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Reduced Exercise Capacity, Chronotropic Incompetence, and Early Systemic Inflammation in Cardiopulmonary Phenotype
Matthew S Durstenfeld1,2, Michael J Peluso1,3, Punita Kaveti1,4
1Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
The Journal of Infectious Diseases
|May 11, 2023
Summary
Persistent cardiopulmonary symptoms after COVID-19 are linked to reduced exercise capacity. Early inflammatory markers correlate with this decreased capacity, and chronotropic incompetence may contribute to exercise intolerance in long COVID patients.
Area of Science:
- Cardiology
- Pulmonology
- Infectious Diseases
Background:
- Mechanisms of persistent cardiopulmonary symptoms after SARS-CoV-2 infection (long COVID) are not well understood.
- Post-acute sequelae of COVID-19 (PASC) can significantly impact quality of life.
- Understanding these long-term effects is crucial for patient management.
Purpose of the Study:
- To investigate the mechanisms behind cardiopulmonary symptoms and reduced exercise capacity in individuals post-COVID-19.
- To identify physiological factors contributing to long COVID-related exercise intolerance.
- To correlate clinical findings with early-stage biomarkers.
Main Methods:
- Cardiopulmonary exercise testing (CPET) was performed on adults over one year after SARS-CoV-2 infection.
- Cardiac magnetic resonance imaging (CMR) and ambulatory rhythm monitoring were utilized.
- Findings were compared between symptomatic and asymptomatic individuals and correlated with prior biomarker data.
Main Results:
- Nearly half of symptomatic participants (49%) exhibited reduced exercise capacity compared to 16% of asymptomatic individuals.
- Symptomatic individuals showed significantly lower peak oxygen consumption (VO2).
- Chronotropic incompetence was frequently observed; no significant cardiac abnormalities or arrhythmias were detected by CMR.
Conclusions:
- Cardiopulmonary symptoms persisting over a year after COVID-19 are associated with diminished exercise capacity.
- Reduced exercise capacity in long COVID is linked to inflammatory markers measured earlier in the disease course.
- Chronotropic incompetence is a potential explanation for exercise intolerance in some long COVID patients.
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