Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation

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Lafeta, Mariana L. ; Souza, Vitor C. ; Menezes, Thais C. F. ; Verrastro, Carlos G. Y. ; Mancuso, Frederico J. ; Albuquerque, Andre Luis P. ; Tanni, Suzana E. ; Izbicki, Meyer ; Carlstron, Julio P. ; Nery, Luiz Eduardo ; Oliveira, Rudolf K. F. ; Sperandio, Priscila A. ; Ferreira, Eloara V. M.

• Tipo de documento: Artigo Científico
• Fonte: ERJ OPEN RESEARCH; v. 9, n. 3, p. 12-pg., 2023-05-01.

Resumo

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-tosevere/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 center dot kg(-1)center dot min(-1), and the tertiles were <= 17.0, 17.1-22.2 and >= 22.3 mL center dot kg(-1)center dot min(-1). Hospitalisation severity was similar among the three groups; however, at the follow-up visit, patients with peak oxygen consumption <= 17.0 mL center dot kg(-1)center dot 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 center dot kg(-1)center dot 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. (AU)

• Processo FAPESP: 20/08996-1 - Avaliação das sequelas pulmonares, qualidade de vida, capacidade de exercício em pacientes pós COVID-19 moderado a grave no estado de São Paulo: um estudo prospectivo e multicêntrico
• Beneficiário: Andre Luis Pereira de Albuquerque
• Modalidade de apoio: Auxílio à Pesquisa - Regular