Most COVID-19 survivors report experiencing at least one persistent symptom after recovery, including sympathovagal imbalance. Relaxation techniques based on slow-paced breathing have proven to be beneficial for cardiovascular and respiratory dynamics in healthy subjects and patients with various diseases. Therefore, the present study aimed to explore the cardiorespiratory dynamics by linear and nonlinear analysis of photoplethysmographic and respiratory time series on COVID-19 survivors under a psychophysiological assessment that includes slow-paced breathing. We analyzed photoplethysmographic and respiratory signals of 49 COVID-19 survivors to assess breathing rate variability (BRV), pulse rate variability (PRV), and pulse–respiration quotient (PRQ) during a psychophysiological assessment. Additionally, a comorbidity-based analysis was conducted to evaluate group changes. Our results indicate that all BRV indices significantly differed when performing slow-paced breathing. Nonlinear parameters of PRV were more appropriate for identifying changes in breathing patterns than linear indices. Furthermore, the mean and standard deviation of PRQ exhibited a significant increase while sample and fuzzy entropies decreased during diaphragmatic breathing. Thus, our findings suggest that slow-paced breathing may improve the cardiorespiratory dynamics of COVID-19 survivors in the short term by enhancing cardiorespiratory coupling via increased vagal activity.

Background: COVID-19 survivors who were hospitalised continue to experience long-term multisystemic sequelae and symptoms, impacting their health-related quality of life (HRQoL). The complexity of post-COVID-19 conditions underscores the importance of adopting a multidisciplinary, patient-centric approach to ensure ongoing care. This study aims to assess HRQoL and post-COVID symptoms in a cohort of severe COVID-19 survivors depending on their participation in a multidisciplinary programme.Methods: This prospective study was conducted in a post-COVID clinic staffed by a multidisciplinary team (physical rehabilitator, nutritionist, psychologist, including experts in pulmonary rehabilitation, nutrition, psychology and others). Subjects over 18 years old who were hospitalised due to severe COVID-19 during the acute phase and had attended the post-COVID clinic within the first 3 months following discharge were included. Subjects who were unable or unwilling to provide informed consent to participate in the protocol were excluded. Linear mixed-effect models were employed to examine changes in 12-Item Short-Form Health Survey (SF-12) component scores. The resolution of post-COVID symptom clusters was compared using the Cox model.Results: A total of 730 patients were included, with a mean±sdage of 55.78±15.43 years; 60.55% were male and 90.62% required mechanical ventilation during hospitalisation. Programme attendants demonstrated improved SF-12 physical and mental component scores at 3 and 12 months. A reduction in the prevalence of post-COVID symptoms was observed in both groups, with greater reductions in those attending the programme.Conclusion: Our study showed that patients enrolled on the multidisciplinary programme experienced improvements in fatigue, musculoskeletal, gastrointestinal, neuropsychiatric and respiratory symptoms, along with enhanced SF-12 mental and physical component scores.

Introduction: Among the different psychological sequelae of post-COVID syndrome are symptoms related to emotional impairment, mostly depression, anxiety, and post-traumatic stress disorder (PTSD).Objective: To describe and compare the prevalence and severity of PTSD, anxiety, depression, and fear of COVID-19 in survivors 3 months after discharge from the hospital.Methods: A cross-sectional descriptive study was conducted, a total of 227 survivors of COVID-19 participated; they were assessed 3 months after being discharged from the hospital. A psychological evaluation focused on anxiety, depression, PTSD, and fear was conducted. Statistical analysis through the t-test for independent samples was performed.Results: Of the patients, 64.5% were men, 60.9% required invasive mechanical ventilation (IMV) during hospitalization, and the average age was about 48.23 ± 14.33 years. Also, 40% showed symptoms associated with PTSD, 38.4% exhibited anxiety, 36.6% depression, and 36.12% exhibited fear of COVID-19. There were statistically significant differences between men and women, in PTSD (t = -3.414, df = 224, p = 0.001, x̅m = 5.10, x̅_w = 6.32), depression (t = -4.680, df = 225, p = 0.000, x̅_m = 3.64, x̅_w = 7.18), anxiety (t = -3.427, df = 152.53, p = 0.001, x̅_m = 3.78, x̅_w = 6.20), and fear of COVID-19 (t = -3.400, df = 224, p = 0.001, x̅_m = 11.88, x̅_w = 15.19). Furthermore, there were also statistically significant differences between the type of treatment during hospitalization (IMV vs. without IMV), in PTSD (t = 2.482, df = 223, p = 0.014, x̅_IMV = 5.21, x̅_WIMV = 6.08) and anxiety (t = -2.006, df = 223, p = 0.046, x̅_IMV = 4.05, x̅_WIMV = 5.44).Conclusion: Survivors of COVID-19 experience a high prevalence of PTSD, anxiety, depression, and fear, even 3 months after discharge from the hospital. Females and patients who did not require IMV during hospitalization are the most affected population, presenting more severe symptoms of these psychological alterations. More research is required to know and observe the long-term evolution of these psychological alterations in this population.

El objetivo del presente trabajo fue investigar el efecto de una intervención psicológica cognitivo-conductual en la capacidad funcional de los pacientes con insuficiencia cardiaca, medida a través de la prueba de caminata de seis minutos. Participaron 53 pacientes, clases funcionales I y II, asignados aleatoriamente a: 1) grupo control (tratamiento médico usual, n=27, edad media 61.07±15.96, 55.6% hombres), o 2) grupo experimental (tratamiento médico usual e intervención psicológica, n=26, edad media 58.42±16.42, 65.4% mujeres). Mediante la prueba de caminata de seis minutos se evalúo la distancia recorrida en metros, el nivel de cansancio físico y el nivel de esfuerzo reportado en la escala de Borg. Las evaluaciones se realizaron antes y al final del programa de intervención, además de un seguimiento a tres meses. El programa de intervención psicológica incluyó psicoeducación, respiración diafragmática, relajación muscular progresiva y entrenamiento en solución de problemas, en cuatro sesiones de 90 minutos cada una, diferidas semanalmente. Los resultados muestran que el grupo experimental incrementó (p=0.00) la distancia recorrida y disminuyó el nivel de cansancio físico (p=0.02) y nivel de esfuerzo reportados (ns), lo cual se traduce en un mejor pronóstico. El grupo control no mostró cambios significativos. Se concluye que la intervención propuesta se adapta a las necesidades de la población con un efecto positivo en su condición de salud, por lo que se sugiere la integración de equipos interdisciplinarios que incluyan programas de intervención psicológica para mejorar la salud cardiovascular y la calidad de vida de los pacientes.