Patients recovered from mild coronavirus 2019 (COVID-19) disease without pulmonaryinvolvement may experience long-term physical impairment and dyspnea. The investigatorsaim to characterize physiologic limitations in patients who recovered from mild COVID-19.Methods: Pulmonary function tests (PFTs), 6-minute walk test (6MWT), echocardiography andcardiopulmonary exercise test (CPET) will be completed in patients recovered from mildCOVID-19 disease with prolonged dyspnea (Subgroup "A") and compared to patients recoveredfrom moderate/severe COVID-19 (subgroup "B") and to non-COVID-19 patients withunexplained dyspnea (subgroup "C").
Infection with severe acute respiratory syndrome coronavirus-2 leads to severe disease
requiring hospitalization in 20% of the cases. Respiratory failure from severe acute
respiratory syndrome coronavirus-2 infection can range from mild pneumonia and hypoxia to
life threatening hypoxia secondary to severe acute respiratory distress syndrome
requiring intensive care unit and mechanical ventilation in about 12-24% of the
hospitalized patients. Most patients are discharged with minimal or no long-term oxygen
therapy while others are discharged with ongoing respiratory symptoms and long-term
oxygen therapy. In the longer term, there is a significant concern that severe
coronavirus disease 2019 can lead to organizing pneumonia and severe acute lung injury
with evolution to widespread fibrotic changes as seen in fatal cases of coronavirus
disease showing pulmonary fibrosis at autopsy. Studies in severe acute respiratory
syndrome survivors, another corona virus infection, showed persistent and significant
impairment of exercise capacity and health status over 24 months based on PFTs, 6-minute
walk test and health questionnaire. Infection with respiratory syndrome coronavirus-2 has
been also associated with multiple direct and indirect cardiovascular complications
including acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism.
However, long term cardiovascular consequences from coronavirus disease 2019 are still
unknown. The investigators sought to determine the pulmonary, cardiac and other
physiologic limitations in patients who recovered from severe coronavirus disease 2019
with physiologic tests including PFTs, echocardiography and cardio-pulmonary exercise
test which is currently the most comprehensive physiologic test that can differentiate
between the different limitations and add novel data regarding short and long term
physiologic consequences of coronavirus disease 2019.
Device: Cardiopulmonary exercise test (CPET)
A symptom-limited test on a treadmill will be performed, using incremental ramp Bruce
protocol up to exhaustion. Patients who will not be able to perform the test on a
treadmill will be tested on a cycle ergometer beginning with a no-resistance warm-up
lasting 2-3 minutes, followed by incrementing resistance (8-30 Watts/minute).
Inclusion Criteria:
- Patients recovering from COVID-19 with a documented infection with severe acute
respiratory syndrome coronavirus-2 and cognitive ability to sign informed consent
and physical ability to participate in exercise tests.
Exclusion Criteria:
- Patients with severe pulmonary, cardiac disease prior to COVID-19, pregnant women,
and patients with active infection or cancer.
Rambam Medical Center
Haifa, Israel
Investigator: Ronen Bar-Yoseph, MD
Contact: +972-4-777-4360
r_bar-yoseph@rambam.health.gov.il
Ronen Bar-Yoseph, MD
+972-4-777-4360
r_bar-yoseph@rambam.health.gov.il
Yaniv Dotan, MD
+972-4-777-2650
y_dotan@rambam.health.gov.il
Not Provided