tetano
Editor, Senior Moderator
J Clin Med
. 2021 Jun 11;10(12):2591.
doi: 10.3390/jcm10122591.
Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation
Álvaro Aparisi[SUP] 1 [/SUP], Cristina Ybarra-Falcón[SUP] 1 [/SUP], Mario García-Gómez[SUP] 1 [/SUP], Javier Tobar[SUP] 1 [/SUP], Carolina Iglesias-Echeverría[SUP] 1 [/SUP], Sofía Jaurrieta-Largo[SUP] 2 [/SUP], Raquel Ladrón[SUP] 1 [/SUP], Aitor Uribarri[SUP] 1 3 [/SUP], Pablo Catalá[SUP] 1 [/SUP], Williams Hinojosa[SUP] 1 [/SUP], Marta Marcos-Mangas[SUP] 1 [/SUP], Laura Fernández-Prieto[SUP] 2 [/SUP], Rosa Sedano-Gutiérrez[SUP] 2 [/SUP], Iván Cusacovich[SUP] 4 [/SUP], David Andaluz-Ojeda[SUP] 5 [/SUP], Blanca de Vega-Sánchez[SUP] 2 6 [/SUP], Amada Recio-Platero[SUP] 1 7 [/SUP], Esther Sanz-Patiño[SUP] 1 7 [/SUP], Dolores Calvo[SUP] 8 [/SUP], Carlos Baladrón[SUP] 1 3 [/SUP], Manuel Carrasco-Moraleja[SUP] 1 3 [/SUP], Carlos Disdier-Vicente[SUP] 2 9 [/SUP], Ignacio J Amat-Santos[SUP] 1 3 [/SUP], J Alberto San Román[SUP] 1 3 [/SUP]
Affiliations
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism.
Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries.
Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO[SUB]2[/SUB] consumption (77.8 (64-92.5) vs. 99 (88-105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467-600) vs. 611 (550-650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VC[SUB]O2[/SUB] slope 32 (28.1-37.4) vs. 29.4 (26.9-31.4); p = 0.022) and high PET[SUB]CO2[/SUB] (34.5 (32-39) vs. 38 (36-40); p = 0.025).
Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome.
Keywords: cardiopulmonary exercise testing; dyspnea; post-COVID-19 syndrome; pulmonary function test; six-minute walking test; ventilatory inefficiency.
. 2021 Jun 11;10(12):2591.
doi: 10.3390/jcm10122591.
Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation
Álvaro Aparisi[SUP] 1 [/SUP], Cristina Ybarra-Falcón[SUP] 1 [/SUP], Mario García-Gómez[SUP] 1 [/SUP], Javier Tobar[SUP] 1 [/SUP], Carolina Iglesias-Echeverría[SUP] 1 [/SUP], Sofía Jaurrieta-Largo[SUP] 2 [/SUP], Raquel Ladrón[SUP] 1 [/SUP], Aitor Uribarri[SUP] 1 3 [/SUP], Pablo Catalá[SUP] 1 [/SUP], Williams Hinojosa[SUP] 1 [/SUP], Marta Marcos-Mangas[SUP] 1 [/SUP], Laura Fernández-Prieto[SUP] 2 [/SUP], Rosa Sedano-Gutiérrez[SUP] 2 [/SUP], Iván Cusacovich[SUP] 4 [/SUP], David Andaluz-Ojeda[SUP] 5 [/SUP], Blanca de Vega-Sánchez[SUP] 2 6 [/SUP], Amada Recio-Platero[SUP] 1 7 [/SUP], Esther Sanz-Patiño[SUP] 1 7 [/SUP], Dolores Calvo[SUP] 8 [/SUP], Carlos Baladrón[SUP] 1 3 [/SUP], Manuel Carrasco-Moraleja[SUP] 1 3 [/SUP], Carlos Disdier-Vicente[SUP] 2 9 [/SUP], Ignacio J Amat-Santos[SUP] 1 3 [/SUP], J Alberto San Román[SUP] 1 3 [/SUP]
Affiliations
- PMID: 34208271
- DOI: 10.3390/jcm10122591
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism.
Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries.
Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO[SUB]2[/SUB] consumption (77.8 (64-92.5) vs. 99 (88-105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467-600) vs. 611 (550-650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VC[SUB]O2[/SUB] slope 32 (28.1-37.4) vs. 29.4 (26.9-31.4); p = 0.022) and high PET[SUB]CO2[/SUB] (34.5 (32-39) vs. 38 (36-40); p = 0.025).
Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome.
Keywords: cardiopulmonary exercise testing; dyspnea; post-COVID-19 syndrome; pulmonary function test; six-minute walking test; ventilatory inefficiency.