Background
Individuals who contract coronavirus disease 2019 (COVID-19) can suffer with persistent and debilitating symptoms long after the initial acute illness. Heart rate (HR) profiles determined during cardiopulmonary exercise testing (CPET) and delivered as part of a post-COVID recovery service may provide insight into the presence and impact of dysautonomia on functional ability.
Objective
Using an active, working-age, post–COVID-19 population, the purpose of this study was to (1) determine and characterize any association between subjective symptoms and dysautonomia; and (2) identify objective exercise capacity differences between patients classified “with” and those “without” dysautonomia.
Methods
Patients referred to a post–COVID-19 service underwent comprehensive clinical assessment, including self-reported symptoms, CPET, and secondary care investigations when indicated. Resting HR >75 bpm, HR increase with exercise <89 bpm, and HR recovery <25 bpm 1 minute after exercise were used to define dysautonomia. Anonymized data were analyzed and associations with symptoms, and CPET outcomes were determined.
Results
Fifty-one of the 205 patients (25%) reviewed as part of this service evaluation had dysautonomia. There were no associations between symptoms or perceived functional limitation and dysautonomia (P >.05). Patients with dysautonomia demonstrated objective functional limitations with significantly reduced work rate (219 ± 37 W vs 253 ± 52 W; P <.001) and peak oxygen consumption (V̇o2: 30.6 ± 5.5 mL/kg/min vs 35.8 ± 7.6 mL/kg/min; P <.001); and a steeper (less efficient) V̇e/V̇co2 slope (29.9 ± 4.9 vs 27.7 ± 4.7; P = .005).
Conclusion
Dysautonomia is associated with objective functional limitations but is not associated with subjective symptoms or limitation.
【저자키워드】 COVID-19, Symptoms, cardiopulmonary exercise testing, Dysautonomia, Exercise testing, 【초록키워드】 coronavirus disease, Exercise capacity, oxygen, Symptom, outcome, Patient, heart rate, association, secondary care, Self-reported symptoms, profile, individual, limitation, acute illness, objective, initial, resting, Result, analyzed, identify, significantly, indicated, reduced, functional, were used, less, determine, demonstrated, to define, bpm, 【제목키워드】 Symptom, limitation, functional,