Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA.
Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
Prog Cardiovasc Dis. 2021 Jul-Aug;67:35-39. doi: 10.1016/j.pcad.2021.04.005. Epub 2021 May 6.
The outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has presented a global public health emergency. Although predominantly a pandemic of acute respiratory disease, corona virus infectious disease-19 (COVID-19) results in multi-organ damage that impairs cardiopulmonary (CP) function and reduces cardiorespiratory fitness. Superimposed on the CP consequences of COVID-19 is a marked reduction in physical activity that exacerbates CP disease (CPD) risk. CP exercise testing (CPET) is routinely used in clinical practice to diagnose CPD and assess prognosis; assess cardiovascular safety for rehabilitation; and delineate the physiological contributors to exercise intolerance and exertional fatigue. As such, CPET plays an important role in clinical assessments of convalescent COVID-19 patients as well as research aimed at understanding the long-term health effects of SARS-CoV-2 infection. However, due to the ventilatory expired gas analysis involved with CPET, the procedure is considered an aerosol generating procedure. Therefore, extra precautions should be taken by health care providers and exercise physiologists performing these tests. This paper provides recommendations for CPET testing during the COVID-19 pandemic. These recommendations include indications for CPET; pre-screening assessments; precautions required for testing; and suggested decontamination protocols. These safety recommendations are aimed at preventing SARS-CoV-2 transmission during CPET.
新型严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染的爆发引发了全球公共卫生紧急事件。虽然冠状病毒病 19 (COVID-19) 主要是一种急性呼吸道疾病大流行，但它会导致多器官损伤，损害心肺 (CP) 功能并降低心肺适应能力。COVID-19 叠加的是身体活动的明显减少，这加剧了 CP 疾病 (CPD) 的风险。CP 运动测试 (CPET) 通常用于临床实践中诊断 CPD 和评估预后；评估康复的心血管安全性；并描绘导致运动不耐受和劳累性疲劳的生理因素。因此，CPET 在对 COVID-19 恢复期患者的临床评估以及旨在了解 SARS-CoV-2 感染的长期健康影响的研究中发挥着重要作用。然而，由于 CPET 涉及通气呼气气体分析，该程序被认为是一种气溶胶产生程序。因此，进行这些测试的医疗保健提供者和运动生理学家应采取额外的预防措施。本文提供了 COVID-19 大流行期间进行 CPET 测试的建议。这些建议包括 CPET 的适应证；预筛选评估；测试所需的预防措施；以及建议的消毒方案。这些安全建议旨在防止 COVID-19 期间在 CPET 期间传播。
