Functional dyspnea as an early marker of vulnerability to persistent physical symptoms in the CONSTANCES population-based cohort 2026 Kachaner et al

[Andy]

Highlights​

• Persistent physical symptoms (PPS) are disabling symptoms defined independently of their underlying etiology.
• Functional dyspnea is a common PPS with no identified physical explanation.
• We assessed whether pre-pandemic functional dyspnea predicted subsequent PPS during the COVID-19 pandemic.
• Among 17,326 CONSTANCES participants, 39% reported at least one PPS during the pandemic.
• Pre-pandemic functional dyspnea was associated with a higher risk of later PPS, including post-COVID condition.

Abstract​

Background​

Persistent Physical Symptoms (PPS) are disabling bodily symptoms lasting several months, irrespective of their underlying cause. They share mechanisms with functional disorders, characterized by a mismatch between reported symptoms and objective findings. Functional dyspnea—self-reported shortness of breath in the absence of identifiable cardiopulmonary disease—may represent an early marker of vulnerability to PPS. We investigated whether functional dyspnea assessed before the COVID-19 pandemic was associated with the incidence of PPS during the pandemic.

Methods​

In this population-based study, we included participants from the French CONSTANCES cohort with normal spirometry and no known condition causing dyspnea at inclusion (2012–2019). Functional dyspnea was assessed at inclusion and incident PPS lasting more than 8 weeks were reported during the COVID-19 pandemic, regardless of SARS-CoV-2 infection. Multivariable logistic regression models adjusted for age, sex, body mass index, and educational level were used to estimate the associations.

Results​

Among 17,326 participants (mean age 47.8 years; 54.3% women), 2230 (12.9%) reported functional dyspnea at inclusion. During the pandemic, 6687 participants (39.0%) reported at least one PPS. Functional dyspnea at inclusion was associated with a higher risk of incident PPS (OR 1.79, 95% CI [1.64–1.97], p < 0.001). Results were consistent across sensitivity analyses, including those accounting for SARS-CoV-2 infection. Depressive symptoms and self-rated health explained only a small proportion of the association.

Conclusion​

In this population-based cohort study, functional dyspnea may be a marker of future PPS, supporting the hypothesis of mechanisms common to all PPS, regardless of their type or origin.
https://www.sciencedirect.com/science/article/abs/pii/S0022399926003715
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[Turtle]

Would 12,9 % of participants call their dyspnea "functional"?

Dear authors, just becase you don't know the underlying cause of dyspnea, is it functional because you say so?

 

[Jonathan Edwards]

Did it cross their minds that 'shortness of breath', which presumably what was asked about, is a normal experience for everyone and that it is normal to go at stuff like climbing stairs until you get short of breath and then ease off a bit?

 

[rvallee]

Persistent physical symptoms (PPS) are disabling symptoms defined independently of their underlying etiology

They share mechanisms

"Fun with words". Also "symptoms are associated with symptoms" will never not be super weird and cringe.