Cardiopulmonary, Functional, Cognitive and Mental Health Outcomes Post-COVID-19, Across the Range of Severity of Acute Illness, in a Physically Active, Working-Age Population

O’Sullivan, Oliver; Holdsworth, David A.; Ladlow, Peter; Barker-Davies, Robert M.; Chamley, Rebecca; Houston, Andrew; May, Samantha; Dewson, Dominic; Mills, Daniel; Pierce, Kayleigh; Mitchell, James; Xie, Cheng; Sellon, Edward; Naylor, Jon; Mulae, Joseph; Cranley, Mark; Talbot, Nick P.; Rider, Oliver J.; Nicol, Edward D.; Bennett, Alexander N.

doi:10.1186/s40798-023-00552-0

Sports Medicine - Open

Table 4 Cardiopulmonary exercise testing (CPET) parameters (mean ± SD)

From: Cardiopulmonary, Functional, Cognitive and Mental Health Outcomes Post-COVID-19, Across the Range of Severity of Acute Illness, in a Physically Active, Working-Age Population

Variable	H	CS	CR	COM	F Score	P value	Post hoc comparison
CPET
V̇O₂ at Rest (ml/kg/min)	4.8 ± 0.9	4.9 ± 1.0	5.5 ± 1.2	5.5 ± 1.8	2.583	0.057
V̇O₂ at VT1 (ml/kg/min)	12.3 ± 1.9	14.5 ± 3.9	17.2 ± 3.0	18.2 ± 5.6	14.665	< 0.001	†*, §, ¥*
V̇O₂ at Peak (ml/kg/min)	30.5 ± 5.4	34.4 ± 7.2	44.3 ± 7.4	43.9 ± 13.1	17.788	< 0.001	†*, §, #, ¥**
V̇O₂ at VT1 (% of predicted peak)	43 ± 7	46 ± 11	49 ± 11	56 ± 17	6.470	< 0.001	§*, ¥*
V̇O₂ at Peak (% of predicted)	108 ± 16	111 ± 19	122 ± 19	133 ± 25	9.510	< 0.001	§*, ¥*
Workload at VT1 (W)	70 ± 15	85 ± 33	100 ± 26	109 ± 34	11.036	< 0.001	†, §, ¥*
Workload at peak (W)	231 ± 35	255 ± 61	308 ± 60	304 ± 65	12.641	< 0.001	†*, §, #, ¥*
Workload at peak (% of predicted)	97 ± 17	100 ± 23	115 ± 16	127 ± 32	10.692	< 0.001	†, §, ¥*
W/Kg at VT1	0.74 ± 0.17	0.92 ± 0.36	1.20 ± 0.29	1.38 ± 0.38	25.266	< 0.001	†*, §, #, ¥**
W/Kg at Peak	2.44 ± 0.47	2.77 ± 0.68	3.73 ± 0.67	3.89 ± 0.82	14.086	< 0.001	†*, §, #, ¥*
Δ V̇O₂ (l/min)/Δ Work (W)	10.9 ± 1.0	11.2 ± 2.2	11.2 ± 0.9	11.5 ± 0.7	1.971	0.123
Lactate at rest (mmol/L)	1.3 ± 0.5	1.3 ± 0.5	1.4 ± 0.4	1.2 ± 0.4	0.691	0.559
Lactate at peak (mmol/L)	12.1 ± 2.5	13.1 ± 2.3	14.1 ± 2.4	14.2 ± 1.5	5.393	0.002	†, §*
O₂ Pulse	16.7 ± 3.8	18.5 ± 4.7	21.1 ± 3.7	21.1 ± 4.7	7.131	< 0.001	† §
O₂ Pulse (% of predicted peak)	97 ± 20	105 ± 20	119 ± 17	126 ± 22	12.045	< 0.001	†, §*, ¥
Heart rate profile
HR at rest (bpm)	82 ± 11	84 ± 13	77 ± 15	73 ± 8	4.791	0.004	§, ¥*
HR at VT1 (bpm)	106 ± 14	108 ± 15	107 ± 12	107 ± 8	0.163	0.921
HR at peak (bpm)	172 ± 15	175 ± 16	178 ± 7	175 ± 8	0.833	0.479
% of predicted max HR	110 ± 10	108 ± 9	107 ± 5	108 ± 7	0.650	0.585
HRR after 1-min (bpm)	25 ± 10	28 ± 11	30 ± 16	26 ± 8	1.053	0.372
Blood pressure (mmHg)
Resting systolic BP (mmHg)	126 ± 10	120 ± 11	117 ± 10	121 ± 10	3.670	0.015	†*
Resting diastolic BP (mmHg)	85 ± 7	84 ± 8	79 ± 8	79 ± 6	5.795	0.001	†, §, ¥
VT1 systolic BP (mmHg)	142 ± 17	144 ± 15	135 ± 17	142 ± 14	1.381	0.252
VT1 diastolic BP (mmHg)	85 ± 17	83 ± 16	76 ± 9	82 ± 12	1.681	0.175
Peak systolic BP (mmHg)	169 ± 20	171 ± 18	160 ± 23	166 ± 37	1.392	0.249
Peak diastolic BP (mmHg)	73 ± 27	79 ± 19	66 ± 20	73 ± 22	1.526	0.212
Ventilation
BF at rest (breaths/min)	17 ± 5	16 ± 5	14 ± 3	16 ± 4	0.998	0.397
BF at VT1 (breaths/min)	20 ± 7	21 ± 6	18 ± 4	20 ± 4	1.158	0.329
BF at peak (breaths/min)	47 ± 12	47 ± 12	46 ± 6	51 ± 11	1.445	0.234
V̇E/ V̇CO₂ at rest	30.8 ± 4.8	30.5 ± 5.3	28.1 ± 2.0	28.0 ± 3.1	3.462	0.019
V̇E/ V̇CO₂ at VT1	27.8 ± 4.0	26.7 ± 4.0	24.1 ± 1.7	24.3 ± 2.0	7.807	< 0.001	†, §, ¥*
V̇E/ V̇CO₂ at peak	34.4 ± 5.5	33.2 ± 4.0	30.5 ± 3.1	31.3 ± 3.3	4.431	0.006	†, §
V̇E/ V̇CO₂ slope	29.6 ± 5.1	27.9 ± 5.3	24.1 ± 6.0	25.5 ± 2.6	6.422	< 0.001	†*, §
pCO₂ rest	5.2 ± 0.8	4.9 ± 0.6	5.1 ± 0.6	5.1 ± 0.5	1.927	0.130
pCO₂ peak	4.5 ± 0.9	4.3 ± 0.8	4.6 ± 0.6	4.4 ± 0.6	0.855	0.467
OUES	3.01 ± 0.58	3.34 ± 0.96	4.88 ± 1.11	3.79 ± 0.93	3.689	0.014	†**
Resting spirometry
FEV1 value (L)	3.7 ± 0.6	3.9 ± 0.8	4.3 ± 0.4	4.1 ± 0.6	2.859	0.041
FEV1% predicted	96 ± 14	93 ± 11	97 ± 14	102 ± 13	2.362	0.076
FVC value (L)	4.7 ± 0.9	5.2 ± 1.1	5.7 ± 0.6	5.3 ± 0.7	4.751	0.004	†**
FVC % predicted	99 ± 14	101 ± 13	106 ± 11	108 ± 10	3.142	0.028	§*

Bold denotes a statistically significant result, with the level denoted by asterisk(s)
Abbreviations: VT1, 1^st ventilatory threshold; HR, heart rate; HRR, heart rate recovery; BP, blood pressure; BF, breathing frequency; OUES, oxygen uptake efficiency slope. H, hospitalised illness; CS, community illness with on-going symptoms (community-symptomatic), CR, community illness now recovered (community-recovered; COM, age-, gender- and job-role-matched comparison population. There was no significant difference between H versus CS and CR versus COM for any CPET-related parameter
^†, H vs. CR; §, H vs. COM; #, CS vs. CR; ¥, CS vs. COM. Level of significance: *P < 0.05, **P < 0.01 ***P < 0.001

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