Journal Article

Exercise Limitation after Critical versus Mild COVID-19 Infection: A Metabolic Perspective

Anne-Françoise Rousseau, Etienne Cavalier, Joël Pincemail, Benoit Misset, Jean Joris, Camille Colson, Julien Guiot, Grégory Minguet, Doriane Calmes, Maurice Joris

2022

Overview

Exercise limitation in COVID-19 survivors is poorly explained. In this retrospective study, cardiopulmonary exercise testing (CPET) was coupled with an oxidative stress assessment in COVID-19 critically ill survivors (ICU group). Thirty-one patients were included in this group. At rest, their oxygen uptake (VO2) was elevated (8 [5.6–9.7] mL/min/kg). The maximum effort was reached at low values of workload and VO2 (66 [40.9–79.2]% and 74.5 [62.6–102.8]% of the respective predicted values). The ventilatory equivalent for carbon dioxide remained within normal ranges. Their metabolic efficiency was low: 15.2 [12.9–17.8]%. The 50% decrease in VO2 after maximum effort was delayed, at 130 [120–170] s, with a still-high respiratory exchange ratio (1.13 [1–1.2]). The blood myeloperoxidase was elevated (92 [75.5–106.5] ng/mL), and the OSS was altered. The CPET profile of the ICU group was compared with long COVID patients after mid-disease (MLC group) and obese patients (OB group). The MLC patients (n = 23) reached peak workload and predicted VO2 values, but their resting VO2, metabolic efficiency, and recovery profiles were similar to the ICU group to a lesser extent. In the OB group (n = 15), no hypermetabolism at rest was observed. In conclusion, the exercise limitation after a critical COVID-19 bout resulted from an altered metabolic profile in the context of persistent inflammation and oxidative stress. Altered exercise and metabolic profiles were also observed in the MLC group. The contribution of obesity on the physiopathology of exercise limitation after a critical bout of COVID-19 did not seem relevant.

• Publisher: MDPI AG,MDPI
• Subject: Anaerobic threshold / Anesthesia & intensive care / Anesthésie & soins intensifs / Bioenergetics / Carbohydrates / Carbon dioxide / Cardiac output / cardiopulmonary exercise testing; COVID-19; critical illness; survivors; long COVID; obesity; hypermetabolism; oxidative stress; inflammation / Clinical medicine / Complications and side effects / Coronaviruses / COVID-19 / Critical care / Energy metabolism / Evaluation / Exercise / Fatigue / Health aspects / Heart rate / Hospitalization / Hospitals / Human health sciences / Infections / Intensive care / Long COVID / Medical research / Medicine / Medicine, Experimental / Metabolic disorders / Obesity / Oxidative stress / Physiological aspects / Pulmonary ventilation / Sciences de la santé humaine / Sports medicine / Ventilators / Workloads