Cardiorespiratory abnormalities in ICU survivors with [PASC] are unrelated to invasive mechanical ventilation, 2024, Longobardi et al.

Cardiorespiratory abnormalities in ICU survivors of COVID-19 with Post-acute Sequelae of SARS-CoV-2 infection are unrelated to invasive mechanical ventilation
Igor Longobardi; Danilo Marcelo Leite do Prado; Danieli Castro Oliveira de Andrade; Karla Fabiana Goessler; Gersiel Nascimento de Oliveira Júnior; Rafael de Almeida Azevedo; Alice Erwig Leitão; Jhonnatan Vasconcelos Pereira Santos; Ana Lúcia de Sá Pinto; Bruno Gualano; Hamilton Roschel

Post-acute Sequelae of SARS-CoV-2 infection (PASC) often leads to exertional intolerance and reduced exercise capacity, particularly in individuals previously admitted to an intensive care unit (ICU). However, the impact of invasive mechanical ventilation (IMV) on PASC-associated cardiorespiratory abnormalities during exercise remains poorly understood. This single-center, cross-sectional study aimed to gather knowledge on this topic.

Fifty-two patients with PASC recruited ~6 months after ICU discharge were clustered based on their need for IMV (PASC+IMV, n=27) or non-invasive support therapy (PASC+NIS, n=25). Patients underwent pulmonary function and cardiopulmonary exercise testing (CPX), and were compared to a reference group (CONTROL, n=19) comprising individuals of both sexes with similar age, comorbidities, and physical activity levels, but without a history of COVID-19 illness.

Individuals with PASC, irrespective of support therapy, presented with higher rates of cardiorespiratory abnormalities than CONTROL, especially dysfunctional breathing patterns, dynamic hyperinflation, reduced oxygen uptake and oxygen pulse, and blunted heart rate recovery (all P<0.05). Only the rate of abnormal oxygen pulse was greater among PASC+IMV than PASC+NIS (P=0.05). Mean estimates for all CPX variables were comparable between PASC-IMV and PASC-NIS (all P>0.05).

These findings indicate significant involvement of both central and peripheral factors, leading to exertional intolerance in individuals with PASC previously admitted to the ICU, regardless of their need for IMV.

Link | PDF (American Journal of Physiology-Heart and Circulatory Physiology)