Functional Capacity in Patients Who Recovered from Mild COVID-19 with Exertional Dyspnea

Abstract

Background: Post mild COVID-19 dyspnea is poorly understood. We assessed physiologic limitations in these patients. Methods: Patients with post mild COVID-19 dyspnea (group A) were compared (pulmonary function tests, 6-min walk test (6MWT), echocardiography and cardiopulmonary exercise test (CPET)) to post moderate/severe COVID-19 (group B) and to CPET and spirometry of patients with unexplained dyspnea (group C). Results: The study included 36 patients (13 in A, 9 in B and 14 in C). Diffusion capacity was lower in group B compared to group A (64 ± 8 vs. 85 ± 9% predicted, p = 0.014). 6MWT was normal and similar in both patient groups. Oxygen uptake was higher in group A compared to groups B and C (108 ± 14 vs. 92 ± 13 and 91 ± 23% predicted, p = 0.013, 0.03, respectively). O2 pulse was normal in all three groups but significantly higher in the mild group compared to the control group. Breathing reserve was low/borderline in 2/13 patients in the mild group, 2/9 in the moderate/severe group and 3/14 in the control group (NS). Conclusions: Patients with post mild COVID-19 dyspnea had normal CPET, similar to patients with unexplained dyspnea. Other mechanisms should be investigated and the added value of CPET to patients with post mild COVID-19 dyspnea is questionable.

Physical exercise-related manifestations of long COVID: A systematic review and meta-analysis

“…In addition, a manual search yielded 687, 374, and 500 records from the WHO Global Research Database on COVID-19, LitCovid, and Google Scholar, respectively. We finally identified 40 studies, of which 25 were further included in the meta-analysis 9 , 10 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 and 15 were excluded owing to incomplete information or data. 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 The detailed search results are presented in the PRISMA flowchart in Fig.…”

“… 38 , 54 Most of the included studies were cohort, cross-sectional and case-control studies, while one did not report the study design. 34 In addition, included studies were published in 2021–2024 and from several countries, including seven from United Kingdom, 10,24,30,38,40,43,55 four each from the United States 9 , 33 , 41 , 54 and Spain, 32 , 44 , 45 , 59 three each from China, 25 , 48 , 51 Netherlands, 28 , 46 , 60 two each from Canada, 23 , 50 Brazil, 31 , 56 Italy, 27 , 42 Turkey, 34 , 58 Austria, 37 , 57 and Israel, 26 , 36 and one each from Ecuador, 47 Belgium, 29 Egypt, 49 Norway, 52 Greece, 35 Switzerland, 53 and Sweden. 39 However, no studies from South Asian and African countries were found.…”

“…The physical exercise-related manifestations of PASC were assessed in the included studies using cardiopulmonary exercise testing (CPET), 9 , 10 , 23 , 24 , 26 , 29 , 30 , 31 , 32 , 33 , 36 , 37 , 40 , 41 , 42 , 43 , 52 6MWT, 25 , 26 , 34 , 35 , 39 , 44 , 49 , 50 , 57 personalized exercise testing, 28 , 58 and/or physical exercise/physical activity-related questionnaires 27 , 30 , 31 , 34 , 38 , 43 , 45 , 46 , 47 , 48 , 50 , 51 , 53 , 54 , 55 , 56 , 59 , 60 in the included studies. Primary and secondary outcomes were measured prior to and/or post exercise testing in both COVID-19 survivors and non-COVID-19 controls at least 3 months post-SARS-CoV-2 infection (from 3 to 15 month).…”

6-minute walk test in patients hospitalized with COVID-19

“…В то же время состояние больных, не имеющих гипоксемии исходно, может ухудшиться в процессе наблюдения. Кроме того, было показано, что даже при минимальной симптоматике люди могут иметь значимые нарушения после выздоровления от острого COVID-19, и это подчеркивает важность превентивных стратегий для смягчения последствий распространения НКИ [13]. Для выявления «скрытой» гипоксемии можно использовать тесты с физической нагрузкой.…”

Spontaneous physical functional recovery after hospitalization for COVID-19: insights from a 1 month follow-up and a model to predict poor trajectory

“…Assessment of the origin of physically limiting symptoms in the post-acute COVID-19 setting is frequently complicated due to significant heterogeneity of possible underlying mechanisms. The latter might include signs of pulmonary restriction and decreased diffusing capacity ( 9 , 10 ), cardiac dysfunction ( 2 , 11 ), and a significant share of unexplained cases, the rate of which is generally higher in non-severe COVID-19 convalescents ( 12 ).…”