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

Respir Physiol Neurobiol. 2023 Jul:313:104062. doi: 10.1016/j.resp.2023.104062. Epub 2023 Apr 17.

Abstract

Objective: 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.

Keywords: Chronotropic intolerance; Dysautonomia; Energy metabolism; Exercise intolerance; Long COVID-19; Post-exertional malaise.

MeSH terms

  • COVID-19*
  • Exercise Test
  • Exercise Tolerance / physiology
  • Humans
  • Oxygen
  • Oxygen Consumption / physiology
  • Post-Acute COVID-19 Syndrome*
  • Retrospective Studies

Substances

  • Oxygen