biostudies-literatureUnknown34(12)Szekely Y<h4>Background</h4>A large number of patients around the world are recovering from coronavirus disease 2019 (COVID-19); many of them report persistence of symptoms. The aim of this study was to test pulmonary, cardiovascular, and peripheral responses to exercise in patients recovering from COVID-19.<h4>Methods</h4>Patients who recovered from COVID-19 were prospectively evaluated using a combined anatomic and functional assessment. All patients underwent clinical examination, laboratory tests, and combined stress echocardiography and cardiopulmonary exercise testing. Left ventricular volumes, ejection fraction, stroke volume, heart rate, E/e' ratio, right ventricular function, oxygen consumption (Vo₂), lung volumes, ventilatory efficiency, oxygen saturation, and muscle oxygen extraction were measured in all effort stages and compared with values in historical control subjects.<h4>Results</h4>A total of 71 patients were assessed 90.6 ± 26 days after the onset of COVID-19 symptoms. Only 23 (33%) were asymptomatic. The most common symptoms were fatigue (34%), muscle weakness or pain (27%), and dyspnea (22%). Vo₂ was lower among post-COVID-19 patients compared with control subjects (P = .03, group-by-time interaction P = .007). Reduction in peak Vo₂ was due to a combination of chronotropic incompetence (75% of post-COVID-19 patients vs 8% of control subjects, P < .0001) and an insufficient increase in stroke volume during exercise (P = .0007, group-by-time interaction P = .03). Stroke volume limitation was mostly explained by diminished increase in left ventricular end-diastolic volume (P = .10, group-by-time interaction P = .03) and insufficient increase in ejection fraction (P = .01, group-by-time interaction P = .01). Post-COVID-19 patients had higher peripheral oxygen extraction (P = .004) and did not have significantly different respiratory and gas exchange parameters compared with control subjects.<h4>Conclusions</h4>Patients recovering from COVID-19 have symptoms associated with objective reduction in peak Vo₂. The mechanism of this reduction is complex and mainly involves a combination of attenuated heart rate and stroke volume reserve.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography1273-1284.e9https://www.ebi.ac.uk/biostudies/studies/S-EPMC8425293biostudies-literatureCardiorespiratory Abnormalities in Patients Recovering from Coronavirus Disease 2019.PMC8425293Friedman STaieb PBanai AHochstadt ALichter YSadon STopilsky YLupu LLaufer-Perl MSzekely YGranot YBanai SSapir OfalseCardiorespiratory Abnormalities in Patients Recovering from Coronavirus Disease 2019.<h4>Background</h4>A large number of patients around the world are recovering from coronavirus disease 2019 (COVID-19); many of them report persistence of symptoms. The aim of this study was to test pulmonary, cardiovascular, and peripheral responses to exercise in patients recovering from COVID-19.<h4>Methods</h4>Patients who recovered from COVID-19 were prospectively evaluated using a combined anatomic and functional assessment. All patients underwent clinical examination, laboratory tests, and combined stress echocardiography and cardiopulmonary exercise testing. Left ventricular volumes, ejection fraction, stroke volume, heart rate, E/e' ratio, right ventricular function, oxygen consumption (Vo₂), lung volumes, ventilatory efficiency, oxygen saturation, and muscle oxygen extraction were measured in all effort stages and compared with values in historical control subjects.<h4>Results</h4>A total of 71 patients were assessed 90.6 ± 26 days after the onset of COVID-19 symptoms. Only 23 (33%) were asymptomatic. The most common symptoms were fatigue (34%), muscle weakness or pain (27%), and dyspnea (22%). Vo₂ was lower among post-COVID-19 patients compared with control subjects (P = .03, group-by-time interaction P = .007). Reduction in peak Vo₂ was due to a combination of chronotropic incompetence (75% of post-COVID-19 patients vs 8% of control subjects, P < .0001) and an insufficient increase in stroke volume during exercise (P = .0007, group-by-time interaction P = .03). Stroke volume limitation was mostly explained by diminished increase in left ventricular end-diastolic volume (P = .10, group-by-time interaction P = .03) and insufficient increase in ejection fraction (P = .01, group-by-time interaction P = .01). Post-COVID-19 patients had higher peripheral oxygen extraction (P = .004) and did not have significantly different respiratory and gas exchange parameters compared with control subjects.<h4>Conclusions</h4>Patients recovering from COVID-19 have symptoms associated with objective reduction in peak Vo₂. The mechanism of this reduction is complex and mainly involves a combination of attenuated heart rate and stroke volume reserve.2021-01-01T00:00:00Z2021 Dec2024-02-15T09:58:14.848Z2022-02-11T13:25:38.723ZS-EPMC84252933450883710.1016/j.echo.2021.08.022