P230 Assessment of Cardio-pulmonary function in children and adolescents with suspected long COVID

Abstract

IntroductionPersistent respiratory symptoms and exercise intolerance following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents is common.1 Our aim was to review the clinical data on patients who had been referred with suspected long COVID (LC). Unfortunately, there is a lack of an agreed definition for LC. The patient cohort were referred with persistent respiratory symptoms/signs (cough, exertional dyspnoea or wheeze) for at least 3 months following confirmed (PCR or antigen test positive) mild SARS-CoV-2 infection that did not require hospitalisation.MethodsThis was a retrospective analysis of clinical data obtained during clinical assessment. Patients had undergone pulmonary function tests (PFTs) including;spirometry, Single breath transfer factor (TLCO) and static lung volume measurements (Vyntus Body – VyaireTM Medical) followed by an incremental maximal ramp cardiopulmonary exercise testing (CPET) performed on a cycle ergometer (Jaeger CPX & Vyntus ONE – VyaireTM Medical).ResultsSeven patients (four male) with suspected LC had undergone PFTs and CPET. Demographics and summary data are presented (table 1). Five had normal PFT results. Of the two that had abnormal PFTs both had co-existing morbidities. One had mild airflow obstruction (previous pneumothorax) and the other had a restrictive defect (Di-George syndrome and obesity). Three patients had a reduced peak Oxygen uptake (VO2peak < 85% predicted). The cardiovascular and gas exchange response to incremental exercise were normal and there was no evidence of ventilatory limitation or dysfunctional breathing in any of the patients.ConclusionsAlthough only a small cohort was examined, this study suggests that SARS-CoV-2 infection does not seem to be causing any longstanding cardiopulmonary function impairment in children and adolescents. Whilst there may be pathophysiological changes following SARS-CoV-2 infection, as previously reported in adults,2 a reduced aerobic capacity is seen in some of these patients and this may due to physical de-conditioning rather than any physiological impairment caused by SARS-CoV-2 infection.ReferencesDobkin S et al. (2021) Protracted respiratory findings in children post-SARS-CoV-2 infection Pediatr Pulmonol.Rinaldo RF et al. (2021). Deconditioning as main mechanism of impaired exercise response in COVID-19 survivors. ERJ 2021 58:2100870.