Cardiopulmonary Exercise Testing Distinguishes between Post-COVID-19 as a Dysfunctional Syndrome and Organ Pathologies.
Johannes KerstenLuis HoyoAlexander WolfElina HüllSamuel NunnMarijana TadicDominik ScharnbeckWolfgang RottbauerDominik BuckertPublished in: International journal of environmental research and public health (2022)
(1) Background: Dyspnea is one of the most frequent symptoms among post-COVID-19 patients. Cardiopulmonary exercise testing (CPET) is key to a differential diagnosis of dyspnea. This study aimed to describe and classify patterns of cardiopulmonary dysfunction in post-COVID-19 patients, using CPET. (2) Methods: A total of 143 symptomatic post-COVID-19 patients were included in the study. All patients underwent CPET, including oxygen consumption, slope of minute ventilation to CO 2 production, and capillary blood gas testing, and were evaluated for signs of limitation by two experienced examiners. In total, 120 patients reached a satisfactory level of exertion and were included in further analyses. (3) Results: Using CPET, cardiovascular diseases such as venous thromboembolism or ischemic and nonischemic heart disease were identified as either cardiac (4.2%) or pulmonary vascular (5.8%) limitations. Some patients also exhibited dysfunctional states, such as deconditioning (15.8%) or pulmonary mechanical limitation (9.2%), mostly resulting from dysfunctional breathing patterns. Most (65%) patients showed no signs of limitation. (4) Conclusions: CPET can identify patients with distinct limitation patterns, and potentially guide further therapy and rehabilitation. Dysfunctional breathing and deconditioning are crucial factors for the evaluation of post-COVID-19 patients, as they can differentiate these dysfunctional syndromes from organic diseases. This highlights the importance of dynamic (as opposed to static) investigations in the post-COVID-19 context.
Keyphrases
- end stage renal disease
- sars cov
- newly diagnosed
- venous thromboembolism
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- cardiovascular disease
- pulmonary hypertension
- type diabetes
- coronavirus disease
- stem cells
- heart failure
- intensive care unit
- left ventricular
- atrial fibrillation
- coronary artery disease
- ionic liquid
- ischemia reperfusion injury
- oxidative stress
- mesenchymal stem cells
- brain injury
- smoking cessation
- blood brain barrier
- mechanical ventilation
- cardiovascular risk factors