Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation



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Aparisi, Álvaro and Ybarra Falcón, Cristina and García Gómez, Mario and Tobar, Javier and Iglesias Echeverría, Carolina and Jaurrieta Largo, Sofía and Ladrón, Raquel and Uribarri, Aitor and Catalá, Pablo and Hinojosa, Williams and Marcos Mangas, Marta and Fernández Prieto, Laura and Sedano Gutiérrez, Rosa and Cusacovich, Iván and Andaluz Ojeda, David and de Vega Sánchez, Blanca and Recio Platero, Amada and Sanz Patiño, Esther and Calvo, Dolores and Baladrón, Carlos and Carrasco Moraleja, Manuel and Disdier Vicente, Carlos and Amat Santos, Ignacio J. and San Román, J. Alberto (2021) Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation. Journal of Clinical Medicine, 10 (12). p. 2591. ISSN 2077-0383

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Official URL: https://doi.org/10.3390/jcm10122591


Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries. Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO2 consumption (77.8 (64–92.5) vs. 99 (88–105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467–600) vs. 611 (550–650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VCO2 slope 32 (28.1–37.4) vs. 29.4 (26.9–31.4); p = 0.022) and high PETCO2 (34.5 (32–39) vs. 38 (36–40); p = 0.025). Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome.

Item Type:Article
Additional Information:

The present study was partially granted by Gerencia Regional de Salud de Castilla y León under grant number GRS COVID 111/A/20 and a grant from the Spanish Society of Cardiology SEC/FEC-INVCLI 2.

Uncontrolled Keywords:Post-COVID-19 syndrome; Cardiopulmonary exercise testing; Six-minute walking test; Pulmonary function test; Dyspnea; Ventilatory inefficiency
Subjects:Medical sciences > Medicine
Medical sciences > Medicine > Communicable diseases
ID Code:77548
Deposited On:18 Apr 2023 09:05
Last Modified:18 Apr 2023 09:12

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