Cardiovascular evaluation using exercise testing performed with face masks during the COVID-19 pandemic

Area of Science:

• Cardiology
• Public Health
• Infectious Diseases

Background:

• Non-communicable diseases cause significant morbidity and mortality globally.
• The COVID-19 pandemic led to delays in diagnosing and treating heart disease, particularly exercise testing (ET).
• Fear of viral transmission and aerosol generation impacted the performance of essential cardiac diagnostics.

Purpose of the Study:

• To evaluate ergometric performance during exercise testing amidst the COVID-19 pandemic.
• To compare exercise test results from the pandemic era (PANDEMIC-G) with a pre-pandemic period (NO PANDEMIC).
• To identify changes in patient response and physiological parameters during exercise under pandemic conditions.

Main Methods:

• A cross-sectional study comparing 152 patients from the PANDEMIC-G group (March-December 2020) with 209 from the NO PANDEMIC group (March-December 2019).
• All PANDEMIC-G participants underwent biological triage and wore N95 masks during ET.
• Demographic and ergometric variables were analyzed, with statistical significance set at p < 0.05.

Main Results:

• Fewer ET were performed during the PANDEMIC-G period (42%) compared to NO PANDEMIC (58%).
• Significantly more ET in the PANDEMIC-G group were terminated due to dyspnea (117 vs. 8).
• While exercise tolerance showed no significant change, systolic blood pressure, double product, and myocardial oxygen utilization were higher in the PANDEMIC-G group (p < 0.01).

Conclusions:

• The COVID-19 pandemic era saw a reduction in exercise stress tests performed.
• Exercise tests were more frequently halted due to dyspnea during the pandemic.
• Elevated systolic blood pressure and myocardial oxygen utilization were noted in patients undergoing exercise testing during the pandemic.