Cardiopulmonary Exercise Testing in Patients with Post-COVID-19 Syndrome.

Barbagelata L; Masson W; Iglesias D; Lillo E; Migone JF; Orazi ML;
Maritano Furcada J

Medicina Clinica. 159(1):6-11, 2022 Jul 08.

BACKGROUND AND AIM: Several reports have shown the persistence of long
term symptoms after the initial COVID-19 infection (post-COVID-19
syndrome). The objective of this study was to analyze the characteristics
of cardiopulmonary exercise testing (CPET) performed in patients with a
history of COVID-19, comparing subjects according to the presence of
post-COVID-19 syndrome.

METHODS: A cross-sectional study was performed. Consecutive patients >18
years with history of SARS-CoV-2 infection confirmed by polymerase chain
reaction test and a CPET performed between 45 and 120 days after the viral
episode were included. The association between variables related to CPET
and post-COVID-19 syndrome was assessed using univariate and multivariate

RESULTS: A total of 200 patients (mean age 48.8+/-14.3 years, 51% men)
were included. Patients with post-COVID-19 syndrome showed significantly
lower main peak VO2 (25.8+/-8.1mL/min/kg vs. 28.8+/-9.6mL/min/kg, p=0.017)
as compared to asymptomatic subjects. Moreover, patients with
post-COVID-19 syndrome developed symptoms more frequently during CPET
(52.7% vs. 13.7%, p<0.001) and were less likely to reach the anaerobic
threshold (50.9% vs. 72.7%, p=0.002) when compared to asymptomatic
subjects. These findings were not modified when adjusting for confounders.

CONCLUSION: Our data suggest that post-COVID-19 syndrome was associated
with less peak VO2, a lower probability of achieving the anaerobic
threshold and a higher probability of presenting symptoms during the CPET.
Future studies are needed to determine if these abnormalities during CPET
would have prognostic value.