Importance of Cardiopulmonary Exercise Testing amongst Subjects Recovering from COVID-19

• Published in: Diagnostics (Basel) Vol. 11; no. 3; p. 507
• Main Authors: Dorelli, Gianluigi, Braggio, Michele, Gabbiani, Daniele, Busti, Fabiana, Caminati, Marco, Senna, Gianenrico, Girelli, Domenico, Laveneziana, Pierantonio, Ferrari, Marcello, Sartori, Giulia, Dalle Carbonare, Luca, Crisafulli, Ernesto
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 12.03.2021; MDPI AG
• Subjects: Brief Report; cardiopulmonary exercise test; cardiovascular alterations; COVID-19; exercise ventilatory inefficiency; heart rate recovery; Life Sciences; COVID-19; cardiopulmonary exercise test; cardiovascular alterations; exercise ventilatory inefficiency; heart rate recovery
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics11030507

The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage’s clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.