Respir Res . Identification of factors impairing exercise capacity after severe COVID-19 pulmonary infection: a 3-month follow-up of prospective COVulnerability cohort

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Respir Res


. 2022 Mar 22;23(1):68.
doi: 10.1186/s12931-022-01977-z.
Identification of factors impairing exercise capacity after severe COVID-19 pulmonary infection: a 3-month follow-up of prospective COVulnerability cohort


Bruno Ribeiro Baptista ^{# 1} , Thomas d'Humières ^{# 1 2} , Frédéric Schlemmer ^{1 3} , Inès Bendib ^{1 2 4} , Grégoire Justeau ¹ , Lara Al-Assaad ² , Mouna Hachem ^{1 3} , Rebecca Codiat ² , Benjamin Bardel ² , Laure Abou Chakra ² , Thibaut Belmondo ⁵ , Etienne Audureau ^{6 7} , Sophie Hue ^{1 5} , Armand Mekontso-Dessap ^{1 4} , Geneviève Derumeaux ^{1 2} , Laurent Boyer ^{8 9}



Affiliations

• PMID: 35317815
• DOI: 10.1186/s12931-022-01977-z

Abstract

Background: Patient hospitalized for coronavirus disease 2019 (COVID-19) pulmonary infection can have sequelae such as impaired exercise capacity. We aimed to determine the frequency of long-term exercise capacity limitation in survivors of severe COVID-19 pulmonary infection and the factors associated with this limitation.
Methods: Patients with severe COVID-19 pulmonary infection were enrolled 3 months after hospital discharge in COVulnerability, a prospective cohort. They underwent cardiopulmonary exercise testing, pulmonary function test, echocardiography, and skeletal muscle mass evaluation.
Results: Among 105 patients included, 35% had a reduced exercise capacity (VO₂peak < 80% of predicted). Compared to patients with a normal exercise capacity, patients with reduced exercise capacity were more often men (89.2% vs. 67.6%, p = 0.015), with diabetes (45.9% vs. 17.6%, p = 0.002) and renal dysfunction (21.6% vs. 17.6%, p = 0.006), but did not differ in terms of initial acute disease severity. An altered exercise capacity was associated with an impaired respiratory function as assessed by a decrease in forced vital capacity (p < 0.0001), FEV1 (p < 0.0001), total lung capacity (p < 0.0001) and DL_CO (p = 0.015). Moreover, we uncovered a decrease of muscular mass index and grip test in the reduced exercise capacity group (p = 0.001 and p = 0.047 respectively), whilst 38.9% of patients with low exercise capacity had a sarcopenia, compared to 10.9% in those with normal exercise capacity (p = 0.001). Myocardial function was normal with similar systolic and diastolic parameters between groups whilst reduced exercise capacity was associated with a slightly shorter pulmonary acceleration time, despite no pulmonary hypertension.
Conclusion: Three months after a severe COVID-19 pulmonary infection, more than one third of patients had an impairment of exercise capacity which was associated with a reduced pulmonary function, a reduced skeletal muscle mass and function but without any significant impairment in cardiac function.

Keywords: COVID-19; Cardiopulmonary exercise testing; Pulmonary function; SARS-CoV-2; Sarcopenia; Skeletal muscle.