The value of clinical cardiopulmonary exercise testing (CPET) within healthcare settings has been established in the last decade. CPET methods remain highly relevant in the COVID-19 endemic phase and should be used to assess those recovering from COVID-19 (SARS-CoV-2) infection. This diagnostic tool could play an integral role in disease prognostication and evaluate the integrative response to incremental exercise. Date from such assessments can enable practitioners to characterise cardio-respiratory fitness and identify reasons for physical impairment or abnormal cardio-respiratory function. More than 50% of patients admitted to hospital will experience cardiorespiratory issues and significant morbidity during their recovery and will require significant rehabilitative support. In this context, measurements obtained from an assessment of cardio-respiratory responses to physiological stress could provide insight regarding the integrity of the pulmonary-vascular interface and characterisation of any impairment or abnormal cardio-respiratory function. Current approaches to rehabilitation are being developed on existing knowledge from Severe Acute Respiratory Syndrome (SARS) and Acute Respiratory Distress Syndrome (ARDS) related illness. These provide important insight but do not provide insight into the novel challenges provided by COVID-19.
Study Type
OBSERVATIONAL
Enrollment
146
Consecutive day 2 day CPET and follow up for 7 days for subjective feelings/fatigue.
University of Illinois at Chicago
Chicago, Illinois, United States
Ramaiah Medical College
Bengaluru, India
University of Derby
Derby, Derbyshire, United Kingdom
Sheffield Hallam University
Sheffield, South Yorkshire, United Kingdom
Northumbria University
Newcastle upon Tyne, United Kingdom
Cardiopulmonary Exercise Test- Rate of Oxygen Utilisation
Rate of Oxygen Utilisation (VO2; l/min)
Time frame: During CPET1 and CPET2
Cardiopulmonary Exercise Test- Rate of carbon dioxide production
Rate of Carbon Dioxide Production (VCO2; l/min)
Time frame: During CPET1 and CPET2
Cardiopulmonary Exercise Test- Respiratory Exchange Ratio
Respiratory Exchange Ratio (VO2/VCO2)
Time frame: During CPET1 and CPET2
Cardiopulmonary Exercise Test: Maximal Rate of Oxygen Utilisation
Maximal Rate of Oxygen Utilisation per kg body mass (VO2max; ml/kg/min)
Time frame: During CPET1 and CPET2
Cardiopulmonary Exercise Test- Respiratory Threshold
Respiratory Threshold breath by breath (l/min)
Time frame: During CPET1 and CPET2
Cardiopulmonary Exercise Test- Minute Ventilation
Minute Ventilation using breath by breath (l/min)
Time frame: During CPET1 and CPET2
Cardiopulmonary Exercise Test- Blood lactate
Blood Lactate Concentration from fingertip (mmol/l)
Time frame: During CPET1 and CPET2
Prevalence of symptoms of post exertional Malaise
Symptom Profile post exercise protocols- Questionnaire
Time frame: 7 days post exercise
Blood biomarkers of Inflammation- IL-6
Concentration of Interleukin 6
Time frame: Day 1 and Day 2
Blood biomarkers of Inflammation- IL-1
Concentration of Interleukin 1
Time frame: Day 1 and Day 2
Blood biomarkers of Inflammation- Microclots
Number of Microclots
Time frame: Day 1 and Day 2
Blood biomarkers of Inflammation- D-Dimer
D-Dimer Concentration
Time frame: Day 1 and Day 2
Blood biomarkers of Inflammation- CRP
C-Reactive protein Concentration
Time frame: Day 1 and Day 2
Echocardiogram
12 lead echocardiogram.
Time frame: Baseline, Day 1 and Day 2
Resting Systolic Blood Pressure
Systolic Blood Pressure at Rest (mmHg)
Time frame: Baseline, Day 1 and Day 2
Resting Diastolic Blood Pressure
Diastolic Blood Pressure at Rest (mmHg)
Time frame: Baseline, Day 1 and Day 2
Exercise Diastolic Blood Pressure
Diastolic Blood Pressure During Exercise (mmHg)
Time frame: Baseline, Day 1 and Day 2
Exercise Systolic Blood Pressure
Systolic Blood Pressure During Exercise (mmHg)
Time frame: Baseline, Day 1 and Day 2
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