School of Medicine in Sports and Exercise, University of Verona, Verona, Italy.
Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
BMC Pulm Med. 2024 May 25;24(1):258. doi: 10.1186/s12890-024-03070-1.
SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EVin) has emerged as a notable long-term sequela, potentially impacting respiratory and cardiovascular health. This study aims to assess the long-term presence of EVin after 34 months and its association with cardiorespiratory health in post-COVID patients.
In a longitudinal study on 32 selected post-COVID subjects, we performed two cardiopulmonary exercise tests (CPETs) at 6 months (T0) and 34 months (T1) after hospital discharge. The study sought to explore the long-term persistence of EVin and its correlation with respiratory and cardiovascular responses during exercise. Measurements included also V̇O end-tidal pressure of CO (PET) levels, oxygen uptake efficiency slope (OUES) and other cardiorespiratory parameters, with statistical significance set at p < 0.05. The presence of EVin at both T0 and T1 defines a persisting EVin (pEVin).
Out of the cohort, five subjects (16%) have pEVin at 34 months. Subjects with pEVin, compared to those with ventilatory efficiency (Evef) have lower values of PET throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DL and oxygen pulse, suggesting a recovery in cardiorespiratory function over time. In contrast, those with pEvin did not exhibit these improvements. Notably, significant correlations were found between hyperventilation (measured by PET), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups.
The study highlights the clinical importance of long-term follow-up for post-COVID patients, as a significant group exhibit persistent EVin, which correlates with altered and potentially unfavorable cardiovascular responses to exercise. These findings advocate for the continued investigation into the long-term health impacts of COVID-19, especially regarding persistent ventilatory inefficiencies and their implications on patient health outcomes.
SARS-CoV-2 感染引发了人们对长期健康影响的担忧。运动通气效率低下（EVin）已成为一个显著的长期后遗症，可能影响呼吸和心血管健康。本研究旨在评估 COVID-19 后患者 34 个月后 EVin 的长期存在及其与心肺健康的关系。
在一项对 32 名 COVID-19 后患者的纵向研究中，我们在出院后 6 个月（T0）和 34 个月（T1）进行了两次心肺运动测试（CPET）。该研究旨在探讨 EVin 的长期持续性及其与运动时呼吸和心血管反应的相关性。测量包括 V̇O 呼气末 CO 分压（PET）水平、摄氧效率斜率（OUES）和其他心肺参数，统计学意义设定为 p < 0.05。在 T0 和 T1 均存在 EVin 的患者定义为持续存在的 EVin（pEVin）。
在队列中，有 5 名患者（16%）在 34 个月时存在 pEVin。与 Evef 患者相比，pEVin 患者在整个运动过程中 PET 值较低，表现为过度通气。Evef 患者的 DL 和氧脉冲选择性改善，表明随着时间的推移心肺功能逐渐恢复。相比之下，pEvin 患者没有表现出这些改善。值得注意的是，PET 测量的过度通气与氧脉冲和 OUES 之间存在显著相关性，表明 OUES 和 EVin 在 COVID-19 随访中的潜在预后价值。
本研究强调了对 COVID-19 后患者进行长期随访的重要性，因为有相当一部分患者存在持续的 EVin，这与运动时心血管反应的改变和潜在不利有关。这些发现表明，需要进一步研究 COVID-19 的长期健康影响，特别是关于持续的通气效率低下及其对患者健康结局的影响。
