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J Appl Physiol (1985) . The effect of medium-term recovery status after COVID-19 illness on cardiopulmonary exercise capacity in a physically active

tetano

Editor, Senior Moderator
J Appl Physiol (1985)


. 2022 May 19.
doi: 10.1152/japplphysiol.00138.2022. Online ahead of print.
The effect of medium-term recovery status after COVID-19 illness on cardiopulmonary exercise capacity in a physically active adult population


Peter Ladlow[SUP] 1 2 [/SUP], Oliver O'Sullivan[SUP] 1 3 [/SUP], Alexander N Bennett[SUP] 1 4 [/SUP], Robert Barker-Davies[SUP] 1 5 [/SUP], Andrew Houston[SUP] 1 [/SUP], Rebecca Chamley[SUP] 6 7 [/SUP], Samantha May[SUP] 1 [/SUP], Daniel Mills[SUP] 1 [/SUP], Dominic Dewson[SUP] 1 [/SUP], Kasha Rogers-Smith[SUP] 1 [/SUP], Christopher Ward[SUP] 1 [/SUP], John Taylor[SUP] 1 [/SUP], Joseph Mulae[SUP] 8 [/SUP], Jon Naylor[SUP] 8 [/SUP], Edward D Nicol[SUP] 9 10 [/SUP], David A Holdsworth[SUP] 6 7 [/SUP]



Affiliations

Abstract

Background: A failure to fully recover following coronavirus disease 2019 (COVID-19) may have a profound impact on high functioning populations ranging from front-line emergency services to professional or amateur/recreational athletes.
Aim: To describe the medium-term cardiopulmonary exercise profiles of individuals with 'persistent symptoms' and individuals who feel 'recovered' after hospitalization or mild-moderate community infection following COVID-19 to an age, sex and job-role matched control group.
Methods: 113 participants underwent cardiopulmonary functional tests at a mean 159±7 days (~5 months) following acute illness; 27 hospitalized with persistent symptoms (hospitalized-symptomatic), 8 hospitalized and now recovered (hospitalized-recovered); 34 community managed with persistent symptoms (community-symptomatic); 18 community managed and now recovered (community-recovered), and 26 controls.
Results: Hospitalized groups had the least favorable body composition (body mass, body mass index and waist circumference) compared to controls. Hospitalized-symptomatic and community-symptomatic individuals had a lower oxygen uptake (V̇O[SUB]2[/SUB]) at peak exercise (hospitalized-symptomatic, 29.9±5.0ml/kg/min; community-symptomatic, 34.4±7.2ml/kg/min; vs. control 43.9±3.1ml/kg/min, both p<0.001). Hospitalized-symptomatic individuals had a steeper V̇E/V̇CO[SUB]2[/SUB] slope (lower ventilatory efficiency) (30.5±5.3 vs. 25.5±2.6, p=0.003) vs. controls. Hospitalized-recovered had a significantly lower oxygen uptake at peak (32.6±6.6ml/kg/min vs. 43.9 ±13.1ml/kg/min, p=0.015) compared to controls. No significant differences were reported between community-recovered individuals and controls in any cardiopulmonary parameter.
Conclusion: Medium term findings suggest community-recovered individuals did not differ in cardiopulmonary fitness from physically active healthy controls. This suggests their readiness to return to higher levels of physical activity. However, the hospitalized-recovered group and both groups with persistent symptoms had enduring functional limitations, warranting further monitoring, rehabilitation and recovery.

Keywords: Long COVID; Recovery; cardiopulmonary exercise testing; exercise capacity.
 
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