Oxygen uptake kinetics and chronotropic responses to exercise are impaired in survivors of severe COVID-19
The post-acute phase of coronavirus disease 2019 (COVID-19) is often marked by several persistent symptoms and exertional intolerance, which compromise survivors' exercise capacity. This was a cross-sectional study aiming to investigate the impact of COVID-19 on oxygen uptake (V̇o2) kinetics and cardiopulmonary function in survivors of severe COVID-19 about 3-6 mo after intensive care unit (ICU) hospitalization. Thirty-five COVID-19 survivors previously admitted to ICU (5 ± 1 mo after hospital discharge) and 18 controls matched for sex, age, comorbidities, and physical activity level with no prior history of SARS-CoV-2 infection were recruited. Subjects were submitted to a maximum-graded cardiopulmonary exercise test (CPX) with an initial 3-min period of a constant, moderate-intensity walk (i.e., below ventilatory threshold, VT). V̇o2 kinetics was remarkably impaired in COVID-19 survivors as evidenced at the on-transient by an 85% (P = 0.008) and 28% (P = 0.001) greater oxygen deficit and mean response time (MRT), respectively. Furthermore, COVID-19 survivors showed an 11% longer (P = 0.046) half-time of recovery of V̇o2 (T1/2V̇o2) at the off-transient. CPX also revealed cardiopulmonary impairments following COVID-19. Peak oxygen uptake (V̇o2peak), percent-predicted V̇o2peak, and V̇o2 at the ventilatory threshold (V̇o2VT) were reduced by 17%, 17%, and 12% in COVID-19 survivors, respectively (all P < 0.05). None of the ventilatory parameters differed between groups (all P > 0.05). In addition, COVID-19 survivors also presented with blunted chronotropic responses (i.e., chronotropic index, maximum heart rate, and heart rate recovery; all P < 0.05). These findings suggest that COVID-19 negatively affects central (chronotropic) and peripheral (metabolic) factors that impair the rate at which V̇o2 is adjusted to changes in energy demands.NEW & NOTEWORTHY Our findings provide novel data regarding the impact of COVID-19 on submaximal and maximal cardiopulmonary responses to exercise. We showed that V̇o2 kinetics is significantly impaired at both the onset (on-transient) and the recovery phase (off-transient) of exercise in these patients. Furthermore, our results suggest that survivors of severe COVID-19 may have a higher metabolic demand at a walking pace. These findings may partly explain the exertional intolerance frequently observed following COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:323 |
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| Enthalten in: |
American journal of physiology. Heart and circulatory physiology - 323(2022), 3 vom: 01. Sept., Seite H569-H576 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Longobardi, Igor [VerfasserIn] |
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| Links: |
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| Themen: |
Aerobic fitness |
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| Anmerkungen: |
Date Completed 08.09.2022 Date Revised 15.09.2022 published: Print-Electronic figshare: 10.6084/m9.figshare.20323812.v2 Citation Status MEDLINE |
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| doi: |
10.1152/ajpheart.00291.2022 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM345033124 |
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| 245 | 1 | 0 | |a Oxygen uptake kinetics and chronotropic responses to exercise are impaired in survivors of severe COVID-19 |
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| 500 | |a Date Revised 15.09.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a figshare: 10.6084/m9.figshare.20323812.v2 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a The post-acute phase of coronavirus disease 2019 (COVID-19) is often marked by several persistent symptoms and exertional intolerance, which compromise survivors' exercise capacity. This was a cross-sectional study aiming to investigate the impact of COVID-19 on oxygen uptake (V̇o2) kinetics and cardiopulmonary function in survivors of severe COVID-19 about 3-6 mo after intensive care unit (ICU) hospitalization. Thirty-five COVID-19 survivors previously admitted to ICU (5 ± 1 mo after hospital discharge) and 18 controls matched for sex, age, comorbidities, and physical activity level with no prior history of SARS-CoV-2 infection were recruited. Subjects were submitted to a maximum-graded cardiopulmonary exercise test (CPX) with an initial 3-min period of a constant, moderate-intensity walk (i.e., below ventilatory threshold, VT). V̇o2 kinetics was remarkably impaired in COVID-19 survivors as evidenced at the on-transient by an 85% (P = 0.008) and 28% (P = 0.001) greater oxygen deficit and mean response time (MRT), respectively. Furthermore, COVID-19 survivors showed an 11% longer (P = 0.046) half-time of recovery of V̇o2 (T1/2V̇o2) at the off-transient. CPX also revealed cardiopulmonary impairments following COVID-19. Peak oxygen uptake (V̇o2peak), percent-predicted V̇o2peak, and V̇o2 at the ventilatory threshold (V̇o2VT) were reduced by 17%, 17%, and 12% in COVID-19 survivors, respectively (all P < 0.05). None of the ventilatory parameters differed between groups (all P > 0.05). In addition, COVID-19 survivors also presented with blunted chronotropic responses (i.e., chronotropic index, maximum heart rate, and heart rate recovery; all P < 0.05). These findings suggest that COVID-19 negatively affects central (chronotropic) and peripheral (metabolic) factors that impair the rate at which V̇o2 is adjusted to changes in energy demands.NEW & NOTEWORTHY Our findings provide novel data regarding the impact of COVID-19 on submaximal and maximal cardiopulmonary responses to exercise. We showed that V̇o2 kinetics is significantly impaired at both the onset (on-transient) and the recovery phase (off-transient) of exercise in these patients. Furthermore, our results suggest that survivors of severe COVID-19 may have a higher metabolic demand at a walking pace. These findings may partly explain the exertional intolerance frequently observed following COVID-19 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a aerobic fitness | |
| 650 | 4 | |a exercise physiology | |
| 650 | 4 | |a long covid | |
| 650 | 4 | |a oxidative capacity | |
| 650 | 4 | |a submaximal exercise | |
| 650 | 7 | |a Oxygen |2 NLM | |
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| 700 | 1 | |a Prado, Danilo Marcelo Leite do |e verfasserin |4 aut | |
| 700 | 1 | |a Goessler, Karla Fabiana |e verfasserin |4 aut | |
| 700 | 1 | |a Meletti, Matheus Molina |e verfasserin |4 aut | |
| 700 | 1 | |a de Oliveira Júnior, Gersiel Nascimento |e verfasserin |4 aut | |
| 700 | 1 | |a de Andrade, Danieli Castro Oliveira |e verfasserin |4 aut | |
| 700 | 1 | |a Gualano, Bruno |e verfasserin |4 aut | |
| 700 | 1 | |a Roschel, Hamilton |e verfasserin |4 aut | |
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