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ObjectiveThis study aimed to compare the relative physical recovery and symptoms after SARS-CoV-2 infection between groups confirmed positive or negative to early strains of COVID-19.MethodsA prospective, longitudinal cohort study compared outcomes of metropolitan adults polymerase chain reaction-tested for COVID-19 between March and November 2020 in Western Australia. Control matching was attempted: inpatients (gender, age) and ambulatory clinic (gender, age, asthma, chronic pulmonary disease). One-year follow-up involved three repeated measures: physical function (grip strength and 1-min sit-to-stand) and patient-reported outcomes (Fatigue Severity Scale, modified Medical Research Council dyspnoea scale and Euroqol-5D-5L).ResultsThree hundred and forty-four participants were recruited (154 COVID+, age 54±18years, 75 females [49%]); 190 COVID-, age 52±16years, 67 females [35%]) prior to national vaccination roll-out. No between-group differences in physical function measures were evident at any time point. Fatigue (OR 6.62, 95% CI 2.74-15.97) and dyspnoea (OR 2.21, 95% CI 1.14-4.30) were higher in the COVID+ group at second assessment (T2). On Euroqol-5D-5L, no between-group differences were evident in the physical function domains of self-care, mobility or usual activities at any time point. However, COVID+ participants were less likely to report an absence of anxiety or depression symptoms at T2 (OR 0.41, 95% CI 0.19-0.89).ConclusionsNeither statistical nor clinically meaningful differences in physical function were evident between COVID+ and COVID- participants to 12-months after acute illness. Symptoms of fatigue, dyspnoea, anxiety or depression were more prevalent in the COVID+ group til ~8months after illness with between-group differences no longer evident at 1 year.
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QUESTION: In adults with advanced lung disease, do the 6-minute walk test (6MWT) and 1-minute sit-to-stand test (1minSTS) elicit similar cardiorespiratory responses? Can the 6-minute walk distance (6MWD) be estimated from the 1minSTS result? DESIGN: Prospective observational study using data collected during routine clinical practice. PARTICIPANTS: Eighty adults (43 males) with advanced lung disease, a mean age of 64 years (SD 10) and a mean forced expiratory volume in 1 second of 1.65 L (SD 0.77). OUTCOME MEASURES: Participants completed a 6MWT and a 1minSTS. During both tests, oxygen saturation (SpO2), pulse rate, dyspnoea and leg fatigue (Borg 0 to 10) were recorded. RESULTS: Compared with the 6MWT, the 1minSTS resulted in higher nadir SpO2 (MD 4%, 95% CI 3 to 5), lower end-test pulse rate (MD -4 beats/minute, 95% CI -6 to -1), similar dyspnoea (MD -0.3, 95% CI -0.6 to 0.1) and greater leg fatigue (MD 1.1, 95% CI 0.6 to 1.6). Among the participants who demonstrated severe desaturation (SpO2 nadir < 85%) on the 6MWT (n = 18), five and ten participants were classified as moderate (nadir 85 to 89%) or mild desaturators (nadir ≥ 90%), respectively, on the 1minSTS. The relationship between the 6MWD and 1minSTS was: 6MWD (m) = 247 + (7 × number of transitions achieved during the 1minSTS) with poor predictive ability (r2 = 0.44). CONCLUSION: The 1minSTS elicited less desaturation than the 6MWT and classified a smaller proportion of people as 'severe desaturators' on exertion. It is therefore inappropriate to use the nadir SpO2 recorded during a 1minSTS to make decisions about whether strategies are needed to prevent severe transient exertional desaturation during walking-based exercise. Further, the extent to which performance on the 1minSTS can estimate a person's 6MWD is poor. For these reasons, the 1minSTS is unlikely to be helpful when prescribing walking-based exercise.