Cardiopulmonary Exercise Testing Reveals Functional Limitations and Work Disability in Severe Post-COVID-19 and...

Area of Science:

• Sports Medicine
• Rehabilitation Medicine
• Occupational Health

Background:

• Post-COVID-19 condition (PCC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often lead to long-term work incapacity.
• Traditional clinical diagnostics may not fully explain the work disability experienced by these patients.

Purpose of the Study:

• To objectively assess physical work ability in severely affected PCC patients using cardiopulmonary exercise testing (CPET).
• To investigate differences in exercise capacity between ME/CFS and non-ME/CFS PCC patients.
• To determine the correlation between objective measures of work disability and subjective patient-reported disability.

Main Methods:

• A cohort of 92 PCC patients underwent symptom-limited CPET.
• Patients completed validated questionnaires including the Canadian Consensus Criteria, Bell Disability Scale, and DePaul Symptom Questionnaire (Post-Exertional Malaise) Short Form.
• Analysis focused on peak oxygen uptake (VO₂peak), peak power output (PPO), and oxygen pulse (O₂ pulse).

Main Results:

• Nearly half of the patients (49%) met ME/CFS criteria, with 79% screening positive for post-exertional malaise.
• ME/CFS patients exhibited significantly lower VO₂peak, PPO, and O₂ pulse compared to non-ME/CFS patients.
• 66% of all patients met objective thresholds for work disability, with reduced exercise capacity correlating with subjective disability and lower occupational status.

Conclusions:

• Severely affected PCC patients, especially those with ME/CFS, exhibit objective work disability.
• CPET-derived measures like VO₂peak and PPO are associated with subjective disability and current occupational status.
• Integrating CPET into clinical and occupational evaluations can aid in personalized therapy and return-to-work strategies.