Moulson Nathaniel, Gustus Sarah K, Scirica Christina, Petek Bradley J, Vanatta Caroyln, Churchill Timothy W, Guseh James Sawalla, Baggish Aaron, Wasfy Meagan M
Cardiology Division, The University of British Columbia, Vancouver, British Columbia, Canada.
Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
Br J Sports Med. 2022 May 18. doi: 10.1136/bjsports-2021-105157.
Persistent or late-onset cardiopulmonary symptoms following COVID-19 may occur in athletes despite a benign initial course. We examined the yield of cardiac evaluation, including cardiopulmonary exercise testing (CPET), in athletes with cardiopulmonary symptoms after COVID-19, compared CPETs in these athletes and those without COVID-19 and evaluated longitudinal changes in CPET with improvement in symptoms.
This prospective cohort study evaluated young (18-35 years old) athletes referred for cardiopulmonary symptoms that were present>28 days from COVID-19 diagnosis. CPET findings in post-COVID athletes were compared with a matched reference group of healthy athletes without COVID-19. Post-COVID athletes underwent repeat CPET between 3 and 6 months after initial evaluation.
Twenty-one consecutive post-COVID athletes with cardiopulmonary symptoms (21.9±3.9 years old, 43% female) were evaluated 3.0±2.1 months after diagnosis. No athlete had active inflammatory heart disease. CPET reproduced presenting symptoms in 86%. Compared with reference athletes (n=42), there was similar peak VO but a higher prevalence of abnormal spirometry (42%) and low breathing reserve (42%). Thirteen athletes (62%) completed longitudinal follow-up (4.8±1.9 months). The majority (69%) had reduction in cardiopulmonary symptoms, accompanied by improvement in peak VO and oxygen pulse, and reduction in resting and peak heart rate (all p<0.05).
Despite a high burden of cardiopulmonary symptoms after COVID-19, no athlete had active inflammatory heart disease. CPET was clinically useful to reproduce symptoms with either normal testing or identification of abnormal spirometry as a potential therapeutic target. Improvement in post-COVID symptoms was accompanied by improvements in CPET parameters.
尽管新冠肺炎患者最初病情较轻，但运动员在感染新冠后仍可能出现持续或迟发性心肺症状。我们研究了新冠后出现心肺症状的运动员进行心脏评估（包括心肺运动试验[CPET]）的结果，比较了这些运动员与未感染新冠的运动员的CPET结果，并评估了随着症状改善CPET的纵向变化。
这项前瞻性队列研究评估了因心肺症状前来就诊的年轻（18 - 35岁）运动员，这些症状在新冠确诊后超过28天仍存在。将新冠后运动员的CPET结果与匹配的未感染新冠的健康运动员对照组进行比较。新冠后运动员在初次评估后的3至6个月内接受重复CPET检查。
连续21名有心肺症状的新冠后运动员（年龄21.9±3.9岁，43%为女性）在确诊后3.0±2.1个月接受了评估。没有运动员患有活动性炎症性心脏病。CPET在86%的患者中重现了症状。与对照组运动员（n = 42）相比，峰值摄氧量相似，但肺功能异常（42%）和低呼吸储备（42%）的患病率更高。13名运动员（62%）完成了纵向随访（4.8±1.9个月）。大多数（69%）运动员的心肺症状有所减轻，同时峰值摄氧量和氧脉搏改善，静息和峰值心率降低（所有p<0.05）。
尽管新冠后心肺症状负担较重，但没有运动员患有活动性炎症性心脏病。CPET在临床上有助于通过正常测试重现症状或识别肺功能异常作为潜在治疗靶点。新冠后症状的改善伴随着CPET参数的改善。
