Cardiorespiratory abnormalities in ICU survivors of COVID-19 with postacute sequelae of SARS-CoV-2 infection are unrelated to invasive mechanical ventilation

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Longobardi, Igor ; do Prado, Danilo Marcelo Leite ; de Andrade, Danieli Castro Oliveira ; Goessler, Karla Fabiana ; de Oliveira Junior, Gersiel Nascimento ; Azevedo, Rafael de Almeida ; Leitao, Alice Erwig ; Santos, Jhonnatan Vasconcelos Pereira ; Pinto, Ana Lucia de Sa ; Gualano, Bruno ; Roschel, Hamilton

• Document type: Journal article
• Source: AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY; v. 326, n. 4, p. 9-pg., 2024-04-09.

Abstract

Postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) often leads to exertional intolerance and reduced exercise capacity, particularly in individuals previously admitted to an intensive care unit (ICU). However, the impact of invasive mechanical ventilation (IMV) on PASC-associated cardiorespiratory abnormalities during exercise remains poorly understood. This single-center, cross-sectional study aimed to gather knowledge on this topic. Fifty-two patients with PASC recruited similar to 6 mo after ICU discharge were clustered based on their need for IMV (PASC + IMV, n = 27) or noninvasive support therapy (PASC + NIS, n = 25). Patients underwent pulmonary function and cardiopulmonary exercise testing (CPX) and were compared with a reference group (CONTROL, n = 19) comprising individuals of both sexes with similar age, comorbidities, and physical activity levels but without a history of COVID-19 illness. Individuals with PASC, irrespective of support therapy, presented with higher rates of cardiorespiratory abnormalities than CONTROL, especially dysfunctional breathing patterns, dynamic hyperinflation, reduced oxygen uptake and oxygen pulse, and blunted heart rate recovery (all P < 0.05). Only the rate of abnormal oxygen pulse was greater among PASC + IMV group than PASC + NIS group (P = 0.05). Mean estimates for all CPX variables were comparable between PASC + IMV and PASC + NIS groups (all P > 0.05). These findings indicate significant involvement of both central and peripheral factors, leading to exertional intolerance in individuals with PASC previously admitted to the ICU, regardless of their need for IMV. (AU)

• FAPESP's process: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study
• Grantee: Bruno Gualano
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 21/13580-1 - Effects of home-based exercise training on quality of life and general health of severe COVID-19 survivors
• Grantee: Igor Longobardi Amin
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 20/07540-4 - Effects of exercise training associated with protein supplementation on bone parameters in older people with sarcopenic obesity under caloric restriction: a randomized controlled clinical trial
• Grantee: Gersiel Nascimento de Oliveira Júnior
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 19/18039-7 - Reducing sedentary time in bariatric patients: a randomized controlled trial
• Grantee: Karla Fabiana Goessler
• Support Opportunities: Scholarships in Brazil - Post-Doctoral