Cardiovascular Disease, Mayo Clinic, Jacksonville, Florida, United States.
Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, United States.
J Appl Physiol (1985). 2023 Nov 1;135(5):1146-1156. doi: 10.1152/japplphysiol.00357.2023. Epub 2023 Oct 19.
Reduced exercise capacity has been suggested as a cardinal sequela of COVID-19. However, only cross-sectional approaches that either do not consider individuals with concomitant cardiorespiratory disease or account for exercise capacity before infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) support this assumption. Is reduced exercise capacity a sequela of SARS-CoV-2 infection in patients with concomitant cardiorespiratory disease? We retrospectively reviewed cardiopulmonary exercise testing (CPET) data collected across three hospitals between October 2018 and March 2022. Forty-two patients who completed a CPET before and after COVID-19 and 25 patients who performed two separate CPETs but did not contract COVID-19 (CTL) were included. Within each patient, the same test protocol was performed at the first and second CPETs. The time between CPETs was similar between the groups (COVID-19 489 ± 534 vs. CTL 534 ± 257 days, = 0.662). The COVID-19 group performed the CPETs 312 ± 232 days before and 176 ± 110 days after infection. Exercise time, peak heart rate, peak systolic pressure, oxygen uptake (V̇o) at anaerobic threshold, peak ventilation, and ventilatory efficiency were not different between the CPETs in both groups. Peak V̇o was reduced from before to after SARS-CoV-2 infection. However, the change in V̇o from the first to the second CPET was not different between COVID-19 vs. CTL. Accounting for V̇o before COVID-19 and including a group of control patients, we find limited evidence for reduced exercise capacity as a sequela of SARS-CoV-2 infection in patients with concomitant cardiorespiratory disease. There is accumulating evidence that reduced exercise capacity is, or can be, an outcome following COVID-19. However, evidence to date relies upon cross-sectional approaches that either do not consider patients with concomitant cardiorespiratory disease or account for pre-infection exercise capacity data. Accounting for V̇o before COVID-19 and including a group of control patients, we find limited evidence for reduced exercise capacity as a sequela of SARS-CoV-2 infection in patients with concomitant cardiorespiratory disease.
运动能力下降被认为是 COVID-19 的主要后遗症之一。然而，只有那些不考虑同时患有心肺疾病的个体，或者仅考虑感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）之前的运动能力的横断面研究支持这一假设。在同时患有心肺疾病的患者中，运动能力下降是 SARS-CoV-2 感染的后遗症吗？我们回顾性地分析了 2018 年 10 月至 2022 年 3 月期间在三所医院收集的心肺运动测试（CPET）数据。共纳入了 42 例在 COVID-19 前后完成两次 CPET 的患者和 25 例未感染 COVID-19（CTL）但进行了两次单独 CPET 的患者。在每个患者中，第一次和第二次 CPET 都采用相同的测试方案。两组之间的 CPET 时间间隔相似（COVID-19 为 489±534 天，CTL 为 534±257 天， = 0.662）。COVID-19 组在感染前 312±232 天和感染后 176±110 天进行 CPET。两组 CPET 之间的运动时间、峰值心率、峰值收缩压、无氧阈时的摄氧量（V̇o）、峰值通气量和通气效率均无差异。从 SARS-CoV-2 感染前到感染后，峰值 V̇o 降低。然而，COVID-19 组和 CTL 组之间从第一次 CPET 到第二次 CPET 的 V̇o 变化没有差异。考虑到 COVID-19 前的 V̇o，并纳入一组对照组患者，我们发现运动能力下降作为同时患有心肺疾病的 COVID-19 患者的后遗症的证据有限。越来越多的证据表明，运动能力下降是 COVID-19 的结果，或者可以是 COVID-19 的结果。然而，迄今为止的证据依赖于横断面研究，这些研究要么不考虑同时患有心肺疾病的患者，要么不考虑感染前的运动能力数据。考虑到 COVID-19 前的 V̇o，并纳入一组对照组患者，我们发现运动能力下降作为同时患有心肺疾病的 COVID-19 患者的后遗症的证据有限。
