Persisting exercise ventilatory inefficiency in subjects recovering from COVID-19. Longitudinal data analysis 34 months post-discharge
Background SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EV in ) has emerged as a notable long-term sequela, potentially impacting respiratory and cardiovascular health. This study aims to assess the long-term presence of EV in afte...
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| Published in | BMC pulmonary medicine Vol. 24; no. 1; pp. 258 - 11 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
25.05.2024
BioMed Central Ltd BMC |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1471-2466 1471-2466 |
| DOI | 10.1186/s12890-024-03070-1 |
Cover
| Abstract | Background
SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EV
in
) has emerged as a notable long-term sequela, potentially impacting respiratory and cardiovascular health. This study aims to assess the long-term presence of EV
in
after 34 months and its association with cardiorespiratory health in post-COVID patients.
Methods
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 EV
in
and its correlation with respiratory and cardiovascular responses during exercise. Measurements included also V̇O
2peak,
end-tidal pressure of CO
2
(PET
CO2
) levels, oxygen uptake efficiency slope (OUES) and other cardiorespiratory parameters, with statistical significance set at
p
< 0.05. The presence of EV
in
at both T0 and T1 defines a persisting EV
in
(pEV
in
).
Results
Out of the cohort, five subjects (16%) have pEV
in
at 34 months. Subjects with pEV
in
, compared to those with ventilatory efficiency (Ev
ef
) have lower values of PET
CO2
throughout exercise, showing hyperventilation. Ev
ef
subjects demonstrated selective improvements in DL
CO
and oxygen pulse, suggesting a recovery in cardiorespiratory function over time. In contrast, those with pEv
in
did not exhibit these improvements. Notably, significant correlations were found between hyperventilation (measured by PET
CO2
), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Ev
in
in post-COVID follow-ups.
Conclusions
The study highlights the clinical importance of long-term follow-up for post-COVID patients, as a significant group exhibit persistent EV
in
, 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. |
|---|---|
| AbstractList | 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.BACKGROUNDSARS-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 V̇O2peak, end-tidal pressure of CO2 (PETCO2) 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).METHODSIn 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 V̇O2peak, end-tidal pressure of CO2 (PETCO2) 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 PETCO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DLCO 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 PETCO2), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups.RESULTSOut 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 PETCO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DLCO 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 PETCO2), 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.CONCLUSIONSThe 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. BackgroundSARS-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.MethodsIn 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 V̇O2peak, end-tidal pressure of CO2 (PETCO2) 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).ResultsOut 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 PETCO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DLCO 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 PETCO2), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups.ConclusionsThe 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 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 VÌO.sub.2peak, end-tidal pressure of CO.sub.2 (PET.sub.CO2) 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.sub.CO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DL.sub.CO 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.sub.CO2), 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. Background SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EV in ) has emerged as a notable long-term sequela, potentially impacting respiratory and cardiovascular health. This study aims to assess the long-term presence of EV in after 34 months and its association with cardiorespiratory health in post-COVID patients. Methods 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 EV in and its correlation with respiratory and cardiovascular responses during exercise. Measurements included also V̇O 2peak, end-tidal pressure of CO 2 (PET CO2 ) levels, oxygen uptake efficiency slope (OUES) and other cardiorespiratory parameters, with statistical significance set at p < 0.05. The presence of EV in at both T0 and T1 defines a persisting EV in (pEV in ). Results Out of the cohort, five subjects (16%) have pEV in at 34 months. Subjects with pEV in , compared to those with ventilatory efficiency (Ev ef ) have lower values of PET CO2 throughout exercise, showing hyperventilation. Ev ef subjects demonstrated selective improvements in DL CO and oxygen pulse, suggesting a recovery in cardiorespiratory function over time. In contrast, those with pEv in did not exhibit these improvements. Notably, significant correlations were found between hyperventilation (measured by PET CO2 ), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Ev in in post-COVID follow-ups. Conclusions The study highlights the clinical importance of long-term follow-up for post-COVID patients, as a significant group exhibit persistent EV in , 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. Abstract Background 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. Methods 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 V̇O2peak, end-tidal pressure of CO2 (PETCO2) 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). Results 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 PETCO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DLCO 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 PETCO2), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups. Conclusions 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 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. Background 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. Methods 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 VÌO.sub.2peak, end-tidal pressure of CO.sub.2 (PET.sub.CO2) 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). Results 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.sub.CO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DL.sub.CO 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.sub.CO2), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups. Conclusions 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. Keywords: COVID-19, Cardiopulmonary exercise test, Exercise ventilatory inefficiency, Hyperventilation, End-tidal pressure of CO.sub.2, Oxygen pulse |
| ArticleNumber | 258 |
| Audience | Academic |
| Author | Carbonare, Luca Dalle Bianchini, Nicola Capelli, Carlo Fasoli, Giulia Grassi, Bruno Dorelli, Gianluigi Ferrari, Marcello Crisafulli, Ernesto Braggio, Michele Sartori, Giulia Venturelli, Massimo Ridella, Nicolò |
| Author_xml | – sequence: 1 givenname: Gianluigi surname: Dorelli fullname: Dorelli, Gianluigi organization: School of Medicine in Sports and Exercise, University of Verona, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona – sequence: 2 givenname: Giulia surname: Sartori fullname: Sartori, Giulia organization: Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona – sequence: 3 givenname: Giulia surname: Fasoli fullname: Fasoli, Giulia organization: School of Medicine in Sports and Exercise, University of Verona – sequence: 4 givenname: Nicolò surname: Ridella fullname: Ridella, Nicolò organization: Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona – sequence: 5 givenname: Nicola surname: Bianchini fullname: Bianchini, Nicola organization: Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona – sequence: 6 givenname: Michele surname: Braggio fullname: Braggio, Michele organization: School of Medicine in Sports and Exercise, University of Verona – sequence: 7 givenname: Marcello surname: Ferrari fullname: Ferrari, Marcello organization: School of Medicine in Sports and Exercise, University of Verona, Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona – sequence: 8 givenname: Massimo surname: Venturelli fullname: Venturelli, Massimo organization: Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona – sequence: 9 givenname: Luca Dalle surname: Carbonare fullname: Carbonare, Luca Dalle organization: School of Medicine in Sports and Exercise, University of Verona – sequence: 10 givenname: Carlo surname: Capelli fullname: Capelli, Carlo organization: Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona – sequence: 11 givenname: Bruno surname: Grassi fullname: Grassi, Bruno organization: Department of Medicine, University of Udine – sequence: 12 givenname: Ernesto surname: Crisafulli fullname: Crisafulli, Ernesto email: ernesto.crisafulli@univr.it organization: Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38796432$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1007_s00421_024_05652_7 |
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| Keywords | COVID-19 Cardiopulmonary exercise test Exercise ventilatory inefficiency Oxygen pulse Hyperventilation End-tidal pressure of CO End-tidal pressure of CO2 |
| Language | English |
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| Snippet | Background
SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EV
in
) has emerged as a notable... SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EVin) has emerged as a notable long-term... Background SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EVin) has emerged as a notable... BackgroundSARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EVin) has emerged as a notable... Abstract Background SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EVin) has emerged as a... |
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| SubjectTerms | Adult Aged Analysis Artificial respiration Asymptomatic Blood pressure Carbon dioxide Cardiopulmonary exercise test Cardiovascular system Chronic illnesses COVID-19 COVID-19 - complications COVID-19 - physiopathology Critical Care Medicine Data analysis Efficiency Electrocardiography End-tidal pressure of CO2 Exercise Exercise - physiology Exercise Test Exercise tests Exercise ventilatory inefficiency Female Humans Hypertension Hyperventilation Hypotheses Infections Intensive Internal Medicine Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Oxygen Consumption - physiology Oxygen pulse Patient Discharge Patient outcomes Patients Physical fitness Physiology, Pathological Pneumology/Respiratory System SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 |
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| Title | Persisting exercise ventilatory inefficiency in subjects recovering from COVID-19. Longitudinal data analysis 34 months post-discharge |
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