Obese Patients With Long COVID-19 Display Abnormal Hyperventilatory Response and Impaired Gas Exchange at Peak Exercise

Abstract

Aim: To analyze the impact of obesity on cardiopulmonary response to exercise in people with chronic post-coronavirus disease 2019 (COVID-19) syndrome. Patients & methods: Consecutive subjects with chronic post-COVID syndrome 6 months after nonsevere acute infection were included. All patients received a complete clinical evaluation, lung function tests and cardiopulmonary exercise testing. A total of 51 consecutive patients diagnosed with chronic post-COVID-19 were enrolled in this study. Results: More than half of patients with chronic post-COVID-19 had a significant alteration in aerobic exercise capacity (VO2peak) 6 months after hospital discharge. Obese long-COVID-19 patients also displayed a marked reduction of oxygen pulse (O2pulse). Conclusion: Obese patients were more prone to have pathological pulmonary limitation and pulmonary gas exchange impairment to exercise compared with nonobese COVID-19 patients.

The impact of body mass index on long-term survival after ICU admission due to COVID-19: A retrospective multicentre study

“…Although the median time spent outside the ICU was 7–10 h, fluid management acutely and the loss of lean mass (over days to weeks in the hospital) could have affected the weight and BMI. Fifth, although there is evidence that patients with obesity were more prone to have pathological pulmonary limitation and pulmonary gas exchange impairment to exercise compared with nonobese COVID-19 patients, 62 we did not have the functional outcome following hospitalisation. Sixth, after discharge, the database did not record any ongoing healthcare needs following discharge.…”

Are the Comorbidities Constitute an Intrinsic Factor for Long COVID?

“…A longitudinal study reported a higher prevalence of persistent symptoms, including fatigue, dyspnea, cognitive dysfunction, and cardiovascular complications among individuals with obesity following acute COVID-19 infection [121]. Also, a study indicated that obesity was associated with abnormal hyperventilatory response and impaired gas exchange during exercise in individuals with long COVID, suggesting a potential link between obesity and long-term respiratory complications [123].…”

The intersection of obesity and (long) COVID-19: Hypoxia, thrombotic inflammation, and vascular endothelial injury

“…Meanwhile, obesity can have additional effects on the pulmonary sequelae in long COVID. Analysis of an observational study found that patients with obesity and chronic COVID-19 displayed exaggerated ventilatory drive and impaired oxygenation at peak exercise, accompanied by lower lung volume, decreased ventilation reserve (25 vs. 40, p = 0.011), and lower peripheral capillary oxygen saturation values (96 vs. 98, p = 0.036) 6 months after hospital discharge ( 104 ). The PHOSP-COVID Collaborative Group compared patient-reported outcomes between 5 months and 1 year and demonstrated that FEV1% < 80% predicted only minimal change, while cognitive impairment significantly improved ( 12 ).…”

“…The PHOSP-COVID Collaborative Group compared patient-reported outcomes between 5 months and 1 year and demonstrated that FEV1% < 80% predicted only minimal change, while cognitive impairment significantly improved ( 12 ). Compared with non-COVID-19 participants with obesity, post-COVID patients with obesity had significantly reduced oxygen pulse (66 vs. 76, p = 0.003), indicating poor cardiac function in convalescence ( 104 ). Both hypoxia and thrombotic inflammation can affect myocardial metabolism, resulting in loss of normal systolic and diastolic functions of the damaged myocardium, pulmonary congestion, and insufficient systemic circulation blood volume.…”