Determinants of 5 Year Progression of Muscle Dysfunction and Inactivity in COPDGene Participants Diversity Supplement

摘要 新冠肺炎病是一种高度传染性的病毒感染，由新型急性冠状病毒引起 呼吸综合征冠状病毒2.人与人之间的快速传播迫使各国实施 限制措施，以减少社区传播的速度和影响。对社会限制的建议尤其是 针对老年人和既往患有慢性病的人，他们罹患疾病的风险更高 严重的新冠肺炎病。这些限制导致许多人躲在家里、单独或 家庭孤立，一次持续数周或更长时间，影响他们的社交活动，并增加糟糕的健康状况 暴饮暴食、缺乏运动等行为。每日体力活动减少是许多 对健康有害的方面，包括但不限于血糖和血脂控制不佳，心血管疾病， 癌症和促炎状态。美国疾病控制与预防中心已将缺乏体力活动确定为慢性疾病的“实际原因” 疾病，导致包括慢性梗阻性疾病在内的许多疾病的病理和进展 肺部疾病(COPD)。 慢性阻塞性肺病是一种进行性肺部疾病，会导致呼吸困难，在新冠肺炎之前，它一直是第四大 在美国的死因。在慢性阻塞性肺疾病中，缺乏运动与肌肉功能障碍有关(例如，丧失 肌肉质量低、氧化能力低和氧化应激增加)和运动不耐受。体力活动 运动量是COPD早期死亡率的最强预测因子，而不是 肺功能受损。许多COPD患者报告说，为缓解 新冠肺炎加剧了身体缺乏活动，增加了抑郁，降低了生活质量。这项研究将 评估新冠肺炎限制对身体活动、症状、抑郁和生活质量的影响。五十 在父母肌肉健康研究中限制新冠肺炎之前进行这些评估的个人 (R01HL151452)，现在将在新冠肺炎限制实施后重复这些评估。 在过去的12个月里，发表了几项研究，阐明了这种疾病的特点、发病机制和 新冠肺炎病的急性并发症，然而，更长期的后果仍然未知。未来 对于患有慢性阻塞性肺疾病等肺部疾病的患者来说，影响尤其相关，这些患者患上 感染后持续至少6个月的后果(例如，呼吸困难、疲劳、精神健康状况不佳、睡眠 问题)。这项提案将为支持和促进肺功能重组的努力提供证据 以虚拟形式为慢性阻塞性肺疾病患者提供有效的康复方案。此外， 这项研究将为罗德岛大学硕士研究生贝兹先生的职业生涯铺平道路 继续接受慢性肺病患者呼吸疗法方面的培训。

ABSTRACT COVID-19 disease is a highly transmittable viral infection caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2. Rapid human-to-human transmission has forced countries to implement restrictions to reduce the rate and impact of community spread. Advice for social restrictions was especially directed to the elderly and individuals with pre-existing chronic conditions, who are at greater risk of developing severe COVID-19 disease. These restrictions led to many individuals sheltering in their homes, in solitary or household isolation, for weeks or more at a time, affecting their social interactions and increasing poor health behaviors such as binge eating and physical inactivity. Reduced daily physical activity underlies many detrimental facets to health, including but not limited to poor glucose and lipid control, cardiovascular disease, cancer and a pro-inflammatory state. The CDC has identified physical inactivity as an “actual cause” of chronic disease, which contributes to the pathology and progression of many diseases including chronic obstructive pulmonary disease (COPD). COPD is a progressive lung disease that causes breathing difficulties, and, until COVID-19, was the 4th leading cause of death in the USA. In COPD, physical inactivity is associated with muscle dysfunction (e.g., loss of muscle mass, low oxidative capacity and increased oxidative stress) and exercise intolerance. Physical activity and exercise capacity are the strongest predictors of early mortality in COPD, rather than the severity of pulmonary function impairment. Many COPD patients report that the social restrictions imposed to mitigate COVID-19 exacerbated physical inactivity, increased depression and reduced quality-of-life. This study will assess the effect of COVID-19 restrictions on physical activity, symptoms, depression and quality-of-life. Fifty individuals who had these assessments made prior to COVID-19 restrictions in the parent Muscle Health Study (R01HL151452), will repeat these assessments now, after COVID-19 restrictions were implemented. In the past twelve months several studies were published elucidating the characteristics, pathogenesis and acute complications of COVID-19 disease, however the longer-term consequences are still unknown. Future impacts are especially relevant for patients with lung conditions such as COPD who are at greater risk of persistent consequences for at least 6 months after infection (e.g., dyspnea, fatigue, poor mental health, sleep problems). This proposal will provide evidence to support and promote efforts to re-tool pulmonary rehabilitation programs to impart impactful benefits in the COPD patients using virtual formats. Furthermore, this study would pave a career path for Mr. Baez, a Master’s Student at the University of Rhode Island, to pursue his training in respiratory therapy for chronic lung disease patients.