Cardiopulmonary exercise pattern in patients with persistent dyspnoea after recovery from COVID-19.

IF 2.3 Multidisciplinary Respiratory Medicine Pub Date : 2021-01-25 eCollection Date: 2021-01-15 DOI:10.4081/mrm.2021.732
Arno Mohr, Laura Dannerbeck, Tobias J Lange, Michael Pfeifer, Stefan Blaas, Bernd Salzberger, Florian Hitzenbichler, Myriam Koch
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引用次数: 39

Abstract

Cause and mechanisms of persistent dyspnoea after recovery from COVID-19 are not well described. The objective is to describe causal factors for persistent dyspnoea in patients after COVID-19. We examined patients reporting dyspnoea after recovery from COVID-19 by cardiopulmonary exercise testing. After exclusion of patients with pre-existing lung diseases, ten patients (mean age 50±13.1 years) were retrospectively analysed between May 14th and September 15th, 2020. On chest computed tomography, five patients showed residual ground glass opacities, and one patient showed streaky residua. A slight reduction of the mean diffusion capacity of the lung for carbon monoxide was noted in the cohort. Mean peak oxygen uptake was reduced with 1512±232 ml/min (72.7% predicted), while mean peak work rate was preserved with 131±29 W (92.4% predicted). Mean alveolar-arterial oxygen gradient (AaDO2) at peak exercise was 25.6±11.8 mmHg. Mean value of lactate post exercise was 5.6±1.8 mmol/l. A gap between peak work rate in (92.4% predicted) to peak oxygen uptake (72.3% pred.) was detected in our study cohort. Mean value of lactate post exercise was high in our study population and even higher (n.s.) compared to the subgroup of patients with reduced peak oxygen uptake and other obvious reason for limitation. Both observations support the hypothesis of anaerobic metabolism. The main reason for dyspnoea may therefore be muscular.
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COVID-19康复后持续性呼吸困难患者的心肺运动模式
COVID-19康复后持续呼吸困难的原因和机制尚未得到很好的描述。目的是描述COVID-19患者持续呼吸困难的原因。我们通过心肺运动测试对COVID-19康复后报告呼吸困难的患者进行了检查。在排除已有肺部疾病的患者后,对2020年5月14日至9月15日期间的10例患者(平均年龄50±13.1岁)进行回顾性分析。胸部计算机断层扫描,5例患者显示残留磨玻璃影,1例患者显示条状残留。在队列中注意到一氧化碳的平均肺扩散能力略有降低。平均峰值摄氧量降低1512±232 ml/min(预测值72.7%),而平均峰值工作速率保持在131±29 W(预测值92.4%)。运动峰值时平均肺泡-动脉氧梯度(AaDO2)为25.6±11.8 mmHg。运动后乳酸均值为5.6±1.8 mmol/l。在我们的研究队列中发现峰值工作率(预测值为92.4%)与峰值摄氧量(预测值为72.3%)之间存在差距。在我们的研究人群中,运动后乳酸的平均值很高,甚至高于峰值摄氧量降低和其他明显限制原因的患者亚组(n.s.)。这两个观察结果都支持无氧代谢假说。因此,呼吸困难的主要原因可能是肌肉。
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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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