Indications and outcomes of exercise challenge tests performed in children before and during COVID-19 pandemic

Abstract

COVID-19 pandemic has had a signi�icant impact on general health. In fact, although barely affected by respiratory problems, children and adolescents undoubtedly suffered from the consequences of the pandemic, especially from a psychological standpoint. We aimed to evaluate whether the COVID-19 pandemic modi�ied the indications and the results of Exercise Challenge Tests (ECTs) conducted in a pediatric pulmonology center. This was an observational retrospective monocenter study. We analyzed indications and results of all the ECTs performed between March 2021 and September 2022 (COVID-19 period) and, for comparison, those performed between September 2018 and March 2020 (pre-COVID-19 period). 62 ECTs were performed during the COVID-19 period and 64 during the pre-COVID-19 (proportion of positive test 19.3% and 18.7%, respectively). During the COVID-19 period there was a signi�icant increase (18 vs 4) in the number of ECTs requested because of a mix of subjective respiratory symptoms and vague non-respiratory symptoms and all these tests resulted negative. During the pandemic era we observed an increased number of children and adolescents complaining mixed subjective exercise-related respiratory and non-respiratory symptoms. The ECTs conducted in these patients were all negative, suggesting a functional nature for the reported symptoms.