Cardiopulmonary Exercise Testing Distinguishes between Post-COVID-19 as a Dysfunctional Syndrome and Organ Pathologies

Johannes Kersten (), Luis Hoyo, Alexander Wolf, Elina Hüll, Samuel Nunn, Marijana Tadic, Dominik Scharnbeck, Wolfgang Rottbauer and Dominik Buckert
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Johannes Kersten: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Luis Hoyo: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Alexander Wolf: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Elina Hüll: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Samuel Nunn: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Marijana Tadic: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Dominik Scharnbeck: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Wolfgang Rottbauer: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany
Dominik Buckert: Department for Internal Medicine II, University of Ulm, 89081 Ulm, Germany

IJERPH, 2022, vol. 19, issue 18, 1-13

Abstract: (1) Background: Dyspnea is one of the most frequent symptoms among post-COVID-19 patients. Cardiopulmonary exercise testing (CPET) is key to a differential diagnosis of dyspnea. This study aimed to describe and classify patterns of cardiopulmonary dysfunction in post-COVID-19 patients, using CPET. (2) Methods: A total of 143 symptomatic post-COVID-19 patients were included in the study. All patients underwent CPET, including oxygen consumption, slope of minute ventilation to CO 2 production, and capillary blood gas testing, and were evaluated for signs of limitation by two experienced examiners. In total, 120 patients reached a satisfactory level of exertion and were included in further analyses. (3) Results: Using CPET, cardiovascular diseases such as venous thromboembolism or ischemic and nonischemic heart disease were identified as either cardiac (4.2%) or pulmonary vascular (5.8%) limitations. Some patients also exhibited dysfunctional states, such as deconditioning (15.8%) or pulmonary mechanical limitation (9.2%), mostly resulting from dysfunctional breathing patterns. Most (65%) patients showed no signs of limitation. (4) Conclusions: CPET can identify patients with distinct limitation patterns, and potentially guide further therapy and rehabilitation. Dysfunctional breathing and deconditioning are crucial factors for the evaluation of post-COVID-19 patients, as they can differentiate these dysfunctional syndromes from organic diseases. This highlights the importance of dynamic (as opposed to static) investigations in the post-COVID-19 context.

Keywords: cardiopulmonary exercise testing (CPET); COVID-19; dysfunctional breathing; deconditioning; long COVID-19; post-COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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