tetano
Editor, Senior Moderator
Respir Res
. 2022 Mar 22;23(1):68.
doi: 10.1186/s12931-022-01977-z.
Identification of factors impairing exercise capacity after severe COVID-19 pulmonary infection: a 3-month follow-up of prospective COVulnerability cohort
Bruno Ribeiro Baptista[SUP] #[/SUP][SUP] 1 [/SUP], Thomas d'Humières[SUP] #[/SUP][SUP] 1 2 [/SUP], Frédéric Schlemmer[SUP] 1 3 [/SUP], Inès Bendib[SUP] 1 2 4 [/SUP], Grégoire Justeau[SUP] 1 [/SUP], Lara Al-Assaad[SUP] 2 [/SUP], Mouna Hachem[SUP] 1 3 [/SUP], Rebecca Codiat[SUP] 2 [/SUP], Benjamin Bardel[SUP] 2 [/SUP], Laure Abou Chakra[SUP] 2 [/SUP], Thibaut Belmondo[SUP] 5 [/SUP], Etienne Audureau[SUP] 6 7 [/SUP], Sophie Hue[SUP] 1 5 [/SUP], Armand Mekontso-Dessap[SUP] 1 4 [/SUP], Geneviève Derumeaux[SUP] 1 2 [/SUP], Laurent Boyer[SUP] 8 9 [/SUP]
Affiliations
Abstract
Background: Patient hospitalized for coronavirus disease 2019 (COVID-19) pulmonary infection can have sequelae such as impaired exercise capacity. We aimed to determine the frequency of long-term exercise capacity limitation in survivors of severe COVID-19 pulmonary infection and the factors associated with this limitation.
Methods: Patients with severe COVID-19 pulmonary infection were enrolled 3 months after hospital discharge in COVulnerability, a prospective cohort. They underwent cardiopulmonary exercise testing, pulmonary function test, echocardiography, and skeletal muscle mass evaluation.
Results: Among 105 patients included, 35% had a reduced exercise capacity (VO[SUB]2[/SUB]peak < 80% of predicted). Compared to patients with a normal exercise capacity, patients with reduced exercise capacity were more often men (89.2% vs. 67.6%, p = 0.015), with diabetes (45.9% vs. 17.6%, p = 0.002) and renal dysfunction (21.6% vs. 17.6%, p = 0.006), but did not differ in terms of initial acute disease severity. An altered exercise capacity was associated with an impaired respiratory function as assessed by a decrease in forced vital capacity (p < 0.0001), FEV1 (p < 0.0001), total lung capacity (p < 0.0001) and DL[SUB]CO[/SUB] (p = 0.015). Moreover, we uncovered a decrease of muscular mass index and grip test in the reduced exercise capacity group (p = 0.001 and p = 0.047 respectively), whilst 38.9% of patients with low exercise capacity had a sarcopenia, compared to 10.9% in those with normal exercise capacity (p = 0.001). Myocardial function was normal with similar systolic and diastolic parameters between groups whilst reduced exercise capacity was associated with a slightly shorter pulmonary acceleration time, despite no pulmonary hypertension.
Conclusion: Three months after a severe COVID-19 pulmonary infection, more than one third of patients had an impairment of exercise capacity which was associated with a reduced pulmonary function, a reduced skeletal muscle mass and function but without any significant impairment in cardiac function.
Keywords: COVID-19; Cardiopulmonary exercise testing; Pulmonary function; SARS-CoV-2; Sarcopenia; Skeletal muscle.
. 2022 Mar 22;23(1):68.
doi: 10.1186/s12931-022-01977-z.
Identification of factors impairing exercise capacity after severe COVID-19 pulmonary infection: a 3-month follow-up of prospective COVulnerability cohort
Bruno Ribeiro Baptista[SUP] #[/SUP][SUP] 1 [/SUP], Thomas d'Humières[SUP] #[/SUP][SUP] 1 2 [/SUP], Frédéric Schlemmer[SUP] 1 3 [/SUP], Inès Bendib[SUP] 1 2 4 [/SUP], Grégoire Justeau[SUP] 1 [/SUP], Lara Al-Assaad[SUP] 2 [/SUP], Mouna Hachem[SUP] 1 3 [/SUP], Rebecca Codiat[SUP] 2 [/SUP], Benjamin Bardel[SUP] 2 [/SUP], Laure Abou Chakra[SUP] 2 [/SUP], Thibaut Belmondo[SUP] 5 [/SUP], Etienne Audureau[SUP] 6 7 [/SUP], Sophie Hue[SUP] 1 5 [/SUP], Armand Mekontso-Dessap[SUP] 1 4 [/SUP], Geneviève Derumeaux[SUP] 1 2 [/SUP], Laurent Boyer[SUP] 8 9 [/SUP]
Affiliations
- PMID: 35317815
- DOI: 10.1186/s12931-022-01977-z
Abstract
Background: Patient hospitalized for coronavirus disease 2019 (COVID-19) pulmonary infection can have sequelae such as impaired exercise capacity. We aimed to determine the frequency of long-term exercise capacity limitation in survivors of severe COVID-19 pulmonary infection and the factors associated with this limitation.
Methods: Patients with severe COVID-19 pulmonary infection were enrolled 3 months after hospital discharge in COVulnerability, a prospective cohort. They underwent cardiopulmonary exercise testing, pulmonary function test, echocardiography, and skeletal muscle mass evaluation.
Results: Among 105 patients included, 35% had a reduced exercise capacity (VO[SUB]2[/SUB]peak < 80% of predicted). Compared to patients with a normal exercise capacity, patients with reduced exercise capacity were more often men (89.2% vs. 67.6%, p = 0.015), with diabetes (45.9% vs. 17.6%, p = 0.002) and renal dysfunction (21.6% vs. 17.6%, p = 0.006), but did not differ in terms of initial acute disease severity. An altered exercise capacity was associated with an impaired respiratory function as assessed by a decrease in forced vital capacity (p < 0.0001), FEV1 (p < 0.0001), total lung capacity (p < 0.0001) and DL[SUB]CO[/SUB] (p = 0.015). Moreover, we uncovered a decrease of muscular mass index and grip test in the reduced exercise capacity group (p = 0.001 and p = 0.047 respectively), whilst 38.9% of patients with low exercise capacity had a sarcopenia, compared to 10.9% in those with normal exercise capacity (p = 0.001). Myocardial function was normal with similar systolic and diastolic parameters between groups whilst reduced exercise capacity was associated with a slightly shorter pulmonary acceleration time, despite no pulmonary hypertension.
Conclusion: Three months after a severe COVID-19 pulmonary infection, more than one third of patients had an impairment of exercise capacity which was associated with a reduced pulmonary function, a reduced skeletal muscle mass and function but without any significant impairment in cardiac function.
Keywords: COVID-19; Cardiopulmonary exercise testing; Pulmonary function; SARS-CoV-2; Sarcopenia; Skeletal muscle.