Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, University of Milan, Milan, Italy.
Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Respir Med. 2021 Oct;187:106577. doi: 10.1016/j.rmed.2021.106577. Epub 2021 Aug 14.
current data on the impact of acute illness severity on exercise capacity and ventilatory efficiency of COVID-19 survivors, evaluated at cardiopulmonary exercise test (CPET), are limited.
in this post-hoc analysis of our previous observational, prospective, cohort study on mechanisms of exercise intolerance in COVID-19 survivors, we aimed at evaluating the impact of acute COVID-19 severity on exercise capacity, pulmonary function testing (PFT) and chest computed tomography (CT) outcomes.
we enrolled 75 patients (18 with mild-to-moderate disease, 18 with severe disease, and 39 with critical disease). Mean (standard deviation - SD) follow-up time was 97 (26) days. Groups showed a similar PFT and CT residual involvement, featuring a mildly reduced exercise capacity with comparable mean (SD) values of peak oxygen consumption as percentage of predicted (83 (17) vs 82 (16) vs 84 (15), p = 0.895) among groups, as well as the median (interquartile range - IQR) alveolar-arterial gradient for O in mmHg at exercise peak (20 (15-28) vs 27 (18-31) vs 26 (21-21), p = 0.154), which was in the limit of normal. In addition, these patients featured a preserved mean ventilatory efficiency evaluated through the slope of the relation between ventilation and carbon dioxide output during exercise (27.1 (2.6) vs 29.8 (3.9) vs 28.3 (2.6), p = 0.028), without a clinically relevant difference.
Disease severity does not impact on exercise capacity in COVID-19 survivors at 3 months after discharge, including a ventilatory response still in the limit of normal.
目前关于急性疾病严重程度对 COVID-19 幸存者心肺运动试验 (CPET) 评估的运动能力和通气效率影响的数据有限。
在我们之前关于 COVID-19 幸存者运动不耐受机制的观察性、前瞻性队列研究的事后分析中，我们旨在评估急性 COVID-19 严重程度对运动能力、肺功能测试 (PFT) 和胸部计算机断层扫描 (CT) 结果的影响。
我们纳入了 75 名患者（18 名轻度至中度疾病，18 名重度疾病，39 名危重病）。平均（标准差 - SD）随访时间为 97（26）天。各组 PFT 和 CT 残留受累情况相似，运动能力轻度降低，各组峰值摄氧量占预计值的百分比（83（17）%、82（16）%和 84（15）%，p=0.895）以及运动峰值时肺泡动脉氧梯度（mmHg）（20（15-28）mmHg、27（18-31）mmHg 和 26（21-21）mmHg，p=0.154）相当，处于正常范围。此外，这些患者的通气效率通过运动期间通气与二氧化碳输出之间关系的斜率来评估，结果保持正常（27.1（2.6）L/min、29.8（3.9）L/min 和 28.3（2.6）L/min，p=0.028），没有明显的差异。
疾病严重程度不会影响 COVID-19 幸存者出院后 3 个月的运动能力，包括通气反应仍在正常范围内。
