Cardiopulmonary Exercise Testing in Children With Long COVID: A Case-controlled Study

Area of Science:

• Pediatric Pulmonology
• Cardiology
• Exercise Physiology

Background:

• Cardiopulmonary exercise testing (CPET) is a valuable tool for assessing cardiopulmonary and skeletal muscle function.
• While extensively used in adults with Long COVID (LC), its application in pediatric LC populations is less understood.

Purpose of the Study:

• To investigate the utility of CPET in evaluating functional capacity in children diagnosed with Long COVID.
• To compare CPET findings between children with LC and healthy controls.
• To analyze CPET results based on symptom clusters in pediatric LC patients.

Main Methods:

• A prospective, case-controlled observational study design was employed.
• Children diagnosed with LC and a group of healthy children underwent standardized CPET.
• CPET data were analyzed and compared between the LC and control groups.

Main Results:

• 90.2% of children with LC exhibited abnormal CPET results, compared to 10.3% in the healthy control group.
• Pediatric LC patients showed significantly higher probabilities of abnormal peak VO2, AT% pred, VO2/HR %, VO2 work slope, and VE/VCO2 slope.
• Mean VO2 peak was significantly lower in children with LC (30.17 ±6.85) versus healthy controls (34.37 ±6.55).

Conclusions:

• Children with Long COVID demonstrate objectively impaired functional capacity, including reduced VO2 peak, deconditioning, and cardiogenic inefficiency, as evidenced by CPET.
• CPET is recommended for routine clinical use in pediatric LC to objectively assess and phenotype functional limitations.
• CPET can aid in monitoring the follow-up progression of functional capacity in children with LC.