Changes in cardiopulmonary exercise capacity and limitations 3 to 12 months after COVID-19
Charlotte Björk Ingul, Anne Edvardsen, Turid Follestad, Divna Trebinjac, Odd Andre Wathne Ankerstjerne, Eivind Brønstad, Øystein Rasch-Halvorsen, Bernt Aarli, Håvard Dalen, Bjarne Martens Nes, Tøri Vigeland Lerum, Gunnar Einvik, Knut Stavem, Ingunn Skjørten
European Respiratory Journal 2022; DOI: 10.1183/13993003.00745-2022
Abstract
Rationale To describe cardiopulmonary function during exercise 12months after hospital discharge for COVID-19, assess the change from 3 to 12months, and compare the results with matched controls without COVID-19.
Methods In this prospective, longitudinal, multicentre cohort study, hospitalized COVID-19 patients were examined with a cardiopulmonary exercise test (CPET) 3 and 12months after discharge. At 3months 180 performed a successful CPET, and 177 at 12months (mean age 59.3years, 85 females). The COVID-19 patients were compared with controls without COVID-19 matched for age, sex, body mass index, and comorbidity. Main outcome was peak oxygen uptake (V′O2peak).
Results Exercise intolerance (V′O2peak <80% predicted) was observed in 23% at 12months, related to circulatory (28%), ventilatory (17%), and other limitations including deconditioning, and dysfunctional breathing (55%). Estimated mean difference between 3 and 12months showed significant increases in V′O2peak % predicted (5.0 percent points (pp), 95% CI (3.1 to 6.9), p<0.001), V′O2peak·kg−1% predicted (3.4 pp, (1.6 to 5.1), p<0.001), and oxygen pulse % predicted (4.6 pp, (2.5 to 6.8), p<0.001). V′O2peak was 2440mL min−1 in COVID-19 patients compared to 2972mL min−1 in matched controls
Conclusions One year after hospital discharge for COVID-19, the majority, 77%, had normal exercise capacity. Only every fourth had exercise intolerance and in these circulatory limiting factors were more common than ventilatory. Deconditioning was common. V′O2peak and oxygen pulse improved significantly from 3months.