PDF(Pubmed)
Abstract：
BACKGROUND: SARS-CoV-2 infection has raised concerns about long-term health repercussions. Exercise ventilatory inefficiency (EVin) has emerged as a notable long-term sequela, potentially impacting respiratory and cardiovascular health. This study aims to assess the long-term presence of EVin after 34 months and its association with cardiorespiratory health in post-COVID patients.
METHODS: In a longitudinal study on 32 selected post-COVID subjects, we performed two cardiopulmonary exercise tests (CPETs) at 6 months (T0) and 34 months (T1) after hospital discharge. The study sought to explore the long-term persistence of EVin and its correlation with respiratory and cardiovascular responses during exercise. Measurements included also V̇O2peak, end-tidal pressure of CO2 (PETCO2) levels, oxygen uptake efficiency slope (OUES) and other cardiorespiratory parameters, with statistical significance set at p < 0.05. The presence of EVin at both T0 and T1 defines a persisting EVin (pEVin).
RESULTS: Out of the cohort, five subjects (16%) have pEVin at 34 months. Subjects with pEVin, compared to those with ventilatory efficiency (Evef) have lower values of PETCO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DLCO and oxygen pulse, suggesting a recovery in cardiorespiratory function over time. In contrast, those with pEvin did not exhibit these improvements. Notably, significant correlations were found between hyperventilation (measured by PETCO2), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups.
CONCLUSIONS: The study highlights the clinical importance of long-term follow-up for post-COVID patients, as a significant group exhibit persistent EVin, which correlates with altered and potentially unfavorable cardiovascular responses to exercise. These findings advocate for the continued investigation into the long-term health impacts of COVID-19, especially regarding persistent ventilatory inefficiencies and their implications on patient health outcomes.
METHODS: In a longitudinal study on 32 selected post-COVID subjects, we performed two cardiopulmonary exercise tests (CPETs) at 6 months (T0) and 34 months (T1) after hospital discharge. The study sought to explore the long-term persistence of EVin and its correlation with respiratory and cardiovascular responses during exercise. Measurements included also V̇O2peak, end-tidal pressure of CO2 (PETCO2) levels, oxygen uptake efficiency slope (OUES) and other cardiorespiratory parameters, with statistical significance set at p < 0.05. The presence of EVin at both T0 and T1 defines a persisting EVin (pEVin).
RESULTS: Out of the cohort, five subjects (16%) have pEVin at 34 months. Subjects with pEVin, compared to those with ventilatory efficiency (Evef) have lower values of PETCO2 throughout exercise, showing hyperventilation. Evef subjects demonstrated selective improvements in DLCO and oxygen pulse, suggesting a recovery in cardiorespiratory function over time. In contrast, those with pEvin did not exhibit these improvements. Notably, significant correlations were found between hyperventilation (measured by PETCO2), oxygen pulse and OUES, indicating the potential prognostic value of OUES and Evin in post-COVID follow-ups.
CONCLUSIONS: The study highlights the clinical importance of long-term follow-up for post-COVID patients, as a significant group exhibit persistent EVin, which correlates with altered and potentially unfavorable cardiovascular responses to exercise. These findings advocate for the continued investigation into the long-term health impacts of COVID-19, especially regarding persistent ventilatory inefficiencies and their implications on patient health outcomes.
摘要：
背景：SARS-CoV-2感染引起了人们对长期健康影响的担忧。运动通气效率低下（EVin）已成为一个值得注意的长期后遗症，可能影响呼吸和心血管健康。这项研究旨在评估34个月后EVin的长期存在及其与COVID后患者心肺健康的关系。
方法：在对32名选定的COVID后受试者的纵向研究中，我们在出院后6个月(T0)和34个月(T1)进行了两项心肺运动试验(CPET).该研究试图探索EVin的长期持久性及其与运动期间呼吸和心血管反应的相关性。测量还包括V♪O2peak，呼气末二氧化碳压力(PETCO2)水平，吸氧效率斜率(OUES)和其他心肺参数，统计学意义设置为p<0.05。在T0和T1处的EVin的存在定义了持续的EVin(pEVin)。
结果：在队列中，5名受试者(16%)在34个月时有pEVin。有pEVin的受试者，与具有通气效率（Evef）的人相比，在整个运动过程中PETCO2的值较低，显示过度换气。Evef受试者表现出DLCO和氧脉冲的选择性改善，表明心肺功能随着时间的推移而恢复。相比之下,那些有pEvin的人没有表现出这些改进。值得注意的是,发现过度换气(通过PETCO2测量)、氧气脉冲和OUES，提示OUES和Evin在COVID后随访中的潜在预后价值。
结论：该研究强调了对COVID后患者进行长期随访的临床重要性，作为一个重要的群体，表现出持续的EVIN，这与对运动的改变和潜在不利的心血管反应相关。这些发现主张继续调查COVID-19对健康的长期影响，特别是关于持续的通气效率低下及其对患者健康结果的影响。
方法：在对32名选定的COVID后受试者的纵向研究中，我们在出院后6个月(T0)和34个月(T1)进行了两项心肺运动试验(CPET).该研究试图探索EVin的长期持久性及其与运动期间呼吸和心血管反应的相关性。测量还包括V♪O2peak，呼气末二氧化碳压力(PETCO2)水平，吸氧效率斜率(OUES)和其他心肺参数，统计学意义设置为p<0.05。在T0和T1处的EVin的存在定义了持续的EVin(pEVin)。
结果：在队列中，5名受试者(16%)在34个月时有pEVin。有pEVin的受试者，与具有通气效率（Evef）的人相比，在整个运动过程中PETCO2的值较低，显示过度换气。Evef受试者表现出DLCO和氧脉冲的选择性改善，表明心肺功能随着时间的推移而恢复。相比之下,那些有pEvin的人没有表现出这些改进。值得注意的是,发现过度换气(通过PETCO2测量)、氧气脉冲和OUES，提示OUES和Evin在COVID后随访中的潜在预后价值。
结论：该研究强调了对COVID后患者进行长期随访的临床重要性，作为一个重要的群体，表现出持续的EVIN，这与对运动的改变和潜在不利的心血管反应相关。这些发现主张继续调查COVID-19对健康的长期影响，特别是关于持续的通气效率低下及其对患者健康结果的影响。
