Abstract
Background
Cardiopulmonary Exercise Testing (CPET) provides a comprehensive assessment of pulmonary, cardiovascular and musculosceletal function. Reduced CPET performance could be an indicator for chronic morbidity after COVID-19.
Methods
Patients ≥18 years with confirmed PCR positive SARS-CoV-2 infection were offered to participate in a prospective observational study of clinical course and outcomes of COVID-19. 54 patients completed CPET, questionnaires on respiratory quality of life and performed pulmonary function tests 12 months after SARS-CoV-2 infection.
Results
At 12 months after SARS-CoV-2 infection, 46.3% of participants had a peak performance and 33.3% a peak oxygen uptake of <80% of the predicted values, respectively. Further impairments were observed in diffusion capacity and ventilatory efficiency. Functional limitations were particularly pronounced in patients after invasive mechanical ventilation and extracorporeal membrane oxygenation treatment. Ventilatory capacity was reduced <80% of predicted values in 55.6% of participants, independent from initial clinical severity. Patient reported dyspnea and respiratory quality of life after COVID-19 correlated with CPET performance and parameters of gas exchange. Risk factors for reduced CPET performance 12 months after COVID-19 were prior intensive care treatment (OR 5.58, p = 0.004), SGRQ outcome >25 points (OR 3.48, p = 0.03) and reduced DLCO (OR 3.01, p = 0.054).
Conclusions
Functional limitations causing chronic morbidity in COVID-19 survivors persist over 12 months after SARS-CoV-2 infection. These limitations were particularly seen in parameters of overall performance and gas exchange resulting from muscular deconditioning and lung parenchymal changes. Patient reported reduced respiratory quality of life was a risk factor for adverse CPET performance.
【초록키워드】 COVID-19, Treatment, exercise, prospective observational study, SARS-COV-2 infection, lung, outcome, risk factor, extracorporeal membrane oxygenation, Clinical course, Testing, Pulmonary function test, Dyspnea, Gas exchange, morbidity, Patient, Quality of life, questionnaire, Clinical severity, Invasive mechanical ventilation, Efficiency, diffusion capacity, changes, Factor, Participants, PCR positive, intensive care treatment, participant, ventilatory, limitation, impairment, survivor, parameter, oxygen uptake, independent, initial, Result, resulting, predicted, performed, reported, reduced, provide, correlated, was reduced, muscular, offered, parenchymal, Ventilatory capacity, 【제목키워드】 COVID-19, SARS-COV-2 infection, Cardiopulmonary, Exercise capacity, convalescent, disease, limitation, initial,