Exercise intolerance associated with impaired oxygen extraction in patients with long COVID

Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for...

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Bibliographic Details
Published in:Respiratory physiology & neurobiology 2023-07, Vol.313, p.104062-104062, Article 104062
Main Authors: Norweg, Anna, Yao, Lanqiu, Barbuto, Scott, Nordvig, Anna S., Tarpey, Thaddeus, Collins, Eileen, Whiteson, Jonathan, Sweeney, Greg, Haas, Francois, Leddy, John
Format: Article
Language:English
Subjects:
Chronotropic intolerance
COVID-19
Dysautonomia
Energy metabolism
Exercise intolerance
Exercise Test
Exercise Tolerance - physiology
Humans
Long COVID-19
Oxygen
Oxygen Consumption - physiology
Post-Acute COVID-19 Syndrome
Post-exertional malaise
Retrospective Studies
Short Communication
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Summary:Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for a cardiopulmonary exercise test (CPET) and included in a COVID-19 Survivorship Registry at one urban health center were retrospectively analyzed. Results: Most subjects did not meet normative criteria for a maximal test, consistent with suboptimal effort and early exercise termination. Mean O2 pulse peak % predicted (of 79 ± 12.9) was reduced, supporting impaired energy metabolism as a mechanism of exercise intolerance in long COVID, n = 59. We further identified blunted rise in heart rate peak during maximal CPET. Our preliminary analyses support therapies that optimize bioenergetics and improve oxygen utilization for treating long COVID-19. •Reduced O2 pulse peak % predicted (impaired oxygen extraction) may be a mechanism of chronic fatigue and exercise intolerance in long COVID.•Our study identified chronotropic intolerance as a potential biomarker in long COVID.•Impaired O2 extraction may have contributed to both mental and peripheral muscle fatigue and early exercise termination in long COVID.•We recommend low-intensity, sub-symptom aerobic exercise to treat long COVID.
ISSN:1569-9048
1878-1519
DOI:10.1016/j.resp.2023.104062