return to the execution of their ADLs without loss of respiratory function.