October 14, 2022 – According to a new study published in Open JAMA Network.
Researchers from the University of California, San Francisco and Zuckerberg General Hospital in San Francisco identified 38 previous studies that used cardiopulmonary exercise testing (CPET) to measure how well people with a long COVID could exercise after recovering from COVID. The CPET measured how much oxygen they used when they exercised on a stationary bike or treadmill to find out how well their heart and lungs were working.
Someone who used to play doubles tennis, for example, may find they need to switch to a low-impact sport like golf if they have long COVID symptoms, said the lead author and cardiologist. UCSF Matthew Durstenfeld, MD, in a press release.
“But it’s important to note that this is an average,” he said. “Some individuals experience a profound decrease in energy capacity and many others experience no decrease at all.”
The team narrowed their sample of 38 studies to 9, comparing the stress test results of 359 people who recovered from COVID to those of 464 people who had symptoms consistent with long COVID. The age range of the people studied was 39 to 56 years old.
If the authors say they have some reservations about the results of their meta-analysis – primarily due to small study sample sizes, oversampling of COVID patients who have been hospitalized, and varying definitions of long COVID – their findings “consistently provided evidence of a clinically significant, mild to moderate decrease in exercise capacity in people with [long COVID] compared to infected people without symptoms despite different definitions of [long COVID],” they wrote.
Losing some exercise capacity due to long COVID symptoms is not new information, but understanding the role of CPET results in long COVID patients can be a powerful measurement tool.
Among the limitations of the study, the researchers noted that their research design was not peer-reviewed and that the studies included in the review were not limited to peer-reviewed articles only. Selection bias – the fact that so many people in the study were assessed after recovering from severe COVID infections – also made it difficult to get a clear picture of how often reduced ability to ‘exercise.
“Further research should include long-term observational assessments to understand the trajectory of exercise capacity,” says author Priscilla Hsue, MD. “Trials of potential therapies are urgently needed, including rehabilitation studies to treat deconditioning, as well as further research into dysfunctional breathing, damage to the nerves that control the body’s automatic functions, and the inability to function. ‘raise the heart rate adequately during exercise.’
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