Aparisi, Álvaro, Ybarra Falcón, Cristina, García Gómez, Mario, Tobar, Javier, Iglesias Echeverría, Carolina, Jaurrieta Largo, Sofía, Ladrón, Raquel, Uribarri, Aitor, Catalá, Pablo, Hinojosa, Williams, Marcos Mangas, Marta, Fernández Prieto, Laura, Sedano Gutiérrez, Rosa, Cusacovich, Iván, Andaluz Ojeda, David, de Vega Sánchez, Blanca, Recio Platero, Amada, Sanz Patiño, Esther, Calvo, Dolores, Baladrón, Carlos, Carrasco Moraleja, Manuel, Disdier Vicente, Carlos, Amat Santos, Ignacio J., San Román, J. Alberto, Aparisi, Álvaro, Ybarra Falcón, Cristina, García Gómez, Mario, Tobar, Javier, Iglesias Echeverría, Carolina, Jaurrieta Largo, Sofía, Ladrón, Raquel, Uribarri, Aitor, Catalá, Pablo, Hinojosa, Williams, Marcos Mangas, Marta, Fernández Prieto, Laura, Sedano Gutiérrez, Rosa, Cusacovich, Iván, Andaluz Ojeda, David, de Vega Sánchez, Blanca, Recio Platero, Amada, Sanz Patiño, Esther, Calvo, Dolores, Baladrón, Carlos, Carrasco Moraleja, Manuel, Disdier Vicente, Carlos, Amat Santos, Ignacio J., and San Román, J. Alberto
The present study was partially granted by Gerencia Regional de Salud de Castilla y León under grant number GRS COVID 111/A/20 and a grant from the Spanish Society of Cardiology SEC/FEC-INVCLI 2., Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries. Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO2 consumption (77.8 (64–92.5) vs. 99 (88–105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467–600) vs. 611 (550–650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VCO2 slope 32 (28.1–37.4) vs. 29.4 (26.9–31.4); p = 0.022) and high PETCO2 (34.5 (32–39) vs. 38 (36–40); p = 0.025). Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome., Junta de Castilla y León. Gerencia Regional de Salud de Castilla y León, Sociedad Española de Cardiología, Fac. de Medicina, TRUE, pub