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1.
PLoS One ; 17(5): e0267053, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35594317

RESUMO

BACKGROUND AND AIM: Gastroesophageal reflux disease (GERD) typically presents with symptoms of heartburn and acid regurgitation but occasionally manifests as atypical chest pain. Coronary artery disease (CAD) and GERD share some risk factors, such as smoking and obesity. The aims of this study were to evaluate the association between GERD and coronary atherosclerosis and to assess the risk factors for coronary atherosclerosis in GERD patients. METHODS: A total of 16616 subjects who underwent upper gastrointestinal endoscopy from 2003 to 2017 and a cardiac computed tomography (CT) scan within one year were included in this study. Coronary atherosclerosis was evaluated by the coronary artery calcium score (CACS). The severity of GERD was evaluated based on endoscopic findings using the Los Angeles classification. RESULTS: The proportion of high CACSs (≥100) increased significantly in subjects with severe GERD (p = 0.008). However, the presence of a high CACS did not increase the risk of GERD (OR = 1.007, 95% CI 0.857-1.182), nor did that of GERD increase the risk of a high CACS (OR = 1.018, 95% CI 0.865-1.198). The risk factors for a high CACS in GERD patients included age (OR = 1.087, 95% CI 1.066-1.109), male sex (OR = 5.645, 95% CI 2.561-12.446), hypertension (OR = 1.800, 95% CI 1.325-2.446), and hypercholesterolemia (OR = 1.684, 95% CI 1.213-2.338). CONCLUSIONS: Although the presence of a high CACS did not increase the risk of GERD or vice versa, the proportion of high CACSs was significantly higher in subjects with severe GERD. Therefore, it might be helpful to assess the CACS in GERD patients with multiple risk factors.


Assuntos
Doença da Artéria Coronariana , Refluxo Gastroesofágico , Dor no Peito/etiologia , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Endoscopia Gastrointestinal/efeitos adversos , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Azia/diagnóstico , Humanos , Masculino , Fatores de Risco
3.
Ned Tijdschr Geneeskd ; 1662022 04 14.
Artigo em Holandês | MEDLINE | ID: mdl-35499678

RESUMO

BACKGROUND: TIPIC-syndrome (Transient Perivascular Inflammation of the Carotid Artery) as a cause of a painful lump in the neck is not often described in the literature. This self-limiting perivascular inflammation of the carotid bifurcation is relatively unknown. CASE: We describe a 50-year old patient, in whom a CT-scan that was performed because of unilateral pain in the neck and paranasal sinuses revealed the unexpected diagnosis of TIPIC-syndrome. CONCLUSION: Knowledge of the symptoms at presentation and the following clinical course of TIPIC-syndrome can prevent unnecessary use of additional tests.


Assuntos
Dor no Peito , Edema , Edema/diagnóstico , Edema/etiologia , Humanos , Inflamação , Pessoa de Meia-Idade , Pescoço , Síndrome
4.
Chest ; 161(5): e299-e304, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35526900

RESUMO

CASE PRESENTATION: A 31-year-old Asian male never-smoker living in the upper Midwest with a past medical history of congenital bilateral hearing loss sought treatment with a 1-week history of fever, fatigue, right-sided pleuritic chest pain, shortness of breath, productive cough with mild intermittent hemoptysis, night sweats, and unintentional 10-lb weight loss over 4 weeks. He was adopted from South Korea as an infant, and thus the family history was unknown. He worked in the heating, ventilation, and air conditioning business, performing installations and repairs. There was no known exposure to animals, caves, rivers, lakes, or wooded areas. He travelled to South Korea and New Hampshire approximately 9 months previously. He did not take any medication.


Assuntos
Dor no Peito , Doenças do Mediastino , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Tosse/diagnóstico , Diagnóstico Diferencial , Dispneia/diagnóstico , Febre/diagnóstico , Febre/etiologia , Humanos , Masculino , Doenças do Mediastino/diagnóstico
7.
Scand J Trauma Resusc Emerg Med ; 30(1): 34, 2022 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-35527302

RESUMO

OBJECTIVES: To develop emergency medical dispatch (EMD) centre prediction models with high sensitivity and satisfying specificity to identify high-priority patients and patients suitable for non-emergency care respectively, when assessing patients with chest pain. METHODS: Observational cohort study of 2917 unselected patients with chest pain who contacted an EMD centre in Sweden due to chest pain during 2018. Multivariate logistic regression was applied to develop models predicting low-risk or high-risk condition, that is, occurrence of time-sensitive diagnosis on hospital discharge. RESULTS: Prediction models were developed for the identification of patients suitable for high- and low-priority dispatch, using 11 and 10 variables respectively. The area under the receiver-operating characteristic curve (AUROC) for the high-risk prediction model was 0.79 and for the low-risk model it was 0.74. When applying the high-risk prediction model, 56% of the EMS missions were given highest priority, compared with 65% with the current standard. When applying the low-risk model, 7% were given the lowest priority compared to 1% for the current standard. The new prediction models outperformed today's dispatch priority accuracy in terms of sensitivity as well as positive and negative predictive value in both high- and low-risk prediction. The low-risk model predicted almost six times as many patients as having low-risk conditions compared with today's standard. This was done without increasing the number of high-risk patients wrongly assessed as low-risk. CONCLUSIONS: By introducing prediction models, based on logistic regression analyses, using variables obtained by standard EMD-questions on age, sex, medical history and symptomology, EMD prioritisation can be improved compared with using current criteria index-based ones. This will allow a more efficient emergency medical services resource allocation.


Assuntos
Despacho de Emergência Médica , Serviços Médicos de Emergência , Dor no Peito/diagnóstico , Dor no Peito/terapia , Estudos de Coortes , Humanos , Triagem
8.
Braz J Cardiovasc Surg ; 37(2): 273-276, 2022 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-35503701

RESUMO

Epicardial cysts are rarer benign tumors than pericardial cysts. There have been few reports on surgical management of epicardial cysts. A 17-year-old normotensive boy presented with chest pain and palpitations, which on evaluation was found to be a mediastinal mass (pericardial cyst). Surgical resection of the cyst via thoracotomy was planned. The cyst was diagnosed as an epicardial cyst intraoperatively. However, due to the epicardial origin of cyst and posterior adhesions, resection was done via midline approach. The base was formed by visceral pericardium and eroding into myocardium of left ventricle, so the resection was concluded with on-pump surgery. In case of erroneous diagnosis or undesirable finding, a safer midline approach with on-pump surgery, as an alternative to minimally invasive approach for complicated epicardial cysts (erosion into ventricle/lying in close proximity to important structures or near to coronary arteries) should be considered.


Assuntos
Cisto Mediastínico , Adolescente , Dor no Peito , Ventrículos do Coração/cirurgia , Humanos , Masculino , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/cirurgia , Pericárdio/cirurgia , Toracotomia
9.
J Vasc Surg ; 75(6): 1896, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35598935
10.
BMC Emerg Med ; 22(1): 57, 2022 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-35366802

RESUMO

BACKGROUND: Following the spread of the Covid-19 pandemic in 2020, reports emerged on decreasing emergency department (ED) visits in many countries. Patients experiencing chest pain was no exception. The aim of the current study was to describe how the Covid-19 pandemic and the subsequential lockdown impacted the chest pain population in a Norwegian ED. METHODS: All patients presenting to the ED with chest pain during the study period were included. Data were collected retrospectively from the time period January 6th to August 30th, 2020, and compared to the corresponding period in 2019, assessing variations in the number of ED visits, severity, gender, and age. RESULTS: Fewer patients with chest pain were seen in the ED following the national lockdown in Norway, compared to the corresponding 2019 period (week 13: 38% fewer; weeks 11-27: 16% fewer). By week 28, the rate normalized compared to 2019 levels. There was a relative increase in lower acuity patients among these patients, while fewer moderate acuity patients were seen. During the initial period following lockdown, the median age was lower compared to the corresponding 2019 period (58 years (IQR 25) vs 62 years (IQR 24), respectively). Admissions due to acute coronary syndromes (ACS) remained proportionally stable. CONCLUSIONS: Succeeding the Covid-19 outbreak and the subsequent national lockdown in Norway, fewer chest pain patients presented to the ED. Paradoxically, the patients seemed to be less severely ill and were on average younger compared to 2019 data. However, the proportion of patients admitted with ACS was stable during this period. This could imply that some patients may have failed to seek medical advice despite experiencing a myocardial infarction.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , Dor no Peito/epidemiologia , Controle de Doenças Transmissíveis , Serviço Hospitalar de Emergência , Humanos , Pandemias , Estudos Retrospectivos
11.
J Healthc Eng ; 2022: 1795588, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35463671

RESUMO

Objective: The study aimed to use machine learning algorithms to predict the need for revascularization in patients presenting with chest pain in the emergency department. Methods: We obtained data from 581 patients with chest pain, 264 who underwent revascularization, and the other 317 were treated with medication alone for 3 months. Using standard algorithms, linear discriminant analysis, and standard algorithms, we analyzed 41 features relevant to coronary artery disease (CAD). Results: We identified seven robust predictive features. The combination of these predictors gave an area under the curve (AUC) of 0.830 to predict the need for revascularization. By contrast, the GRACE score gave an AUC of 0.68. Conclusions: This machine learning-based approach predicts the need for revascularization in patients with chest pain.


Assuntos
Dor no Peito , Doença da Artéria Coronariana , Doença da Artéria Coronariana/cirurgia , Serviço Hospitalar de Emergência , Humanos , Aprendizado de Máquina , Valor Preditivo dos Testes , Medição de Risco
12.
Dis Markers ; 2022: 9713326, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35371340

RESUMO

The use of high-sensitivity cardiac troponin (hs-cTn) assays has become part of the daily practice in most of the laboratories worldwide in the initial evaluation of the typical chest pain. Due to their early surge, the use of hs-cTn may reduce the time needed to recognise myocardial infarctions (MI), which is vital for the patients presenting in the emergency departments for chest pain. The latest European Society of Cardiology Guidelines did not only recognise their central role in the diagnosis algorithm but also recommended their use for rapid rule-in/rule-out of MI. High-sensitivity cardiac troponins are also powerful prognostic markers for long-term events and mortality, not only in a wide spectrum of other cardiovascular diseases (CVD) but also in several non-CVD pathologies. Moreover, these biomarkers became a powerful tool in special populations, such as paediatric patients and, most recently, COVID-19 patients. Although highly investigated, the assessment and interpretation of the hs-cTn changes are still challenging in the patients with basal elevation such as CKD or critically ill patients. Moreover, there are still various analytical characteristics not completely understood, such as circadian or sex variability, with major clinical implications. In this context, the present review focuses on summarizing the most recent research in the current use of hs-cTn, with a main consideration for its role in the diagnosis of MI but also its prognostic value. We have also carefully selected the most important studies regarding the challenges faced by clinicians from different specialties in the correct interpretation of this biomarker. Moreover, future perspectives have been proposed and analysed, as more research and cross-disciplinary collaboration are necessary to improve their performance.


Assuntos
COVID-19 , Infarto do Miocárdio , Biomarcadores , COVID-19/diagnóstico , Dor no Peito , Criança , Humanos , Infarto do Miocárdio/diagnóstico , Troponina
13.
Chest ; 161(4): e233-e240, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35396057

RESUMO

CASE PRESENTATION: A 20-year-old woman presented with dry cough, right-sided thoracic pain, and gradually progressive dyspnea on exertion. She had no hemoptysis or fever. There was no relevant medical history. She was a never smoker and used no medication besides oral contraceptives. There were no other risk factors for a pulmonary embolism. There was a family history of ovarian and breast cancer. Physical examination showed a mildly ill-looking woman, with shallow breathing and normal blood oxygen saturation. Auscultation revealed normal breath sounds without crackles or wheezing. Laboratory testing showed a significantly increased D-dimer (4,560 µg/L [normal, < 500 µg/L]), elevated C-reactive protein (131 mg/L [normal, < 5 mg/L]), normal leucocytes, and elevated lactate dehydrogenase (825 units/L [normal, 50 to 250 units/L).


Assuntos
Esforço Físico , Tomografia Computadorizada por Raios X , Adulto , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/etiologia , Feminino , Humanos , Adulto Jovem
14.
BMJ Case Rep ; 15(4)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365475

RESUMO

Acute chest pain is a leading cause of emergency department (ED) visits in the adult population. However, patients with a life-threatening cause of chest pain comprise only a small fraction, hence identification of those who need immediate intervention is very important. One rare cause is rupture of the aneurysm, which may present with a wide variety of symptomatology, including anginal chest pain. In a busy ED, evaluation of chest pain suggestive of myocardial ischaemia needs to cater to early identification of acute coronary syndrome (ACS), limit over investigating patients for low or intermediate probability of ACS and appropriate decision making for discharge, to reduce ED over boarding. Validated scores for evaluating the low or intermediate probability chest pain like the HEART pathway may miss such rare diagnoses in the absence of ECG changes, requiring high degree of suspicion and individualisation of patient care.


Assuntos
Aneurisma Aórtico , Seio Aórtico , Adulto , Angina Pectoris/complicações , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/diagnóstico por imagem , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Serviço Hospitalar de Emergência , Humanos , Seio Aórtico/diagnóstico por imagem
15.
J Am Heart Assoc ; 11(8): e022697, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-35411790

RESUMO

Background The utility of a given pretest probability score in predicting obstructive coronary artery disease (CAD) is population dependent. Previous studies investigating the additive value of coronary artery calcium (CAC) on pretest probability scores were predominantly limited to Western populations. This retrospective study seeks to evaluate the CAD Consortium (CAD2) model in a mixed Asian cohort within Singapore with stable chest pain and to evaluate the incremental value of CAC in predicting obstructive CAD. Methods and Results Patients who underwent cardiac computed tomography and had chest pain were included. The CAD2 clinical model comprised of age, sex, symptom typicality, diabetes, hypertension, hyperlipidemia, and smoking status and was compared with the CAD2 extended model that added CAC to assess the incremental value of CAC scoring, as well as to the corresponding locally calibrated local assessment of the heart models. A total of 522 patients were analyzed (mean age 54±11 years, 43.1% female). The CAD2 clinical model obtained an area under the curve of 0.718 (95% CI, 0.668-0.767). The inclusion of CAC score improved the area under the curve to 0.896 (95% CI, 0.867-0.925) in the CAD2 models and from 0.767 (95% CI, 0.721-0.814) to 0.926 (95% CI, 0.900-0.951) in the local assessment of the heart models. The locally calibrated local assessment of the heart models showed better discriminative performance than the corresponding CAD2 models (P<0.05 for all). Conclusions The CAD2 model was validated in a symptomatic mixed Asian cohort and local calibration further improved performance. CAC scoring provided significant incremental value in predicting obstructive CAD.


Assuntos
Cálcio , Doença da Artéria Coronariana , Adulto , Idoso , Dor no Peito , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco
16.
J Int Med Res ; 50(4): 3000605221093678, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35466750

RESUMO

Acute myocarditis is often secondary to an acute virus infection, which can be the first manifestation of upper respiratory tract symptoms, followed by chest tightness, shortness of breath, palpitations, chest pain and other non-specific symptoms. In severe cases, it can quickly progress to serious complications such as heart failure, shock and respiratory failure. Laboratory examinations can show an increase of myocardial injury markers, infection and inflammatory indicators. Cardiac ultrasound can detect the weakening of the myocardial contraction and valve regurgitation. On imaging, bilateral pulmonary oedema demonstrates symmetrical infiltration along the hilum of lung, called the "butterfly shadow". This current case report describes a patient with unilateral pulmonary oedema caused by myocarditis that was initially misdiagnosed and treated as pneumonia. The patient was subsequently treated with the application of extracorporeal membrane oxygenation and he made a full recovery. A review of this case highlights that when a patient's symptoms are not typical, a comprehensive examination and evaluation are required to avoid incorrect treatment.


Assuntos
Oxigenação por Membrana Extracorpórea , Miocardite , Edema Pulmonar , Choque , Dor no Peito , Oxigenação por Membrana Extracorpórea/efeitos adversos , Oxigenação por Membrana Extracorpórea/métodos , Humanos , Masculino , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/etiologia
17.
BMJ Open ; 12(4): e055123, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-35440450

RESUMO

INTRODUCTION: Identifying and excluding coronary artery disease (CAD) in patients with atypical angina pectoris (AP) and non-specific thoracic complaints is a challenge for general practitioners (GPs). A diagnostic and prognostic tool could help GPs in determining the likelihood of CAD and guide patient management. Studies in outpatient settings have shown that the CT-based coronary calcium score (CCS) has high accuracy for diagnosis and exclusion of CAD. However, the CT CCS test has not been tested in a primary care setting. In the COroNary Calcium scoring as fiRst-linE Test to dEtect and exclude coronary artery disease in GPs patients with stable chest pain (CONCRETE) study, the impact of direct access of GPs to CT CCS will be investigated. We hypothesise that this will allow for early diagnosis of CAD and treatment, more efficient referral to the cardiologist and a reduction of healthcare-related costs. METHODS AND ANALYSIS: CONCRETE is a pragmatic multicentre trial with a cluster randomised design, in which direct GP access to the CT CCS test is compared with standard of care. In both arms, at least 40 GP offices, and circa 800 patients with atypical AP and non-specific thoracic complaints will be included. To determine the increase in detection and treatment rate of CAD in GP offices, the CVRM registration rate is derived from the GPs electronic registration system. Individual patients' data regarding cardiovascular risk factors, expressed chest pain complaints, quality of life, downstream testing and CAD diagnosis will be collected through questionnaires and the electronic GP dossier. ETHICS AND DISSEMINATION: CONCRETE has been approved by the Medical Ethical Committee of the University Medical Center of Groningen. TRIAL REGISTRATION NUMBER: NTR 7475; Pre-results.


Assuntos
Doença da Artéria Coronariana , Clínicos Gerais , Angina Pectoris/complicações , Angina Pectoris/diagnóstico , Cálcio , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Angiografia Coronária/métodos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Pragmáticos como Assunto , Valor Preditivo dos Testes , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Open Heart ; 9(1)2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35444050

RESUMO

OBJECTIVES: To describe a cohort of patients with arrhythmogenic left ventricular cardiomyopathy (ALVC), focusing on the spectrum of the clinical presentations. METHODS: Patients were retrospectively evaluated between January 2012 and June 2020. Diagnosis was based on (1) ≥3 contiguous segments with subepicardial/midwall late gadolinium enhancement in the left ventricle (LV) at cardiac magnetic resonance plus a likely pathogenic/pathogenic arrhythmogenic cardiomyopathy (AC) associated genetic mutation and/or familial history of AC and/or red flags for ALVC (ie, negative T waves in V4-6/aVL, low voltages in limb leads, right bundle branch block like ventricular tachycardia) or (2) pathology examination of explanted hearts or autoptic cases suffering sudden cardiac death (SCD). Significant right ventricular involvement was an exclusion criterion. RESULTS: Fifty-two patients (63% males, age 45 years (31-53)) composed the study cohort. Twenty-one (41%) had normal echocardiogram, 13 (25%) a hypokinetic non-dilated cardiomyopathy (HNDC) and 17 (33%) a dilated cardiomyopathy (DCM). Of 47 tested patients, 29 (62%) were carriers of a pathogenic/likely pathogenic DNA variant. Clinical contexts leading to diagnosis were SCD in 3 (6%), ventricular arrhythmias in 15 (29%), chest pain in 8 (15%), heart failure in 6 (12%) and familial screening in 20 (38%). Thirty patients (57%) had previously received a diagnosis other than ALVC with a diagnostic delay of 6 years (IQR 1-7). CONCLUSIONS: ALVC is hidden in different clinical scenarios with a phenotypic spectrum ranging from normal LV to HNDC and DCM. Ventricular arrhythmias, chest pain, heart failure and SCD are the main clinical presentations, being familial screening essential for the affected relatives' identification.


Assuntos
Displasia Arritmogênica Ventricular Direita , Cardiomiopatias , Cardiomiopatia Dilatada , Insuficiência Cardíaca , Arritmias Cardíacas , Displasia Arritmogênica Ventricular Direita/complicações , Displasia Arritmogênica Ventricular Direita/diagnóstico , Displasia Arritmogênica Ventricular Direita/genética , Cardiomiopatias/diagnóstico , Dor no Peito , Meios de Contraste , Morte Súbita Cardíaca/etiologia , Diagnóstico Tardio , Feminino , Gadolínio , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
BMJ Case Rep ; 15(4)2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35459642

RESUMO

A woman in her 70s presented with chest pain, which was initially thought to be an acute coronary syndrome but subsequently felt to be pericarditis. Chest radiography and echocardiography demonstrated striking cardiomegaly and marked biatrial dilatation, likely secondary to undiagnosed restrictive cardiomyopathy. The patient remained well on the ward for some days with only mild discomfort and stable haemodynamics. CT of the thorax went on to unexpectedly demonstrate a Stanford type A aortic dissection. The patient was promptly transferred for emergent surgery but sadly died intraoperatively.Delayed or missed diagnosis of acute aortic dissection (AAD) is common. The dual-processing theory (DPT) of human judgement can be applied to medical decision making and used to explain this potential for diagnostic error in AAD diagnosis. A greater awareness of DPT and the role of heuristics and biases in medical decision making may help to reduce medical diagnostic error.


Assuntos
Aneurisma Dissecante , Aneurisma Dissecante/complicações , Aneurisma Dissecante/diagnóstico por imagem , Dor no Peito , Erros de Diagnóstico , Ecocardiografia , Feminino , Humanos
20.
BMJ Open ; 12(4): e057863, 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35487745

RESUMO

OBJECTIVE: To investigate if the physical activity (PA) prior to infection is associated with the severity of the disease in patients positively tested for COVID-19, as well as with the most common symptoms. DESIGN: A cross-sectional study using baseline data from a prospective, hybrid cohort study (Predi-COVID) in Luxembourg. Data were collected from May 2020 to June 2021. SETTING: Real-life setting (at home) and hospitalised patients. PARTICIPANTS: All volunteers aged >18 years with confirmed SARS-CoV-2 infection, as determined by reverse transcription-PCR, and having completed the PA questionnaire (n=452). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was disease severity (asymptomatic, mild illness and moderate illness). The secondary outcomes were self-reported symptoms. RESULTS: From the 452 patients included, 216 (48%) were female, the median (IQR) age was 42 (31-51) years, 59 (13%) were classified as asymptomatic, 287 (63%) as mild illness and 106 (24%) as moderate illness. The most prevalent symptoms were fatigue (n=294; 65%), headache (n=281; 62%) and dry cough (n=241; 53%). After adjustment, the highest PA level was associated with a lower risk of moderate illness (OR 0.37; 95% CI 0.14 to 0.98, p=0.045), fatigue (OR 0.54; 95% CI 0.30 to 0.97, p=0.040), dry cough (OR 0.55; 95% CI 0.32 to 0.96, p=0.034) and chest pain (OR 0.32; 95% CI 0.14 to 0.77, p=0.010). CONCLUSIONS: PA before COVID-19 infection was associated with a reduced risk of moderate illness severity and a reduced risk of experiencing fatigue, dry cough and chest pain, suggesting that engaging in PA may be an effective approach to minimise the severity of COVID-19. TRIAL REGISTRATION NUMBER: NCT04380987.


Assuntos
COVID-19 , COVID-19/epidemiologia , Dor no Peito , Estudos de Coortes , Tosse , Estudos Transversais , Exercício Físico , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Estudos Prospectivos , SARS-CoV-2 , Índice de Gravidade de Doença
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