The effect of medium-term recovery status after COVID-19 illness on cardiopulmonary exercise capacity in a..., 2022, Ladlow et al

[Andy]

Full title: The effect of medium-term recovery status after COVID-19 illness on cardiopulmonary exercise capacity in a physically active adult population

Abstract

Background: A failure to fully recover following coronavirus disease 2019 (COVID-19) may have a profound impact on high functioning populations ranging from front-line emergency services to professional or amateur/recreational athletes.

Aim: To describe the medium-term cardiopulmonary exercise profiles of individuals with 'persistent symptoms' and individuals who feel 'recovered' after hospitalization or mild-moderate community infection following COVID-19 to an age, sex and job-role matched control group.

Methods: 113 participants underwent cardiopulmonary functional tests at a mean 159±7 days (~5 months) following acute illness; 27 hospitalized with persistent symptoms (hospitalized-symptomatic), 8 hospitalized and now recovered (hospitalized-recovered); 34 community managed with persistent symptoms (community-symptomatic); 18 community managed and now recovered (community-recovered), and 26 controls.

Results: Hospitalized groups had the least favorable body composition (body mass, body mass index and waist circumference) compared to controls. Hospitalized-symptomatic and community-symptomatic individuals had a lower oxygen uptake (V̇O2) at peak exercise (hospitalized-symptomatic, 29.9±5.0ml/kg/min; community-symptomatic, 34.4±7.2ml/kg/min; vs. control 43.9±3.1ml/kg/min, both p<0.001). Hospitalized-symptomatic individuals had a steeper V̇E/V̇CO2 slope (lower ventilatory efficiency) (30.5±5.3 vs. 25.5±2.6, p=0.003) vs. controls. Hospitalized-recovered had a significantly lower oxygen uptake at peak (32.6±6.6ml/kg/min vs. 43.9 ±13.1ml/kg/min, p=0.015) compared to controls. No significant differences were reported between community-recovered individuals and controls in any cardiopulmonary parameter.

Conclusion: Medium term findings suggest community-recovered individuals did not differ in cardiopulmonary fitness from physically active healthy controls. This suggests their readiness to return to higher levels of physical activity. However, the hospitalized-recovered group and both groups with persistent symptoms had enduring functional limitations, warranting further monitoring, rehabilitation and recovery.

Open access, https://journals.physiology.org/doi/abs/10.1152/japplphysiol.00138.2022

 

[Trish]

Does this mean they found that it was not a loss if fitness that was causing the non-hospitalisted long COVID patients to lose function? If so, that rather hits on the head the BPS hypothesis of deconditioning causing post viral loss of function.
The conclusion is concerning:

This suggests their readiness to return to higher levels of physical activity. However, the hospitalized-recovered group and both groups with persistent symptoms had enduring functional limitations, warranting further monitoring, rehabilitation and recovery.

It seems to imply that anyone who had not lost fitness has no barrier to returning to full function, all they need is 'rehabilitation'.

 

[rvallee]

What would rehabilitation do, then? It's basically used like a magical step, where whatever the problem is, "rehabilitation occurs". The reasoning is always deconditioning. Of course it was always BS but even after they find that it's not deconditioning, they still say it should be useful, even though the reason it's said to be useful is to recondition (and always using severely bedbound states as the reason, no matter how many times they are told explicitly that the vast majority never were, they straight up don't care what's true).

What a disaster this all is. This cult of mind over matter and toxic positivity has complete corrupted medicine's ability to do anything but mindlessly execute scripts. The complete detachment from not just reality but their own affirmations, their own if statements that are false and somehow still have to be performed.

 

[Snow Leopard]

All this means is that many LongCOVID symptoms are not due to reductions in cardiopulmonary exercise capacity.

It is extremely reductionistic to assume that lung (or heart) damage is the only limiting factor that prevents patients from exercising normally.