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 VO2 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/VCO2 slope 32 (28.1-37.4) vs. 29.4 (26.9-31.4); p = 0.022) and high PETCO2 (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.
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-19patients 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 VO2 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/VCO2 slope 32 (28.1-37.4) vs. 29.4 (26.9-31.4); p = 0.022) and high PETCO2 (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.
Authors: Ty J Gluckman; Nicole M Bhave; Larry A Allen; Eugene H Chung; Erica S Spatz; Enrico Ammirati; Aaron L Baggish; Biykem Bozkurt; William K Cornwell; Kimberly G Harmon; Jonathan H Kim; Anuradha Lala; Benjamin D Levine; Matthew W Martinez; Oyere Onuma; Dermot Phelan; Valentina O Puntmann; Saurabh Rajpal; Pam R Taub; Amanda K Verma Journal: J Am Coll Cardiol Date: 2022-03-16 Impact factor: 27.203
Authors: Peter Ladlow; Oliver O'Sullivan; Alexander N Bennett; Robert Barker-Davies; Andrew Houston; Rebecca Chamley; Samantha May; Daniel Mills; Dominic Dewson; Kasha Rogers-Smith; Christopher Ward; John Taylor; Joseph Mulae; Jon Naylor; Edward D Nicol; David A Holdsworth Journal: J Appl Physiol (1985) Date: 2022-05-19
Authors: Christopher C Huntley; Ketan Patel; Shahnoor-E-Salam Bil Bushra; Farah Mobeen; Michael N Armitage; Anita Pye; Chloe B Knight; Alyaa Mostafa; Marie Kershaw; Aishah Z Mughal; Emily McKemey; Alice M Turner; P Sherwood Burge; Gareth I Walters Journal: ERJ Open Res Date: 2022-05-30
Authors: Álvaro Aparisi; Cristina Ybarra-Falcón; Carolina Iglesias-Echeverría; Mario García-Gómez; Marta Marcos-Mangas; Gonzalo Valle-Peñacoba; Manuel Carrasco-Moraleja; César Fernández-de-Las-Peñas; Ángel L Guerrero; David García-Azorín Journal: Int J Environ Res Public Health Date: 2022-03-26 Impact factor: 3.390