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Observational Study
. 2021 Oct:187:106577.
doi: 10.1016/j.rmed.2021.106577. Epub 2021 Aug 14.

Severity does not impact on exercise capacity in COVID-19 survivors

Rocco Francesco Rinaldo  1 , Michele Mondoni  2 , Elena Maria Parazzini  3 , Andrea Baccelli  4 , Federica Pitari  5 , Elena Brambilla  6 , Simone Luraschi  7 , Maurizio Balbi  8 , Marco Guazzi  9 , Fabiano Di Marco  10 , Stefano Centanni  11
Affiliations
Observational Study

Severity does not impact on exercise capacity in COVID-19 survivors

Rocco Francesco Rinaldo et al. Respir Med. 2021 Oct.

Abstract

Background: current data on the impact of acute illness severity on exercise capacity and ventilatory efficiency of COVID-19 survivors, evaluated at cardiopulmonary exercise test (CPET), are limited.

Methods: in this post-hoc analysis of our previous observational, prospective, cohort study on mechanisms of exercise intolerance in COVID-19 survivors, we aimed at evaluating the impact of acute COVID-19 severity on exercise capacity, pulmonary function testing (PFT) and chest computed tomography (CT) outcomes.

Results: we enrolled 75 patients (18 with mild-to-moderate disease, 18 with severe disease, and 39 with critical disease). Mean (standard deviation - SD) follow-up time was 97 (26) days. Groups showed a similar PFT and CT residual involvement, featuring a mildly reduced exercise capacity with comparable mean (SD) values of peak oxygen consumption as percentage of predicted (83 (17) vs 82 (16) vs 84 (15), p = 0.895) among groups, as well as the median (interquartile range - IQR) alveolar-arterial gradient for O2 in mmHg at exercise peak (20 (15-28) vs 27 (18-31) vs 26 (21-21), p = 0.154), which was in the limit of normal. In addition, these patients featured a preserved mean ventilatory efficiency evaluated through the slope of the relation between ventilation and carbon dioxide output during exercise (27.1 (2.6) vs 29.8 (3.9) vs 28.3 (2.6), p = 0.028), without a clinically relevant difference.

Conclusions: Disease severity does not impact on exercise capacity in COVID-19 survivors at 3 months after discharge, including a ventilatory response still in the limit of normal.

Keywords: COVID-19; Cardiopulmonary exercise test; Pulmonary function testing.

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Conflict of interest statement

Conflict of interest: Dr. Rinaldo has nothing to disclose. Conflict of interest: Dr. Mondoni has nothing to disclose. Conflict of interest: Dr. Parazzini has nothing to disclose. Conflict of interest: Dr Baccelli has nothing to disclose. Conflict of interest: Dr. Pitari has nothing to disclose. Conflict of interest: Dr. Brambilla has nothing to disclose. Conflict of interest: Dr. Luraschi has nothing to disclose. Conflict of interest: Dr. Balbi has nothing to disclose. Conflict of interest: Prof. Guazzi has nothing to disclose. Conflict of interest: Prof. Di Marco has nothing to disclose. Conflict of interest: Prof. Centanni has nothing to disclose.

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