1. Guest, the 'News in Brief' for the week beginning 12th July 2021 is here.
    Dismiss Notice
  2. Welcome! To read the Core Purpose and Values of our forum, click here.
    Dismiss Notice
  3. Contribute to feedback on the CDC Evidence Review, for more details click here
    Dismiss Notice

[CPET] in Critically Ill Coronavirus Disease 2019 Survivors: Evidence of a Sustained Exercise Intolerance and Hypermetabolism, 2021, Joris et al

Discussion in 'Epidemics (including Covid-19)' started by Andy, Jul 20, 2021 at 1:08 PM.

  1. Andy

    Andy Committee Member (& Outreach when energy allows)

    Likes Received:
    Hampshire, UK
    Full title: Cardiopulmonary Exercise Testing in Critically Ill Coronavirus Disease 2019 Survivors: Evidence of a Sustained Exercise Intolerance and Hypermetabolism

    To investigate exercise capacity at 3 and 6 months after a prolonged ICU stay.

    Observational monocentric study.

    A post-ICU follow-up clinic in a tertiary university hospital in Liège, Belgium.

    Patients surviving an ICU stay greater than or equal to 7 days for a severe coronavirus disease 2019 pneumonia and attending our post-ICU follow-up clinic.

    Cardiopulmonary and metabolic variables provided by a cardiopulmonary exercise testing on a cycle ergometer were collected at rest, at peak exercise, and during recovery. Fourteen patients (10 males, 59 yr [52–62 yr], all obese with body mass index > 27 kg/m2) were included after a hospital stay of 40 days (35–53 d). At rest, respiratory quotient was abnormally high at both 3 and 6 months (0.9 [0.83–0.96] and 0.94 [0.86–0.97], respectively). Oxygen uptake was also abnormally increased at 3 months (8.24 mL/min/kg [5.38–10.54 mL/min/kg]) but significantly decreased at 6 months (p = 0.013). At 3 months, at the maximum workload (67% [55–89%] of predicted workload), oxygen uptake peaked at 81% (64–104%) of predicted maximum oxygen uptake, with oxygen pulse and heart rate reaching respectively 110% (76–140%) and 71% (64–81%) of predicted maximum values. Ventilatory equivalent for carbon dioxide remains within normal ranges. The 50% decrease in oxygen uptake after maximum effort was delayed, at 130 seconds (115–142 s). Recovery was incomplete with a persistent anaerobic metabolism. At 6 months, no significant improvement was observed, excepting an increase in heart rate reaching 79% (72–95%) (p = 0.008).

    Prolonged reduced exercise capacity was observed up to 6 months in critically ill coronavirus disease 2019 survivors. This disability did not result from residual pulmonary or cardiac dysfunction but rather from a metabolic disorder characterized by a sustained hypermetabolism and an impaired oxygen utilization.

    Open access, https://journals.lww.com/ccejournal...ry_Exercise_Testing_in_Critically_Ill.24.aspx
    Forbin, Michelle, Louie41 and 10 others like this.
  2. strategist

    strategist Senior Member (Voting Rights)

    Likes Received:
    Sounds like rehab is ineffective.

    Sounds similar to what was reported by Fluge and Mella (increased consumption of amino acids for energy productin in a pattern consistent with impaired pyruvate dehydrogenase).
  3. Michiel Tack

    Michiel Tack Senior Member (Voting Rights)

    Likes Received:
    Yes, but they only had 14 patients at 6-month follow-up so the lack of statistical significance could simply be due to this small sample size.
    Michelle, Trish, Snow Leopard and 8 others like this.

Share This Page