Fatigue and Fatigability in Veterans Following SARS-CoV-2 Infection

退伍军人感染 SARS-CoV-2 后的疲劳和容易疲劳

• 批准号: 10703633
• 负责人: JARED M. GOLLIE
• 金额: --
• 依托单位: U.S. DEPT/VETS AFFAIRS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10703633
• 关键词: 2019-nCoV; Address; Affective; Anxiety; Atrophic; Award; Awareness; COVID-19 pandemic; Chronic; Clinical; Clinical Trials; Communities; Data; Dose; Effectiveness; Exercise; Exhibits; Extensor; Fatigue; Feeling; Fiber; Goals; Health; Home; Individual; Isometric Exercise; Knee; Measures; Mental Depression; Metabolic dysfunction; Motor; Muscle; Near-Infrared Spectroscopy; Neurobiology; Oxygen; Patients; Performance; Persons; Physical Exercise; Physical activity; Physiological; Population; Prevalence; Property; Quarantine; Randomized; Rehabilitation therapy; Reporting; Risk; SARS-CoV-2 infection; Severities; Skeletal Muscle; Symptoms; Testing; Veterans; appropriate dose; base; combat; design; exercise program; experience; feasibility trial; functional outcomes; health related quality of life; improved; insight; neurobehavioral; neuromuscular; novel; patient population; post SARS-CoV-2 infection; post-COVID-19; psychologic; remote delivery; resistance exercise; response; safety and feasibility; sedentary lifestyle; skeletal muscle weakness; vastus lateralis

Project Summary/Abstract The chronic presence of elevations in fatigue suggests that individuals with post-COVID-19 fatigue (PCF) may be at risk for experiencing increased fatigability when engaging in physical activity. An individual’s level of fatigability is determined by the interactions between objective declines in performance (performance fatigability) and perceptual changes regulating activity performance (i.e., perceived fatigability). Skeletal muscle alterations including reduced force capacity, fiber atrophy, and metabolic dysfunction have been observed in patients following SARS-CoV-2 infection. In addition, depression and anxiety have been identified as common pre-existing conditions in patients with PCF. Thus, psychological as well as physiological consequences of SARS-CoV-2 may provide insight into co-occurring mechanisms by which increased fatigability occurs and persists following SARS-CoV-2 infection. While there have been widespread calls for the implementation of rehabilitation for individuals recovering from SARS-CoV-2 infection, relatively little is known about the potential benefits of physical exercise in this population. Home-based exercise programs maybe particularly advantageous due to its ability to provide an exercise option to combat sedentary behavior imposed by lockdowns, quarantines, and restrictions on community activity caused by the COVID-19 pandemic. To date, the safety and feasibility of home-based exercise has yet to be thoroughly investigated in people previously infected by SARS-CoV-2. The overall goal of this project is to advance our understanding of underlying mechanisms impacting performance fatigability and perceived fatigability in Veterans with PCF and explore the safety and feasibility of a home-based “minimal-dose” resistance exercise program in this population. The central hypothesis is that declines in force capacity, skeletal muscle oxygen extraction, and affective responses to physical activity offer potential mechanisms through which fatigability is increased in Veterans with PCF. Moreover, home-based resistance exercise delivered remotely may provide a safe and feasible treatment option for this population. To address this hypothesis, the following aims are proposed: Aim 1: Compare fatigability, and the underlying neuromuscular and neurobiological factors, in Veterans with post- COVID-19 fatigue to Veterans previously infected by SARS-CoV-2 without fatigue. Hypothesis 1a. Veterans with post-COVID-19 fatigue will exhibit greater performance fatigability and perceived fatigability compared to Veterans previously infected with SARS-CoV-2 not reporting post-COVID-19 fatigue. Hypothesis 1b. Veterans with post-COVID-19 fatigue will exhibit reductions in knee extensor force capacity, muscle oxygen extraction, and affective valence compared to Veterans previously infected with SARS-CoV-2 not reporting post-COVID-19 fatigue. Aim 2: Determine the safety and feasibility of an 8-week home-based “minimal-dose” resistance exercise program for Veterans with post-COVID-19 fatigue. Hypothesis 2a. 8 weeks of home-based minimal- dose resistance exercise will be safe and feasible in Veterans with post-COVID-19 fatigue. To test aim 2, we will use a randomized controlled feasibility trial. Skeletal muscle force will be assessed during isometric and dynamic knee extensor contractions using dynamometry and muscle oxygen extraction of the vastus lateralis will be estimated using near-infrared spectroscopy. Affective responses will be measured using the Feeling Scale. Secondary measures include motor unit properties, functional outcomes, and health-related quality of life.

项目总结/摘要 疲劳的长期存在表明，患有COVID-19后疲劳（PCF）的个体可能 在从事体力活动时有增加疲劳的风险。个人的水平 疲劳性是由性能（性能）的客观下降之间的相互作用决定的 易疲劳性）和调节活动表现的感知变化（即，感知疲劳）。骨骼 肌肉改变，包括力量能力降低、纤维萎缩和代谢功能障碍， 在SARS-CoV-2感染后的患者中观察到。此外，抑郁症和焦虑症也被确定为 是PCF患者常见的既存疾病。因此，心理上和生理上 SARS-CoV-2的结果可能提供对增加的并发机制的深入了解。 在SARS-CoV-2感染后出现并持续疲劳。虽然人们普遍呼吁 对从SARS-CoV-2感染中康复的个人实施康复， 了解体育锻炼在这一人群中的潜在益处。家庭锻炼计划 由于其提供锻炼选择以对抗久坐行为的能力， 由于COVID-19导致的封锁、禁令和对社区活动的限制， 流行病到目前为止，家居运动的安全性和可行性仍有待深入研究， 曾感染过SARS-CoV-2的人。这个项目的总体目标是促进我们对 影响退伍军人PCF患者表现疲劳和感知疲劳的潜在机制， 探讨安全性和可行性的家庭为基础的“最小剂量”的阻力锻炼计划，在这方面， 人口核心假设是，力量能力、骨骼肌氧摄取和 对身体活动的情感反应提供了潜在的机制，通过这种机制， 患有PCF的退伍军人。此外，远程提供的基于家庭的阻力锻炼可以提供安全且 为这一人群提供可行的治疗方案。为了解决这一假设，提出了以下目标： 1：比较疲劳，以及潜在的神经肌肉和神经生物学因素，在退伍军人与后 COVID-19疲劳对先前感染SARS-CoV-2而没有疲劳的退伍军人。假设1A。退伍军人 与COVID-19后疲劳相比， 曾感染SARS-CoV-2的退伍军人未报告COVID-19后疲劳。假设1b。退伍军人 COVID-19后疲劳将表现出膝伸肌力量能力，肌肉氧提取， 与先前感染SARS-CoV-2但未报告COVID-19后感染的退伍军人相比， 疲劳目的2：确定8周家庭“最小剂量”抵抗的安全性和可行性 为患有COVID-19后疲劳的退伍军人提供锻炼计划。假设2a。8周的居家最低- 大剂量抗阻运动对患有COVID-19后疲劳的退伍军人是安全可行的。为了测试目标2，我们将 使用随机对照可行性试验。将在等长收缩期间评估骨骼肌肌力， 使用股外侧肌测力计和肌肉氧提取的动态膝伸肌收缩 将使用近红外光谱进行估计。情感反应将使用感觉测量 规模次要指标包括运动单位特性、功能结果和与健康相关的质量。 生活

项目成果

Endothelial dysfunction in autoimmune, pulmonary, and kidney systems, and exercise tolerance following SARS-CoV-2 infection.

• DOI: 10.3389/fmed.2023.1197061
• 发表时间: 2023
• 期刊: Frontiers in medicine
• 影响因子: 3.9