Panting after exercise? Maybe it's another symptom of the new crown

Regarding the symptoms of long COVID-19, we may have heard of brain fog, fatigue and headaches
.
Now, a new study published in JAMA Network Open points to another lasting effect of SARS-CoV-2 months after infection: reduced
exercise capacity.

Researchers at the University of California, San Francisco and Zuckerberg San Francisco General Hospital analyzed 38 previous studies that tracked the athletic performance of more than 2,000 participants who had previously contracted COVID-19, including those who may have long COVID
.
They then narrowed the analysis to nine studies that compared
the exercise performance of 359 participants without symptoms with 464 participants.

In these nine studies, participants had an average age of 39 to 56 years and an average BMI of
between 26 (overweight) and 30 (obesity).

The findings showed that the mid-COVID group in this subgroup had reduced muscle oxygen uptake, irregular breathing patterns, and a weaker
ability to increase heart rate during exercise to match cardiac output.
In addition, the researchers point out that there is evidence that after most diseases that cause lack of exercise, some degree of dysregulation occurs
.
However, not all findings can be attributed to dysregulation
.

Participants underwent exercise tests, including cardiopulmonary exercise tests (which measure oxygen and carbon dioxide levels), and other indicators
of cardiorespiratory function at least three months after SARS-CoV-2 infection.
Participants exercise
on a treadmill or spinning bike.
Projects such as tennis and swimming can be too hard for those with COVID
.

When comparing exercise tolerance, the researchers found that the maximum oxygen uptake in the Changxue group was 4.
9 ml/kg/min
lower than that in the rehabilitation group.
Lead author Matthew S.
Durstenfeld of the Department of Cardiology at UCSF Medical College and Zuckerberg San Francisco General Hospital said the difference equated to a metabolic equivalent (MET)
of 1.
4.
"The decrease in VO2 roughly means that a 40-year-old woman's expected exercise capacity of 9.
5 MET dropped to 8.
1 METs, which is equivalent to the expected exercise capacity
of a 50-year-old woman.
"

From another perspective, Durstenfeld said, people who normally play tennis may need to switch to golf or stretching, while swimmers may find low-intensity aerobic exercise to be a better option
.
"It's important to note that this is just an average," he cautioned
.
"Some people experience a significant decrease in athletic ability, while others don't experience any decline
.
"

In their analysis of the studies, the researchers said that although they found "moderate but consistent" evidence of reduced exercise capacity in patients with long COVID, there was "a lack of confidence in the extent of the impact.
"
They attributed this to the small size of the study, oversampling of hospitalized participants, and variability
in the definition of long COVID and cardiopulmonary exercise test patterns.
None of the studies tested cardiopulmonary exercise for comparison
before infection.

Senior author Priscilla Y.
Hsue, M.
D.
, of the UCSF School of Medicine, said: "Further research should include long-term observational assessments to understand the trajectory
of exercise capacity.
There is an urgent need to trial potential therapies, including research into rehabilitation, as well as further investigation
into respiratory dysfunction, nerve damage to control automatic skills, and inability to adequately raise heart rate during exercise.
”

Original text search

Matthew S.
Durstenfeld, Kaiwen Sun, Peggy Tahir, Michael J.
Peluso, Steven G.
Deeks, Mandar A.
Aras, Donald J.
Grandis, Carlin S.
Long, Alexis Beatty, Priscilla Y.
Hsue.
Use of Cardiopulmonary Exercise Testing to Evaluate Long COVID-19 Symptoms in Adults.
JAMA Network Open, 2022; 5 (10): e2236057 DOI: 10.
1001/jamanetworkopen.
2022.
36057