Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation

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dc.contributor.authorLafetá, Mariana L.
dc.contributor.authorSouza, Vitor C.
dc.contributor.authorMenezes, Thaís C. F.
dc.contributor.authorVerrastro, Carlos G. Y.
dc.contributor.authorMancuso, Frederico J.
dc.contributor.authorAlbuquerque, André Luis P.
dc.contributor.authorTanni, Suzana E. [UNESP]
dc.contributor.authorIzbicki, Meyer
dc.contributor.authorCarlstron, Júlio P.
dc.contributor.authorNery, Luiz Eduardo
dc.contributor.authorOliveira, Rudolf K. F.
dc.contributor.authorSperandio, Priscila A.
dc.contributor.authorFerreira, Eloara V. M.
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionSírio-Libanês Teaching and Research Institute
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.date.accessioned2023-07-29T13:57:08Z
dc.date.available2023-07-29T13:57:08Z
dc.date.issued2023-05-01
dc.description.abstractRationale 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·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.en
dc.description.affiliationPulmonary Function and Clinical Exercise Physiology Unit (SEFICE) Division of Respiratory Diseases Federal University of Sao Paulo (UNIFESP)
dc.description.affiliationRadiology Division UNIFESP
dc.description.affiliationDivision of Cardiology UNIFESP
dc.description.affiliationPulmonary Division Heart Institute (INCOR) Clinical Hospital HCFMUSP Faculty of the Medicine University of Sao Paulo
dc.description.affiliationSírio-Libanês Teaching and Research Institute
dc.description.affiliationDivision of Internal Medicine of Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationUnespDivision of Internal Medicine of Botucatu Medical School São Paulo State University (UNESP)
dc.identifierhttp://dx.doi.org/10.1183/23120541.00538-2022
dc.identifier.citationERJ Open Research, v. 9, n. 3, 2023.
dc.identifier.doi10.1183/23120541.00538-2022
dc.identifier.issn2312-0541
dc.identifier.scopus2-s2.0-85160613581
dc.identifier.urihttp://hdl.handle.net/11449/248910
dc.language.isoeng
dc.relation.ispartofERJ Open Research
dc.sourceScopus
dc.titleExercise intolerance in post-coronavirus disease 2019 survivors after hospitalisationen
dc.typeArtigo
unesp.author.orcid0000-0002-8714-9953[1]
unesp.author.orcid0000-0003-4993-857X[3]
unesp.author.orcid0000-0002-2252-8119[11]
unesp.author.orcid0000-0002-3291-6473[13]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt
unesp.departmentClínica Médica - FMBpt

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Botucatu - FMB - Faculdade de Medicina