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

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 analysis. 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 +/- 8.1 mL/min/kg vs. 28.8 +/- 9.6 mL/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. (C) 2021 Elsevier Espana, S.L.U. All rights reserved.

Automated summary

This study analyzed the characteristics of cardiopulmonary exercise testing (CPET) in patients with a history of COVID-19 and compared patients with post-COVID-19 syndrome with asymptomatic subjects. The results showed that patients with post-COVID-19 syndrome had lower peak VO2, were more likely to experience symptoms during CPET, and had a lower probability of reaching the anaerobic threshold compared to asymptomatic subjects.