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Exercise Intolerance Associated with Impaired Oxygen Extraction in Patients with Long COVID 2023 Norweg et al

Discussion in 'Long Covid research' started by Andy, Apr 20, 2023.

  1. Andy

    Andy Committee Member

    Hampshire, UK
    • Ours is one of the first CPET studies to highlight reduced O2 pulse peak % predicted (impaired oxygen extraction) as a mechanism of chronic fatigue and exercise intolerance in long COVID.

    • Our study identified chronotropic intolerance as a potential biomarker in long COVID.

    • We hypothesized that impaired O2 extraction as a mechanism contributed to both mental and peripheral muscle fatigue and early exercise termination in our sample of participants with long COVID.

    • Based on our findings, we recommend low-intensity, sub-symptom aerobic exercise to treat long COVID.


    Chronic mental and physical fatigue and post-exertional malaise are the more debilitating symptoms of long COVID-19. The study objective was to explore factors contributing to exercise intolerance in long COVID-19 to guide development of new therapies. Exercise capacity data of patients referred for a cardiopulmonary exercise test (CPET) and included in a COVID-19 Survivorship Registry at one urban health center were retrospectively analyzed. Results:

    Most subjects did not meet normative criteria for a maximal test, consistent with suboptimal effort and early exercise termination. Mean O2 pulse peak % predicted (of 79 ± 12.9) was reduced, supporting impaired energy metabolism as a mechanism of exercise intolerance in long COVID, n=59. We further identified blunted rise in heart rate peak during maximal CPET. Our preliminary analyses support therapies that optimize bioenergetics and improve oxygen utilization for treating long COVID-19.

    Open access, https://www.sciencedirect.com/science/article/pii/S1569904823000502
    DokaGirl and Peter Trewhitt like this.
  2. John Mac

    John Mac Senior Member (Voting Rights)

    And the cure is........more of the same exercise intolerance
    EzzieD, MEMarge, bobbler and 8 others like this.
  3. Sean

    Sean Moderator Staff Member

    Based on our findings, we recommend low-intensity, sub-symptom aerobic exercise to treat long COVID.

    EzzieD, MEMarge, alktipping and 5 others like this.
  4. DokaGirl

    DokaGirl Senior Member (Voting Rights)

    Basically GET.

    ETA: The authors do speculate about underlying causes, but these seem to be set aside when they recommend exercise as a treatment. As if exercise will correct this complex disease.
    Last edited: Apr 20, 2023
  5. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    quick search and there are at least 9 other threads on cpet studies for long covid, including a couple of reviews. I haven't checked to see what their findings were but I doubt this is one of the first to raise this issue.
    RedFox, MEMarge, alktipping and 4 others like this.
  6. rvallee

    rvallee Senior Member (Voting Rights)

    Here we find the vast gulf between intelligence and wisdom, which clearly don't always come in pairs. Intelligence is only useful when it's wisely applied.

    The problem? Clear exertion intolerance. It takes intelligence to figure this out.

    The solution? Well, the problem, of course. Now this is just extremely foolish.

    Answering a question isn't the same as solving a problem. Especially when the problem is misunderstood. And so is the question. And the context.

    At least this adds to prior research, but the reckless speculation about treatment here really takes wind out of this. I guess it isn't chronic illness research without at least a few giant gaping flaws that are completely detached from reality.

    How does anyone work on this problem and isn't aware that almost all patients do this naturally? After 3 years? Do they simply not pay attention to anything at all that isn't career-building? Seriously? The outside world is simply of no interest to those people? They don't think they should pay attention to it?
    EzzieD, alktipping, DokaGirl and 2 others like this.
  7. Sean

    Sean Moderator Staff Member

    If exercise was going to fix it, or even just help significantly alleviate it, that would have been clear decades ago.
    EzzieD, rvallee, merylg and 9 others like this.
  8. Trish

    Trish Moderator Staff Member

    Peter Trewhitt likes this.

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