A1 Journal article (refereed)
Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up (2021)
Clavario, P., De Marzo, V., Lotti, R., Barbara, C., Porcile, A., Russo, C., Beccaria, F., Bonavia, M., Bottaro, L. C., Caltabellotta, M., Chioni, F., Santangelo, M., Hautala, A. J., Griffo, R., Parati, G., Corrà, U., & Porto, I. (2021). Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up. International Journal of Cardiology, 340, 113-118. https://doi.org/10.1016/j.ijcard.2021.07.033
JYU authors or editors
Publication details
All authors or editors: Clavario, Piero; De Marzo, Vincenzo; Lotti, Roberta; Barbara, Cristina; Porcile, Annalisa; Russo, Carmelo; Beccaria, Federica; Bonavia, Marco; Bottaro, Luigi Carlo; Caltabellotta, Marta; et al.
Journal or series: International Journal of Cardiology
ISSN: 0167-5273
eISSN: 1874-1754
Publication year: 2021
Volume: 340
Pages range: 113-118
Publisher: Elsevier
Publication country: Netherlands
Publication language: English
DOI: https://doi.org/10.1016/j.ijcard.2021.07.033
Publication open access: Not open
Publication channel open access:
Abstract
Long-term effects of Coronavirus Disease of 2019 (COVID-19) and their sustainability are of the utmost relevance.
We aimed to determine: 1) functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET); 2) characteristics associated with cardiopulmonary exercise testing (CPET) performance; 3) safety and tolerability of CPET.
Methods
We prospectively enrolled consecutive patients with laboratory-confirmed COVID-19 discharged alive at Azienda Sanitaria Locale-3, Genoa. At 3-month from hospital discharge, complete clinical evaluation, trans-thoracic echocardiography, CPET, pulmonary function test, and dominant leg extension (DLE) maximal strength evaluation were performed.
Results
From 225 patients discharged from March to November 2020, we excluded 12 incomplete/missing cases, 13 unable to perform CPET leading to a final population of 200. Median percent-predicted peak oxygen uptake (%pVO2) was 88% (78.3–103.1).
Ninety-nine(49.5%) patients had %pVO2 below, whereas 101(50.5%) above the 85% predicted value (indicating normality).
Of 61/99 patients with reduced %pVO2 but normal anaerobic threshold, 9(14.8%) had respiratory, 21(34.4%) cardiac, and 31(50.8%) non-cardiopulmonary limitation of exercise. One-hundred sixty(80.0%) patients complain at least one symptom, without relationship with pVO2.
Multivariate linear regression analysis showed percent-predicted forced expiratory volume in one-second(β = 5.29,p = 0.023), percent-predicted diffusing capacity of lungs for carbon monoxide(β = 6.31,p = 0.001), and DLE maximal strength(β = 14.09,p = 0.008) independently associated with pVO2.
None adverse event was reported during/after CPET neither the involved health professionals developed COVID-19.
Conclusions
CPET after COVID-19 is safe and about 1/3rd of COVID-19 survivors show functional capacity limitation mainly explained by muscular impairment, calling for future research to identify patients at higher risk of long-term effects that may benefit from careful surveillance and targeted rehabilitation.
Keywords: communicable diseases; lung diseases; COVID-19; long-term effects; physical fitness; oxygen uptake; maximal oxygen uptake
Free keywords: COVID-19; coronavirus infection; severe acute respiratory syndrome; lung diseases; cardiopulmonary exercise testing; coronavirus
Contributing organizations
Ministry reporting: Yes
Reporting Year: 2021
JUFO rating: 1
