Purpose: This study assessed the impact of a 12-week, home-based exercise training (HBET) program on health-related quality of life (HRQOL, primary outcome), cardiovascular and metabolic parameters in pediatric COVID-19 patients.Methods: In this single-center, randomized controlled trial conducted in Sao Paulo (Brazil) from October 2020 to January 2022, 32 patients (mean age 12 ± 3.3 years; median 4 months [range: 0.7-6.6] between COVID-19 diagnosis [n = 25 mild, n = 4 moderate, n = 3 severe illness] and study entry) from a tertiary hospital were randomly assigned to either HBET or standard of care (CONTROL) in a 2:1 ratio. The HBET group underwent supervised and unsupervised sessions 3 times/week for 12 weeks emphasizing aerobic and bodyweight exercises and the CONTROL group received standard care which included general advice for a healthy lifestyle with no prescribed exercise intervention. HRQOL (Pediatric Quality of Life Inventory [PedsQL], cardiopulmonary exercise test (CPET), brachial flow-mediated dilation (b-FMD) and echocardiography assessments were conducted in both groups. Statistical analysis was performed using an intention-to-treat approach (ITT) for the primary analysis and complete-case (per-protocol) as sensitivity analysis and significance was set at P ≤ 0.05 (P ≤ 0.10 were considered as trend).Results: There was no difference in HRQOL between groups. Intention-to-treat analysis showed a trend toward increased VO2 at anaerobic threshold at post-intervention for the HBET group. Additionally, a sensitivity analysis showed significant changes in peak HR, HRR1min, RER and chronotropic response and tendency towards significance in VE/MVV and chronotropic response for the HBET group. No other between-group differences were detected for CPET, b-FMD and echocardiography variables (all p > 0.05).Conclusions: In this RCT, a 12-week HBET intervention did not impact HRQOL in pediatric COVID-19 patients. However, HBET led to greater improvements in VO2 VAT, heart rate peak and one-minute recovery and in chronotropic response with no changes in other cardiovascular parameters. Further studies are needed to explore the effects of exercise on the recovery of pediatric COVID-19 patients with persistent COVID-19 symptoms.

中文翻译：

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儿科 COVID-19 运动：一项随机对照试验。


目的： 本研究评估了为期 12 周的家庭运动训练 （HBET） 计划对儿科 COVID-19 患者健康相关生活质量 （HRQOL，主要结果）、心血管和代谢参数的影响。方法：在 2020 年 10 月至 2022 年 1 月在圣保罗（巴西）进行的这项单中心随机对照试验中，32 名患者 （平均年龄 12 ± 3.3 岁;中位 4 个月 [范围：0.7-6.6] 在 COVID-19 诊断之间 [n = 25 轻度，n = 4 中度，n = 3 重症] 和研究开始之间）以 2：1 的比例随机分配到 HBET 或护理标准 （CONTROL）。HBET 组每周接受 3 次有监督和无监督的会议，持续 12 周，强调有氧和自重运动，而 CONTROL 组接受标准护理，其中包括健康生活方式的一般建议，没有规定的运动干预。两组均进行 HRQOL （儿科生活质量量表 [PedsQL ]、心肺运动试验 （CPET） 、肱血流介导的扩张 （b-FMD） 和超声心动图评估。使用意向性治疗方法 （ITT） 进行统计分析进行初步分析，完全病例 （根据方案） 作为敏感性分析和显着性设置为 P ≤ 0.05 （P ≤ 0.10 被认为是趋势）。结果： 组间 HRQOL 无差异。意向治疗分析显示，HBET 组干预后厌氧阈值的 VO2 有增加的趋势。此外，敏感性分析显示 HBET 组的峰值 HR 、 HRR1min 、 RER 和变时反应以及 VE/MVV 和变时反应的显著性趋势发生显著变化。 CPET 、 b-FMD 和超声心动图变量未检测到其他组间差异 （均 p > 0.05）。结论： 在这项 RCT 中，为期 12 周的 HBET 干预不会影响儿科 COVID-19 患者的 HRQOL。然而，HBET 导致 VO2 VAT、心率峰值和 1 分钟恢复以及变时反应有更大的改善，而其他心血管参数没有变化。需要进一步的研究来探讨运动对具有持续 COVID-19 症状的儿科 COVID-19 患者恢复的影响。