Exercise intolerance associated with impaired oxygen extraction in patients with long COVID

Anna Norweg; Lanqiu Yao; Scott Barbuto; Anna S. Nordvig; Thaddeus Tarpey; Eileen Collins; Jonathan Whiteson; Greg Sweeney; Francois Haas; John Leddy

doi:10.1016/j.resp.2023.104062

Exercise intolerance associated with impaired oxygen extraction in patients with long COVID

Anna Norweg
, Lanqiu Yao
, Scott Barbuto
, Anna S. Nordvig
, Thaddeus Tarpey
, Eileen Collins
, Jonathan Whiteson
, Greg Sweeney
, Francois Haas
, John Leddy

Orthopaedics

Columbia University
New York University
Cornell University
University of Illinois at Chicago

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

Objective: Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for a cardiopulmonary exercise test (CPET) and included in a COVID-19 Survivorship Registry at one urban health center were retrospectively analyzed. Results: Most subjects did not meet normative criteria for a maximal test, consistent with suboptimal effort and early exercise termination. Mean O₂ pulse peak % predicted (of 79 ± 12.9) was reduced, supporting impaired energy metabolism as a mechanism of exercise intolerance in long COVID, n = 59. We further identified blunted rise in heart rate peak during maximal CPET. Our preliminary analyses support therapies that optimize bioenergetics and improve oxygen utilization for treating long COVID-19.

Original language	English
Article number	104062
Journal	Respiratory Physiology and Neurobiology
Volume	313
DOIs	https://doi.org/10.1016/j.resp.2023.104062
State	Published - Jul 2023

Keywords

Chronotropic intolerance
Dysautonomia
Energy metabolism
Exercise intolerance
Long COVID-19
Post-exertional malaise

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10.1016/j.resp.2023.104062

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title = "Exercise intolerance associated with impaired oxygen extraction in patients with long COVID",

abstract = "Objective: Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for a cardiopulmonary exercise test (CPET) and included in a COVID-19 Survivorship Registry at one urban health center were retrospectively analyzed. Results: Most subjects did not meet normative criteria for a maximal test, consistent with suboptimal effort and early exercise termination. Mean O2 pulse peak \% predicted (of 79 ± 12.9) was reduced, supporting impaired energy metabolism as a mechanism of exercise intolerance in long COVID, n = 59. We further identified blunted rise in heart rate peak during maximal CPET. Our preliminary analyses support therapies that optimize bioenergetics and improve oxygen utilization for treating long COVID-19.",

keywords = "Chronotropic intolerance, Dysautonomia, Energy metabolism, Exercise intolerance, Long COVID-19, Post-exertional malaise",

author = "Anna Norweg and Lanqiu Yao and Scott Barbuto and Nordvig, \{Anna S.\} and Thaddeus Tarpey and Eileen Collins and Jonathan Whiteson and Greg Sweeney and Francois Haas and John Leddy",

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year = "2023",

month = jul,

doi = "10.1016/j.resp.2023.104062",

language = "English",

volume = "313",

journal = "Respiratory Physiology and Neurobiology",

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T1 - Exercise intolerance associated with impaired oxygen extraction in patients with long COVID

AU - Norweg, Anna

AU - Yao, Lanqiu

AU - Barbuto, Scott

AU - Nordvig, Anna S.

AU - Tarpey, Thaddeus

AU - Collins, Eileen

AU - Whiteson, Jonathan

AU - Sweeney, Greg

AU - Haas, Francois

AU - Leddy, John

PY - 2023/7

Y1 - 2023/7

N2 - Objective: Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for a cardiopulmonary exercise test (CPET) and included in a COVID-19 Survivorship Registry at one urban health center were retrospectively analyzed. Results: Most subjects did not meet normative criteria for a maximal test, consistent with suboptimal effort and early exercise termination. Mean O2 pulse peak % predicted (of 79 ± 12.9) was reduced, supporting impaired energy metabolism as a mechanism of exercise intolerance in long COVID, n = 59. We further identified blunted rise in heart rate peak during maximal CPET. Our preliminary analyses support therapies that optimize bioenergetics and improve oxygen utilization for treating long COVID-19.

AB - Objective: Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for a cardiopulmonary exercise test (CPET) and included in a COVID-19 Survivorship Registry at one urban health center were retrospectively analyzed. Results: Most subjects did not meet normative criteria for a maximal test, consistent with suboptimal effort and early exercise termination. Mean O2 pulse peak % predicted (of 79 ± 12.9) was reduced, supporting impaired energy metabolism as a mechanism of exercise intolerance in long COVID, n = 59. We further identified blunted rise in heart rate peak during maximal CPET. Our preliminary analyses support therapies that optimize bioenergetics and improve oxygen utilization for treating long COVID-19.

KW - Chronotropic intolerance

KW - Dysautonomia

KW - Energy metabolism

KW - Exercise intolerance

KW - Long COVID-19

KW - Post-exertional malaise

UR - https://www.scopus.com/pages/publications/85152964099

U2 - 10.1016/j.resp.2023.104062

DO - 10.1016/j.resp.2023.104062

M3 - Article

C2 - 37076024

AN - SCOPUS:85152964099

SN - 1569-9048

VL - 313

JO - Respiratory Physiology and Neurobiology

JF - Respiratory Physiology and Neurobiology

M1 - 104062

ER -

Exercise intolerance associated with impaired oxygen extraction in patients with long COVID

Abstract

Keywords

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