Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up

Marzo, Vincenzo De; Clavario, Piero; Lotti, Roberta; Bárbara, Cristina; Porcile, Annalisa; Guglielmi, G; Russo, C Allison; Autala, A J; Griffo, Raffaele; Parati, Gianfranco; Corrà, Ugo; Porto, Italo

doi:10.1093/eurheartj/ehab724.2669

Cited by 4 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Kardiopulmonale Belastungstests bei 200 Patienten 3 Monate nach akuter COVID-19 zeigten, dass etwa die Hälfte der COVID-19-Überlebenden eine signifikant reduzierte Spitzen-Sauerstoffaufnahme (VO 2peak ) hatte [ 22 , 23 ]. Bei fast einem Drittel (31/99) der Patienten mit reduzierter VO 2peak war dies wahrscheinlich auf ein gewisses Maß an Muskelschwäche zurückzuführen, da die maximale Kraft der Streckung des dominanten Beins unabhängig mit der VO 2peak assoziiert war.…”

Section: Diskussionunclassified

Beeinträchtigung der inspiratorischen Muskelfunktion nach COVID-19

et al. 2023

View full text Add to dashboard Cite

Hintergrund: Anhaltende Symptome nach akuter Coronavirus-Krankheit-2019 (COVID-19) sind häufig und es besteht kein signifikanter Zusammenhang mit der Schwere der akuten Erkrankung. Bei Long COVID (anhaltende Symptome > 4 Wochen nach akuter COVID-19) treten häufig respiratorische Symptome auf, aber Lungenfunktionstests zeigen nur leichte Veränderungen, die die Symptome nicht erklären. Obwohl COVID-19 zu einer Beeinträchtigung des peripheren Nervensystems und der Skelettmuskulatur führen kann, wurde die Funktion der Atemmuskulatur in diesem Zusammenhang nicht untersucht. Methoden: In dieser Studie haben wir den Schweregrad der Dyspnoe (NYHA-Funktionsklasse) bei Long-COVID-Patienten untersucht und analysierten dessen Zusammenhang mit dem Body-Mass-Index (BMI), der Einsekundenkapazität (FEV1), der forcierten Vitalkapazität, anderen Parametern der Bodyplethysmographie, der Diffusionskapazität für Kohlenmonoxid (DLCO), den arteriellen Blutgasen und der Funktion der Atemmuskulatur, die anhand des Atemwegsokklusionsdrucks (P0,1) und des maximalen Inspirationsdrucks (PImax) in 2 Atemwegskliniken in Deutschland zwischen Oktober 2020 und August 2021 gemessen wurde. Ergebnisse: Insgesamt wurden 116 Patienten in die Studie aufgenommen. Das Durchschnittsalter betrug 50,2 ± 14,5 Jahre, BMI 26,7 ± 5,87 kg/m2, NYHA-Klasse I 19%, II 27%, III 41% und IV 14%. Während die Lungenfunktionswerte und die Computertomografie oder die konventionelle Röntgenaufnahme des Brustkorbs im normalen Bereich lagen, war die Funktion der Atemmuskulatur deutlich beeinträchtigt. Der P0,1 war auf 154 ± 83% des Sollwerts erhöht und der PImax war auf 41 ± 25% des Sollwerts reduziert. Die PImax-Reduktion war stark mit dem Schweregrad der Dyspnoe verbunden, aber nicht abhängig vom BMI, der Zeit nach der akuten COVID-19 und den meisten anderen Parametern. Schlussfolgerungen: Diese Studie zeigt, dass die Atemwegssymptome bei Patienten mit Long COVID hauptsächlich durch eine verminderte Inspirationsmuskelkraft verursacht sein können. Die Bewertung von PImax und P0,1 könnte eine Dyspnoe besser erklären als klassische Lungenfunktionstests und die DLCO. Eine prospektive Studie ist erforderlich, um diese Ergebnisse zu bestätigen.

show abstract

Section: Diskussionunclassified

Beeinträchtigung der inspiratorischen Muskelfunktion nach COVID-19

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Cardiopulmonary exercise testing in 200 patients, 3 months after acute COVID-19, revealed that about half of COVID-19 survivors had a significantly reduced peak oxygen uptake (VO 2peak ) [22,23]. In nearly one third (31/99) of patients with reduced VO 2peak , this was probably due to some degree of muscle impairment, as dominant leg extension maximal strength was independently associated with VO 2peak .…”

Section: Respiratory Muscle Impairment Can Be Improved By Inspiratory...mentioning

confidence: 99%

Impairment of Inspiratory Muscle Function after COVID-19

et al. 2022

View full text Add to dashboard Cite

Background: Persistent symptoms after acute coronavirus-disease-2019 (COVID-19) are common, and there is no significant correlation with the severity of the acute disease. In long-COVID (persistent symptoms >4 weeks after acute COVID-19), respiratory symptoms are frequent, but lung function testing shows only mild changes that do not explain the symptoms. Although COVID-19 may lead to an impairment of the peripheral nervous system and skeletal muscles, respiratory muscle function has not been examined in this setting. Methods: In this study, we assessed the severity of dyspnea (NYHA-function class) in long-COVID patients and analyzed its association with body mass index (BMI), FEV1, forced vital capacity, other parameters of body plethysmography, diffusing capacity for carbon monoxide (DLCO), arterial blood gases, and inspiratory muscle function, assessed by airway occlusion pressure (P0.1) and maximal inspiratory pressure (PImax) in two respiratory clinics in Germany between Oct 2020 and Aug 2021. Results: A total of 116 patients were included in the study. The mean age was 50.2 ± 14.5 years; BMI, 26.7 ± 5.87 kg/m2; NYHA class I, 19%; II, 27%; III, 41%; and IV, 14%. While lung function values and computed tomography or conventional X-ray of the chest were in the normal range, inspiratory muscle function was markedly impaired. P01 was elevated to 154 ± 83%predicted and PImax was reduced to 41 ± 25%predicted. PImax reduction was strongly associated with the severity of dyspnea but independent of BMI, time after acute COVID-19 and most of the other parameters. Conclusions: This study shows that in long-COVID patients, respiratory symptoms may be mainly caused by reduced inspiratory muscle strength. Assessment of PImax and P0.1 might better explain dyspnea than classical lung function tests and DLCO. A prospective study is needed to confirm these results.

show abstract

“…Furthermore, athletes, who mostly do not have comorbidities, can be seriously affected by COVID-19 [5,6]. In addition, symptoms can also occur for the first time after recovery from the infection [1], resulting in a lower performance capability of patients and athletes [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Recovery of performance and persistent symptoms in athletes after COVID-19

et al. 2022

View full text Add to dashboard Cite

Introduction After the acute Sars-CoV-2-infection, some athletes suffer from persistent, performance-impairing symptoms, although the course of the disease is often mild to moderate. The relation between cardiopulmonary performance and persistent symptoms after the acute period is still unclear. In addition, information about the development of this relationship is lacking. Objective To assess the prevalence of persistent symptoms over time and their association with the performance capability of athletes. Methods We conducted two cardiopulmonary exercise tests (CPET) in a three months interval with 60 athletes (age: 35.2±12.1 years, 56.7% male) after infection with Sars-CoV-2 (t0: study inclusion; t1: three months post t0). At each examination, athletes were asked about their persistent symptoms. To evaluate the change of Peak VO2/BM (Body Mass) between the time before infection and the first examination, the VO2/BM (predVO2) before infection was predicted based on anthropometric data and exercise history of the athletes. For data analysis, athletes were grouped according to their symptom status (symptom-free, SF; persistent symptoms, PS) and its progression from the first to the second examination 1) SF-SF, 2) PS-SF and 3) PS-PS. Results Comparing the SF and PS groups at t0, significant differences for Max Power/BM, Max Power/lbm (lean body mass), Peak VO2, Peak VO2/BM, Peak VO2/lbm, Peak VO2/HR, Peak VE, Peak Vt and VE/VCO2-Slope were observed. Regarding the progression over three months, an increase in Max Power/BM was shown in SF-SF and PS-SF (tendency). Max Power/lbm increased in SF-SF and PS-PS (tendency). A decrease of VE/VCO2-Slope in PS-PS was found. Conclusion COVID-19 led to a decline in performance that was greater in PS than in SF. Additionally, PS had decreased ventilatory parameters compared to SF. Furthermore, an improvement over time was observed in some CPET parameters and a partial recovery was observed judging by the decrease in various symptoms.

show abstract

Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up

Cited by 4 publications

References 19 publications

Beeinträchtigung der inspiratorischen Muskelfunktion nach COVID-19

Beeinträchtigung der inspiratorischen Muskelfunktion nach COVID-19

Impairment of Inspiratory Muscle Function after COVID-19

Recovery of performance and persistent symptoms in athletes after COVID-19

Contact Info

Product

Resources

About