COVID-19: the new cause of dyspnoea as a result of reduced lung and peripheral muscle performance

Abstract

This study aimed to evaluate the cardiopulmonary function and impairment of exercise endurance in patients with COVID-19 after 3 months of the second wave of the pandemic in Turkey. A total of 51 consecutive COVID-19 survivors, mostly healthcare providers, still working in the emergency room and intensive care units of the hospital after the second wave of Covid 19 pandemia were included in this study. Cardiopulmonary exercise stress test was performed. The median of the exercise time of the COVID-19 survivors, was 10 (4.5–13) minutes and the mean 6.8 ± 1.3 Mets was achieved. The VO2 max of the COVID-19 survivors was 24 ± 4.6 ml kg−1 min−1 which corresponds the 85 ± 10% of the predicted VO2 max value. The VO2WRs value which was reported about 8.5–11 ml min−1 per watt in healthy individuals as normal was found lower in Covid 19 survivors (5.6 ± 1.4). The percentage of the maximum peak VO2 calculated according to the predictable peak VO2 of the COVID-19 survivors, was found significantly lower in male patients (92 ± 9.5% vs 80 ± 8.5%, p: 0.000). Also, there was a positive correlation between the percentage of the maximum predicted VO2 measurements and age (r: 0.320, p: 0000). The peak VO2 values of COVID-19 survivors decreased, and simultaneously, their exercise performance decreased due to peripheral muscle involvement. We believe that COVID-19 significantly affects men and young patients.

Low Cardiorespiratory Fitness Post-COVID-19: A Narrative Review

“…As discussed earlier on, O 2 /work rate ratio was abnormal at 3 months post-infection [ 44 ] and only slightly reduced or normal between 3 and 9 months post-infection (see Sect. 3.3 ) [ 6 , 32 , 34 , 43 ].…”

“…Spirometry parameters ⇔ ⇓ DLCO ⇓ (74% of pred.) Breathing reserve ⇔ ⇓ (< 25% in 11 patients) Decreased physical fitness ( N = 11, 35.5%) or decreased ventilatory capacity ( N = 5, 16%) as main reason for abnormal CPET Acar et al [ 44 ] N = 51 42 (NR) y, 55% male NR ex-/smoker = NR diabetes = NR Moderate ( n = 34), severe ( n = 17) Inclusion: patients who survived the second wave of the COVID-19 pandemic Exclusion: contraindications to CPET (i.e. unstable angina, arrhythmia, severe aortic stenosis, heart failure, pulmonary hyper-tension, atrioventricular blocks, or severe hypertension) Assessed at 3 months post-NR: O 2peak ⇓ (85% of pred.)…”

“…Up to 4 months post-infection, there were six studies [ 5 , 16 , 31 , 33 , 42 , 44 ] reporting normal O 2 -pulse, of which three found at least mild chronotropic incompetence (see Tables 1 , 2 ). Another study additionally performed stress-echocardiography, an indirect imaging method to obtain more precise estimates of cardiac output compared with O 2 -pulse [ 24 ].…”

“…The O 2 /work rate slope is often abnormal in patients with cardiovascular diseases, thus reflecting limitations in the supply and/or metabolism of oxygen [ 27 , 63 ]. Five studies reported O 2 /work rate slope [ 6 , 32 , 34 , 44 , 64 ]. Considering 10–11 mL min −1 W −1 as normal [ 63 ], results were inconsistent.…”

“…Considering 10–11 mL min −1 W −1 as normal [ 63 ], results were inconsistent. In one study, O 2 /work rate slope was markedly reduced 3 months post-discharge (5.6 mL min −1 W −1 , moderate and severe COVID-19) [ 44 ]. In the other studies, this parameter was only slightly below normal or normal (9.3, 9.9, 11.8 and 9.7 mL min −1 W −1 at 3 months to 9 months post-discharge) [ 6 , 32 , 34 , 43 ].…”