Use of cardiopulmonary exercise testing to identify mechanisms of exertional symptoms in children with long COVID.

IF 2.2 4区医学 Q1 REHABILITATION PM&R Pub Date : 2024-09-26 DOI:10.1002/pmrj.13263

Adam Lowe, Arash Sabati, Rajeev Bhatia

{"title":"Use of cardiopulmonary exercise testing to identify mechanisms of exertional symptoms in children with long COVID.","authors":"Adam Lowe, Arash Sabati, Rajeev Bhatia","doi":"10.1002/pmrj.13263","DOIUrl":null,"url":null,"abstract":"Background: Little is known about the mechanisms of exercise intolerance and exertional symptoms in children with long COVID. Through utilization of cardiopulmonary exercise testing (CPET), this study is the first of its kind to evaluate exertional symptoms and attempt to identify potential mechanism of long COVID-19 in children.Objective: To determine if CPET will uncover potential reasons for persistent symptoms of long COVID when there is no indication of cardiopulmonary or upper airway disease.Methods: We performed a retrospective chart review study involving children 6-17 years of age with symptoms of long COVID at Phoenix Children''s Hospital from January 1, 2021, to June 1, 2022. Symptoms included but were not limited to exercise intolerance, fatigue, shortness of breath, dyspnea on exertion, and chest pain. We recorded any measurable abnormalities present on CPET after comparing it to established normal reference ranges. Range, median, and SD of data points were calculated and p values were determined using the Mann-Whitney U and Fisher's exact test.Results: Twenty-three children with exertional symptoms consistent with long COVID were identified. The most frequent symptoms reported during exercise include dyspnea on exertion (35%), followed by chest pain (30%) and dizziness (13%). Nearly half of the children (47%) demonstrated decreased exercise capacity with 30% displaying limitations due to deconditioning, 22% limited by body habitus, and 13% due to bronchospasm. Other contributing factors include ventilation to perfusion mismatch and volitional hyperventilation.Conclusion: Decreased aerobic activity due to multiple factors was found in 47% of children with a history of COVID-19. This study illustrates the importance of ongoing research into this phenomenon to elucidate its mechanism and assist physicians in making decisions regarding referral to specialists for further testing.","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PM&R","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pmrj.13263","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Little is known about the mechanisms of exercise intolerance and exertional symptoms in children with long COVID. Through utilization of cardiopulmonary exercise testing (CPET), this study is the first of its kind to evaluate exertional symptoms and attempt to identify potential mechanism of long COVID-19 in children.

Objective: To determine if CPET will uncover potential reasons for persistent symptoms of long COVID when there is no indication of cardiopulmonary or upper airway disease.

Methods: We performed a retrospective chart review study involving children 6-17 years of age with symptoms of long COVID at Phoenix Children''s Hospital from January 1, 2021, to June 1, 2022. Symptoms included but were not limited to exercise intolerance, fatigue, shortness of breath, dyspnea on exertion, and chest pain. We recorded any measurable abnormalities present on CPET after comparing it to established normal reference ranges. Range, median, and SD of data points were calculated and p values were determined using the Mann-Whitney U and Fisher's exact test.

Results: Twenty-three children with exertional symptoms consistent with long COVID were identified. The most frequent symptoms reported during exercise include dyspnea on exertion (35%), followed by chest pain (30%) and dizziness (13%). Nearly half of the children (47%) demonstrated decreased exercise capacity with 30% displaying limitations due to deconditioning, 22% limited by body habitus, and 13% due to bronchospasm. Other contributing factors include ventilation to perfusion mismatch and volitional hyperventilation.

Conclusion: Decreased aerobic activity due to multiple factors was found in 47% of children with a history of COVID-19. This study illustrates the importance of ongoing research into this phenomenon to elucidate its mechanism and assist physicians in making decisions regarding referral to specialists for further testing.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

利用心肺运动测试确定长程 COVID 患儿出现劳累症状的机制。

背景：人们对长COVID儿童运动不耐受和劳累症状的机制知之甚少。通过使用心肺运动测试 (CPET)，本研究首次对儿童的劳累症状进行评估，并试图确定长 COVID-19 的潜在机制：目的：确定在没有心肺或上呼吸道疾病迹象的情况下，CPET 是否能发现长 COVID 持续症状的潜在原因：我们对凤凰城儿童医院 2021 年 1 月 1 日至 2022 年 6 月 1 日期间出现长 COVID 症状的 6-17 岁儿童进行了回顾性病历研究。症状包括但不限于运动不耐受、疲劳、气短、用力时呼吸困难和胸痛。在将 CPET 与既定的正常参考范围进行比较后，我们记录了任何可测量的异常情况。计算数据点的范围、中位数和标度，并使用 Mann-Whitney U 和费雪精确检验法确定 p 值：结果：23 名儿童的运动症状与长 COVID 一致。运动时最常见的症状包括用力时呼吸困难（35%），其次是胸痛（30%）和头晕（13%）。近一半的患儿（47%）显示运动能力下降，其中 30% 的患儿因体质下降而运动能力受限，22% 的患儿因体型限制而运动能力受限，13% 的患儿因支气管痉挛而运动能力受限。其他诱因包括通气与灌注不匹配和自愿过度通气：结论：在有 COVID-19 病史的儿童中，47% 的儿童因多种因素导致有氧活动减少。这项研究表明，对这一现象进行持续研究以阐明其机制并协助医生决定是否转诊至专科医生进行进一步检查非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

PM&R REHABILITATION-SPORT SCIENCES

CiteScore

4.30

自引率

4.80%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.