Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience
Background. Following COVID-19, patients often present with ongoing symptoms comparable to chronic fatigue and subjective deterioration of exercise capacity (EC), which has been recently described as postacute COVID-19 syndrome. Objective. To objectify the reduced EC after COVID-19 and to evaluate f...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2022/2466789 |
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| author | Georg Evers Arik Bernard Schulze Irina Osiaevi Kimon Harmening Richard Vollenberg Rainer Wiewrodt Rudin Pistulli Matthias Boentert Phil-Robin Tepasse Juergen R. Sindermann Ali Yilmaz Michael Mohr |
| author_facet | Georg Evers Arik Bernard Schulze Irina Osiaevi Kimon Harmening Richard Vollenberg Rainer Wiewrodt Rudin Pistulli Matthias Boentert Phil-Robin Tepasse Juergen R. Sindermann Ali Yilmaz Michael Mohr |
| author_sort | Georg Evers |
| collection | DOAJ |
| description | Background. Following COVID-19, patients often present with ongoing symptoms comparable to chronic fatigue and subjective deterioration of exercise capacity (EC), which has been recently described as postacute COVID-19 syndrome. Objective. To objectify the reduced EC after COVID-19 and to evaluate for pathologic limitations. Methods. Thirty patients with subjective limitation of EC performed cardiopulmonary exercise testing (CPET). If objectively limited in EC or deteriorated in oxygen pulse, we offered cardiac stress magnetic resonance imaging (MRI) and a follow-up CPET. Results. Eighteen male and 12 female patients were included. Limited relative EC was detected in 11/30 (36.7%) patients. Limitation correlated with reduced body weight-indexed peak oxygen (O2) uptake (peakV̇O2/kg) (mean 74.7 (±7.1) % vs. 103.6 (±14.9) %, p<0.001). Reduced peakV̇O2/kg was found in 18/30 (60.0%) patients with limited EC. Patients with reduced EC widely presented an impaired maximum O2 pulse (75.7% (±5.6) vs. 106.8% (±13.9), p<0.001). Abnormal gas exchange was absent in all limited EC patients. Moreover, no patient showed signs of reduced pulmonary perfusion. Using cardiac MRI, diminished biventricular ejection fraction was ruled out in 16 patients as a possible cause for reduced O2 pulse. Despite noncontrolled training exercises, follow-up CPET did not reveal any exercise improvements. Conclusions. Deterioration of EC was not associated with ventilatory or pulmonary vascular limitation. Exercise limitation was related to both reduced O2 pulse and peakV̇O2/kg, which, however, did not correlate with the initial severity of COVID-19. We hypothesize that impaired microcirculation or limited peripheral O2 utilization might be causative for prolonged deterioration of EC following acute COVID-19 infection. |
| format | Article |
| id | doaj-art-02ab8f225afe4b7281a943cc9d65a463 |
| institution | Kabale University |
| issn | 1916-7245 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-02ab8f225afe4b7281a943cc9d65a4632025-02-03T06:13:36ZengWileyCanadian Respiratory Journal1916-72452022-01-01202210.1155/2022/2466789Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center ExperienceGeorg Evers0Arik Bernard Schulze1Irina Osiaevi2Kimon Harmening3Richard Vollenberg4Rainer Wiewrodt5Rudin Pistulli6Matthias Boentert7Phil-Robin Tepasse8Juergen R. Sindermann9Ali Yilmaz10Michael Mohr11Department of Medicine A,Hematology,Oncology and Pulmonary MedicineDepartment of Medicine A,Hematology,Oncology and Pulmonary MedicineDepartment of Medicine A,Hematology,Oncology and Pulmonary MedicineDepartment of Medicine A,Hematology,Oncology and Pulmonary MedicineDepartment of Medicine B for Gastroenterology,Hepatology,Endocrinology and Clinical InfectiologyDepartment of Medicine A,Hematology,Oncology and Pulmonary MedicineDepartment of Cardiology I,Coronary and Peripheral Vascular Disease and Heart FailureDepartment of NeurologyDepartment of Medicine B for Gastroenterology,Hepatology,Endocrinology and Clinical InfectiologyDepartment of Cardiology I,Coronary and Peripheral Vascular Disease and Heart FailureDepartment of Cardiology I,Coronary and Peripheral Vascular Disease and Heart FailureDepartment of Medicine A,Hematology,Oncology and Pulmonary MedicineBackground. Following COVID-19, patients often present with ongoing symptoms comparable to chronic fatigue and subjective deterioration of exercise capacity (EC), which has been recently described as postacute COVID-19 syndrome. Objective. To objectify the reduced EC after COVID-19 and to evaluate for pathologic limitations. Methods. Thirty patients with subjective limitation of EC performed cardiopulmonary exercise testing (CPET). If objectively limited in EC or deteriorated in oxygen pulse, we offered cardiac stress magnetic resonance imaging (MRI) and a follow-up CPET. Results. Eighteen male and 12 female patients were included. Limited relative EC was detected in 11/30 (36.7%) patients. Limitation correlated with reduced body weight-indexed peak oxygen (O2) uptake (peakV̇O2/kg) (mean 74.7 (±7.1) % vs. 103.6 (±14.9) %, p<0.001). Reduced peakV̇O2/kg was found in 18/30 (60.0%) patients with limited EC. Patients with reduced EC widely presented an impaired maximum O2 pulse (75.7% (±5.6) vs. 106.8% (±13.9), p<0.001). Abnormal gas exchange was absent in all limited EC patients. Moreover, no patient showed signs of reduced pulmonary perfusion. Using cardiac MRI, diminished biventricular ejection fraction was ruled out in 16 patients as a possible cause for reduced O2 pulse. Despite noncontrolled training exercises, follow-up CPET did not reveal any exercise improvements. Conclusions. Deterioration of EC was not associated with ventilatory or pulmonary vascular limitation. Exercise limitation was related to both reduced O2 pulse and peakV̇O2/kg, which, however, did not correlate with the initial severity of COVID-19. We hypothesize that impaired microcirculation or limited peripheral O2 utilization might be causative for prolonged deterioration of EC following acute COVID-19 infection.http://dx.doi.org/10.1155/2022/2466789 |
| spellingShingle | Georg Evers Arik Bernard Schulze Irina Osiaevi Kimon Harmening Richard Vollenberg Rainer Wiewrodt Rudin Pistulli Matthias Boentert Phil-Robin Tepasse Juergen R. Sindermann Ali Yilmaz Michael Mohr Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience Canadian Respiratory Journal |
| title | Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience |
| title_full | Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience |
| title_fullStr | Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience |
| title_full_unstemmed | Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience |
| title_short | Sustained Impairment in Cardiopulmonary Exercise Capacity Testing in Patients after COVID-19: A Single Center Experience |
| title_sort | sustained impairment in cardiopulmonary exercise capacity testing in patients after covid 19 a single center experience |
| url | http://dx.doi.org/10.1155/2022/2466789 |
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