The value of clinical cardiopulmonary exercise testing (CPET) within healthcare settings has been established in the last decade. CPET methods remain highly relevant in the COVID-19 endemic phase and should be used to assess those recovering from COVID-19 (SARS-CoV-2) infection. This diagnostic tool could play an integral role in disease prognostication and evaluate the integrative response to incremental exercise. Date from such assessments can enable practitioners to characterise cardio-respiratory fitness and identify reasons for physical impairment or abnormal cardio-respiratory function. More than 50% of patients admitted to hospital will experience cardiorespiratory issues and significant morbidity during their recovery and will require significant rehabilitative support. In this context, measurements obtained from an assessment of cardio-respiratory responses to physiological stress could provide insight regarding the integrity of the pulmonary-vascular interface and characterisation of any impairment or abnormal cardio-respiratory function. Current approaches to rehabilitation are being developed on existing knowledge from Severe Acute Respiratory Syndrome (SARS) and Acute Respiratory Distress Syndrome (ARDS) related illness. These provide important insight but do not provide insight into the novel challenges provided by COVID-19.
Not Provided
Procedure: 2 day cardiopulmonary exercise test
Consecutive day 2 day CPET and follow up for 7 days for subjective feelings/fatigue.
Inclusion Criteria:
- • Aged 18 to 65 years old
- Diagnosed with COVID-19
- Still suffering from symptoms of COVID-19, 3 months after initial infection
- Sufficient English language comprehension and cognitive ability to understand the
study protocol, give informed consent and follow instructions.
Exclusion Criteria:
- • <18 years of age
- Admitted to or received treatment from Intensive Care Units
- Unconfirmed COVID-19 test diagnosis
- Unable to understand verbal or written information in English
- Achieving a grade 0 or 1 on the PCFS.
- Unstable angina
- Uncontrolled hypertension, that is, resting systolic blood pressure (SBP)
>180mmHg, or resting diastolic blood pressure (BP) (DBP) >110mmHg
- Orthostatic blood pressure drop of >20 mmHg with symptoms
- Significant aortic stenosis (aortic valve area 120 bpm)
- Acute pericarditis or myocarditis
- Decompensated HF
- Third degree (complete) atrioventricular (AV) block without pacemaker
- Recent embolism
- Acute thrombophlebitis
- Resting ST segment displacement (>2 mm)
- Uncontrolled diabetes mellitus
- Severe orthopaedic conditions that would prohibit exercise
- Other metabolic conditions, such as acute thyroiditis, hypokalaemia,
hyperkalaemia or hypovolaemia (until adequately treated)
- Severe grade 3 rejection (cardiac transplantation recipients Appendix N).
University of Illinois at Chicago
Chicago, Illinois, United States
Ramaiah Medical College
Bengaluru, India
University of Derby
Derby, Derbyshire, United Kingdom
Sheffield Hallam University
Sheffield, South Yorkshire, United Kingdom
Northumbria University
Newcastle Upon Tyne, United Kingdom
Mark Faghy, PhD
01332 592109
m.a.faghy@derby.ac.uk
Tom Maden-Wilkinson, PhD
t.maden-wilkinson@shu.ac.uk
Not Provided