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Predictors of Submaximal Exercise Test Attainment in Adults Reporting Long COVID Symptoms, 2022, Romero-Ortuno et al

Discussion in 'Long Covid research' started by Andy, May 15, 2022.

  1. Andy

    Andy Committee Member

    Messages:
    16,664
    Location:
    Hampshire, UK
    Abstract

    Adults with long COVID often report intolerance to exercise. Cardiopulmonary exercise testing (CPET) has been used in many settings to measure exercise ability but has been conducted in a few long COVID cohorts. We conducted CPET in a sample of adults reporting long COVID symptoms using a submaximal cycle ergometer protocol.

    We studied pre-exercise predictors of achieving 85% of the age-predicted maximum heart rate (85%HRmax) using logistic regression. Eighty participants were included (mean age 46 years, range 25–78, 71% women). Forty participants (50%) did not reach 85%HRmax. On average, non-achievers reached 84% of their predicted 85%HRmax. No adverse events occurred.

    Participants who did not achieve 85%HRmax were older (p < 0.001), had more recent COVID-19 illness (p = 0.012) with higher frequency of hospitalization (p = 0.025), and had been more affected by dizziness (p = 0.041) and joint pain (p = 0.028). In the logistic regression model including age, body mass index, time since COVID-19, COVID-19-related hospitalization, dizziness, joint pain, pre-existing cardiopulmonary disease, and use of beta blockers, independent predictors of achieving 85%HRmax were younger age (p = 0.001) and longer time since COVID-19 (p = 0.008).

    Our cross-sectional findings suggest that exercise tolerance in adults with long COVID has potential to improve over time. Longitudinal research should assess the extent to which this may occur and its mechanisms.

    Open access, https://www.mdpi.com/2077-0383/11/9/2376/htm
     
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    19,527
    Location:
    Australia
    I don't think this tells us anything much, other than these researchers were ill-equipped to be carrying out CPET research on Long Covid cohorts.

    The people included in the study almost certainly had a range of reasons for their reported fatigue and lingering symptoms, and there was no attempt to begin to identify them with, for example, lung function tests. While not discounting other possibilities, these researchers seem rather keen on an explanation of deconditioning that improves over time.

    Chalder Fatigue Scale

    There's no mention of PEM, or any reference to research on repeat CPETs. If a significant portion of the people tested experience PEM, then the particular result achieved in a single test says very little about their fitness levels. I don't see how participants could give informed consent if PEM was not discussed.
    They talk about the safety of their study and the lack of adverse events, and yet there was no monitoring of patients after the CPET.

    I find the 'non-achievers' term rather offensive. They could have used 'people who did not achieve their predicted 85%HRmax' or the 'sub-85%HRmax cohort' rather than that term that suggests a much more global failure.

    The researchers probably did not mean to cause harm. I hope someone can contact these people at the School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland and offer to help them learn what they need to know in order to be more effective investigators. @Tom Kindlon, @PhysiosforME
     
    Last edited: May 16, 2022

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