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

oleh: Gianluigi Dorelli, Michele Braggio, Daniele Gabbiani, Fabiana Busti, Marco Caminati, Gianenrico Senna, Domenico Girelli, Pierantonio Laveneziana, Marcello Ferrari, Giulia Sartori, Luca Dalle Carbonare, Ernesto Crisafulli, on behalf of the RESPICOVID Study Investigators

Format: Article
Diterbitkan: MDPI AG 2021-03-01

Deskripsi

The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (V<sub>E</sub>) coupled to carbon dioxide output (V<sub>CO2</sub>) (V<sub>E</sub>/V<sub>CO2</sub>); high values of V<sub>E</sub>/V<sub>CO2 slope</sub> define an exercise ventilatory inefficiency (EV<i>in</i>). 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 V<sub>E</sub>/V<sub>CO2 slope</sub>, subjects were divided into having EV<i>in</i> and exercise ventilatory efficiency (EV<i>ef</i>). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EV<i>in</i>. As compared to subjects with EV<i>ef</i>, subjects with EV<i>in</i> showed a reduction in heart rate (HR) recovery. V<sub>E</sub>/V<sub>CO2 slope</sub> 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 EV<i>in</i>. The relationship between EV<i>in</i> and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.