Cargando…
Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation
RATIONALE: Post-coronavirus disease 2019 (COVID-19) survivors frequently have dyspnoea that can lead to exercise intolerance and lower quality of life. Despite recent advances, the pathophysiological mechanisms of exercise intolerance in the post-COVID-19 patients remain incompletely characterised....
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204824/ https://www.ncbi.nlm.nih.gov/pubmed/37228270 http://dx.doi.org/10.1183/23120541.00538-2022 |
_version_ | 1785045913244270592 |
---|---|
author | Lafetá, Mariana L. Souza, Vitor C. Menezes, Thaís C.F. Verrastro, Carlos G.Y. Mancuso, Frederico J. Albuquerque, André Luis P. Tanni, Suzana E. Izbicki, Meyer Carlstron, Júlio P. Nery, Luiz Eduardo Oliveira, Rudolf K.F. Sperandio, Priscila A. Ferreira, Eloara V.M. |
author_facet | Lafetá, Mariana L. Souza, Vitor C. Menezes, Thaís C.F. Verrastro, Carlos G.Y. Mancuso, Frederico J. Albuquerque, André Luis P. Tanni, Suzana E. Izbicki, Meyer Carlstron, Júlio P. Nery, Luiz Eduardo Oliveira, Rudolf K.F. Sperandio, Priscila A. Ferreira, Eloara V.M. |
author_sort | Lafetá, Mariana L. |
collection | PubMed |
description | RATIONALE: Post-coronavirus disease 2019 (COVID-19) survivors frequently have dyspnoea that can lead to exercise intolerance and lower quality of life. Despite recent advances, the pathophysiological mechanisms of exercise intolerance in the post-COVID-19 patients remain incompletely characterised. The objectives of the present study were to clarify the mechanisms of exercise intolerance in post-COVID-19 survivors after hospitalisation. METHODS: This prospective study evaluated consecutive patients previously hospitalised due to moderate-to-severe/critical COVID-19. Within mean±sd 90±10 days of onset of acute COVID-19 symptoms, patients underwent a comprehensive cardiopulmonary assessment, including cardiopulmonary exercise testing with earlobe arterialised capillary blood gas analysis. MEASUREMENTS AND MAIN RESULTS: 87 patients were evaluated; mean±sd peak oxygen consumption was 19.5±5.0 mL·kg(−1)·min(−1), and the tertiles were ≤17.0, 17.1–22.2 and ≥22.3 mL·kg(−1)·min(−1). Hospitalisation severity was similar among the three groups; however, at the follow-up visit, patients with peak oxygen consumption ≤17.0 mL·kg(−1)·min(−1) reported a greater sensation of dyspnoea, along with indices of impaired pulmonary function, and abnormal ventilatory, gas-exchange and metabolic responses during exercise compared to patients with peak oxygen consumption >17 mL·kg(−1)·min(−1). By multivariate logistic regression analysis (receiver operating characteristic curve analysis) adjusted for age, sex and prior pulmonary embolism, a peak dead space fraction of tidal volume ≥29 and a resting forced vital capacity ≤80% predicted were independent predictors of reduced peak oxygen consumption. CONCLUSIONS: Exercise intolerance in the post-COVID-19 survivors was related to a high dead space fraction of tidal volume at peak exercise and a decreased resting forced vital capacity, suggesting that both pulmonary microcirculation injury and ventilatory impairment could influence aerobic capacity in this patient population. |
format | Online Article Text |
id | pubmed-10204824 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-102048242023-05-24 Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation Lafetá, Mariana L. Souza, Vitor C. Menezes, Thaís C.F. Verrastro, Carlos G.Y. Mancuso, Frederico J. Albuquerque, André Luis P. Tanni, Suzana E. Izbicki, Meyer Carlstron, Júlio P. Nery, Luiz Eduardo Oliveira, Rudolf K.F. Sperandio, Priscila A. Ferreira, Eloara V.M. ERJ Open Res Original Research Articles RATIONALE: Post-coronavirus disease 2019 (COVID-19) survivors frequently have dyspnoea that can lead to exercise intolerance and lower quality of life. Despite recent advances, the pathophysiological mechanisms of exercise intolerance in the post-COVID-19 patients remain incompletely characterised. The objectives of the present study were to clarify the mechanisms of exercise intolerance in post-COVID-19 survivors after hospitalisation. METHODS: This prospective study evaluated consecutive patients previously hospitalised due to moderate-to-severe/critical COVID-19. Within mean±sd 90±10 days of onset of acute COVID-19 symptoms, patients underwent a comprehensive cardiopulmonary assessment, including cardiopulmonary exercise testing with earlobe arterialised capillary blood gas analysis. MEASUREMENTS AND MAIN RESULTS: 87 patients were evaluated; mean±sd peak oxygen consumption was 19.5±5.0 mL·kg(−1)·min(−1), and the tertiles were ≤17.0, 17.1–22.2 and ≥22.3 mL·kg(−1)·min(−1). Hospitalisation severity was similar among the three groups; however, at the follow-up visit, patients with peak oxygen consumption ≤17.0 mL·kg(−1)·min(−1) reported a greater sensation of dyspnoea, along with indices of impaired pulmonary function, and abnormal ventilatory, gas-exchange and metabolic responses during exercise compared to patients with peak oxygen consumption >17 mL·kg(−1)·min(−1). By multivariate logistic regression analysis (receiver operating characteristic curve analysis) adjusted for age, sex and prior pulmonary embolism, a peak dead space fraction of tidal volume ≥29 and a resting forced vital capacity ≤80% predicted were independent predictors of reduced peak oxygen consumption. CONCLUSIONS: Exercise intolerance in the post-COVID-19 survivors was related to a high dead space fraction of tidal volume at peak exercise and a decreased resting forced vital capacity, suggesting that both pulmonary microcirculation injury and ventilatory impairment could influence aerobic capacity in this patient population. European Respiratory Society 2023-05-22 /pmc/articles/PMC10204824/ /pubmed/37228270 http://dx.doi.org/10.1183/23120541.00538-2022 Text en Copyright ©The authors 2023 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Original Research Articles Lafetá, Mariana L. Souza, Vitor C. Menezes, Thaís C.F. Verrastro, Carlos G.Y. Mancuso, Frederico J. Albuquerque, André Luis P. Tanni, Suzana E. Izbicki, Meyer Carlstron, Júlio P. Nery, Luiz Eduardo Oliveira, Rudolf K.F. Sperandio, Priscila A. Ferreira, Eloara V.M. Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
title | Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
title_full | Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
title_fullStr | Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
title_full_unstemmed | Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
title_short | Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
title_sort | exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204824/ https://www.ncbi.nlm.nih.gov/pubmed/37228270 http://dx.doi.org/10.1183/23120541.00538-2022 |
work_keys_str_mv | AT lafetamarianal exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT souzavitorc exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT menezesthaiscf exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT verrastrocarlosgy exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT mancusofredericoj exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT albuquerqueandreluisp exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT tannisuzanae exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT izbickimeyer exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT carlstronjuliop exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT neryluizeduardo exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT oliveirarudolfkf exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT sperandiopriscilaa exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation AT ferreiraeloaravm exerciseintoleranceinpostcoronavirusdisease2019survivorsafterhospitalisation |