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Reduced Exercise Capacity, Chronotropic Incompetence, and Early Systemic Inflammation in Cardiopulmonary Phenotype Long Coronavirus Disease 2019.
Durstenfeld, Matthew S; Peluso, Michael J; Kaveti, Punita; Hill, Christopher; Li, Danny; Sander, Erica; Swaminathan, Shreya; Arechiga, Victor M; Lu, Scott; Goldberg, Sarah A; Hoh, Rebecca; Chenna, Ahmed; Yee, Brandon C; Winslow, John W; Petropoulos, Christos J; Kelly, J Daniel; Glidden, David V; Henrich, Timothy J; Martin, Jeffrey N; Lee, Yoo Jin; Aras, Mandar A; Long, Carlin S; Grandis, Donald J; Deeks, Steven G; Hsue, Priscilla Y.
Afiliação
  • Durstenfeld MS; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Peluso MJ; Division of Cardiology, Zuckerberg San Francisco General, University of California, San Francisco, San Francisco, California, USA.
  • Kaveti P; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Hill C; Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California, USA.
  • Li D; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Sander E; Division of Cardiology, UCSF Health, San Francisco, California, USA.
  • Swaminathan S; School of Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Arechiga VM; Division of Cardiology, Zuckerberg San Francisco General, University of California, San Francisco, San Francisco, California, USA.
  • Lu S; Division of Cardiology, UCSF Health, San Francisco, California, USA.
  • Goldberg SA; Division of Cardiology, Zuckerberg San Francisco General, University of California, San Francisco, San Francisco, California, USA.
  • Hoh R; Division of Cardiology, Zuckerberg San Francisco General, University of California, San Francisco, San Francisco, California, USA.
  • Chenna A; Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California, USA.
  • Yee BC; School of Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Winslow JW; Division of Cardiology, Zuckerberg San Francisco General, University of California, San Francisco, San Francisco, California, USA.
  • Petropoulos CJ; Monogram Biosciences, LabCorp, University of California, San Francisco, California, USA.
  • Kelly JD; Monogram Biosciences, LabCorp, University of California, San Francisco, California, USA.
  • Glidden DV; Monogram Biosciences, LabCorp, University of California, San Francisco, California, USA.
  • Henrich TJ; Monogram Biosciences, LabCorp, University of California, San Francisco, California, USA.
  • Martin JN; Institute of Global Health Sciences, University of California, San Francisco, San Francisco, California, USA.
  • Lee YJ; F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA.
  • Aras MA; Division of Experimental Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Long CS; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
  • Grandis DJ; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Deeks SG; Division of Experimental Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Hsue PY; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
J Infect Dis ; 228(5): 542-554, 2023 08 31.
Article em En | MEDLINE | ID: mdl-37166076
ABSTRACT

BACKGROUND:

Mechanisms underlying persistent cardiopulmonary symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (postacute sequelae of coronavirus disease 2019 [COVID-19; PASC] or "long COVID") remain unclear. This study sought to elucidate mechanisms of cardiopulmonary symptoms and reduced exercise capacity.

METHODS:

We conducted cardiopulmonary exercise testing (CPET), cardiac magnetic resonance imaging (CMR) and ambulatory rhythm monitoring among adults >1 year after SARS-CoV-2 infection, compared those with and those without symptoms, and correlated findings with previously measured biomarkers.

RESULTS:

Sixty participants (median age, 53 years; 42% female; 87% nonhospitalized; median 17.6 months after infection) were studied. At CPET, 18/37 (49%) with symptoms had reduced exercise capacity (<85% predicted), compared with 3/19 (16%) without symptoms (P = .02). The adjusted peak oxygen consumption (VO2) was 5.2 mL/kg/min lower (95% confidence interval, 2.1-8.3; P = .001) or 16.9% lower percent predicted (4.3%-29.6%; P = .02) among those with symptoms. Chronotropic incompetence was common. Inflammatory markers and antibody levels early in PASC were negatively correlated with peak VO2. Late-gadolinium enhancement on CMR and arrhythmias were absent.

CONCLUSIONS:

Cardiopulmonary symptoms >1 year after COVID-19 were associated with reduced exercise capacity, which was associated with earlier inflammatory markers. Chronotropic incompetence may explain exercise intolerance among some with "long COVID."
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Tolerância ao Exercício / COVID-19 Tipo de estudo: Prognostic_studies Limite: Female / Humans / Male Idioma: En Revista: J Infect Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Tolerância ao Exercício / COVID-19 Tipo de estudo: Prognostic_studies Limite: Female / Humans / Male Idioma: En Revista: J Infect Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos