Brito Gisele Mendes, do Prado Danilo Marcelo Leite, Rezende Diego Augusto, de Matos Luciana Diniz Nagem Janot, Loturco Irineu, Vieira Marcelo Luiz Campos, de Sá Pinto Ana Lúcia, Alô Rodrigo Otávio Bougleux, de Albuquerque Lorena Christine Araújo, Bianchini Flavia Riva, Pinto Ana Jéssica, Roschel Hamilton, Lemes Ítalo Ribeiro, Gualano Bruno
Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, and School of Medicine, University of São Paulo, São Paulo, Brazil.
Hospital Israelita Albert Einstein, São Paulo, Brazil.
Front Med (Lausanne). 2023 Apr 26;10:1128414. doi: 10.3389/fmed.2023.1128414. eCollection 2023.
Cardiopulmonary exercise testing (CPET) may capture potential impacts of COVID-19 during exercise. We described CPET data on athletes and physically active individuals with or without cardiorespiratory persistent symptoms.
Participants' assessment included medical history and physical examination, cardiac troponin T, resting electrocardiogram, spirometry and CPET. Persistent symptoms were defined as fatigue, dyspnea, chest pain, dizziness, tachycardia, and exertional intolerance persisting >2 months after COVID-19 diagnosis.
A total of 46 participants were included; sixteen (34.8%) were asymptomatic and thirty participants (65.2%) reported persistent symptoms, with fatigue and dyspnea being the most reported ones (43.5 and 28.1%). There were a higher proportion of symptomatic participants with abnormal data for slope of pulmonary ventilation to carbon dioxide production (VE/VCO slope; <0.001), end-tidal carbon dioxide pressure at rest (PETCO2 rest; =0.007), PETCO2 max (=0.009), and dysfunctional breathing (=0.023) vs. asymptomatic ones. Rates of abnormalities in other CPET variables were comparable between asymptomatic and symptomatic participants. When assessing only elite and highly trained athletes, differences in the rate of abnormal findings between asymptomatic and symptomatic participants were no longer statistically significant, except for expiratory air flow-to-percent of tidal volume ratio (EFL/VT) (more frequent among asymptomatic participants) and dysfunctional breathing (=0.008).
A considerable proportion of consecutive athletes and physically active individuals presented with abnormalities on CPET after COVID-19, even those who had had no persistent cardiorespiratory symptomatology. However, the lack of control parameters (e.g., pre-infection data) or reference values for athletic populations preclude stablishing the causality between COVID-19 infection and CPET abnormalities as well as the clinical significance of these findings.
心肺运动试验（CPET）可能会捕捉到新型冠状病毒肺炎（COVID-19）在运动期间的潜在影响。我们描述了有或无心肺持续性症状的运动员和身体活跃个体的CPET数据。
对参与者的评估包括病史和体格检查、心肌肌钙蛋白T、静息心电图、肺功能测定和CPET。持续性症状定义为在COVID-19诊断后持续超过2个月的疲劳、呼吸困难、胸痛、头晕、心动过速和运动不耐受。
共纳入46名参与者；16名（34.8%）无症状，30名（65.2%）报告有持续性症状，其中疲劳和呼吸困难最为常见（分别为43.5%和28.1%）。有症状参与者中，肺通气与二氧化碳产生斜率（VE/VCO斜率；<0.001）、静息呼气末二氧化碳分压（PETCO2静息；=0.007）、PETCO2最大值（=0.009）和功能性呼吸障碍（=0.023）数据异常的比例高于无症状参与者。无症状和有症状参与者之间其他CPET变量的异常率相当。仅评估精英和训练有素的运动员时，无症状和有症状参与者之间异常发现率的差异不再具有统计学意义，但呼气气流与潮气量百分比比值（EFL/VT）（无症状参与者中更常见）和功能性呼吸障碍（=0.008）除外。
相当比例的连续运动员和身体活跃个体在COVID-19后CPET出现异常，即使是那些没有持续性心肺症状的人。然而，缺乏对照参数（如感染前数据）或运动员群体的参考值，妨碍了确定COVID-19感染与CPET异常之间的因果关系以及这些发现的临床意义。
