Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome

Patients recovering from COVID-19 commonly report persistence of dyspnea, exertional fatigue, and difficulties in carrying out their daily activities. However, the nature of these symptoms is still unknown. The purpose of the study was to identify limiting causes of cardiopulmonary origin for the pe...

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Autores principales:	Amaya Jimeno-Almazán, Jesús G. Pallarés, Ángel Buendía-Romero, Alejandro Martínez-Cava, Javier Courel-Ibáñez
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	post-COVID-19 condition long COVID-19 long-haulers chronic fatigue post-exertional malaise autonomic nervous system Medicine R
Acceso en línea:	https://doaj.org/article/2f5f90ffdf6e4f918952896f2389012e
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spelling	oai:doaj.org-article:2f5f90ffdf6e4f918952896f2389012e2021-11-25T18:02:48ZChronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome10.3390/jcm102254342077-0383https://doaj.org/article/2f5f90ffdf6e4f918952896f2389012e2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5434https://doaj.org/toc/2077-0383Patients recovering from COVID-19 commonly report persistence of dyspnea, exertional fatigue, and difficulties in carrying out their daily activities. However, the nature of these symptoms is still unknown. The purpose of the study was to identify limiting causes of cardiopulmonary origin for the performance of physical exercise in post-COVID-19 condition that could explain the symptomatic persistence of dyspnea or fatigue-related symptoms. Thirty-two non-hospitalized patients with post-COVID-19 condition (i.e., still presenting a chronic symptomatic phase lasting >90 days since debut of symptoms that lasted for at least 2 months and cannot be explained by an alternative diagnosis) completed a clinical examination including echocardiography, submaximal and maximal cardiorespiratory fitness tests (Ekblom-Bak and Bruce’s protocols), and a battery of validated questionnaires about fatigue and exercise intolerance. Four participants (12.5%) reported an abnormal cardiac response to exercise during the submaximal test, which aroused suspicion of the presence of chronotropic incompetence. All of them were confirmed with a positive diagnosis maximal exercise test after cardiology screening, even with a comprehensive clinical examination, resting ECG, and echocardiogram, without other findings. No statistical differences were found in any physiological variables or questionnaire values, between patients with positive and negative diagnoses. Chronotropic incompetence and other autonomic disorders may appear in patients with mild forms of COVID-19 presentation and may persist in the long term, being responsible for exercise intolerance after resolution of acute infection. Clinicians should be aware that chronotropic incompetence and other autonomic disorders may be a complication of COVID-19 and should consider appropriate diagnostic and therapeutic interventions in these patients, especially when early exercise-related fatigability is reported.Amaya Jimeno-AlmazánJesús G. PallarésÁngel Buendía-RomeroAlejandro Martínez-CavaJavier Courel-IbáñezMDPI AGarticlepost-COVID-19 conditionlong COVID-19long-haulerschronic fatiguepost-exertional malaiseautonomic nervous systemMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5434, p 5434 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	post-COVID-19 condition long COVID-19 long-haulers chronic fatigue post-exertional malaise autonomic nervous system Medicine R
spellingShingle	post-COVID-19 condition long COVID-19 long-haulers chronic fatigue post-exertional malaise autonomic nervous system Medicine R Amaya Jimeno-Almazán Jesús G. Pallarés Ángel Buendía-Romero Alejandro Martínez-Cava Javier Courel-Ibáñez Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome
description	Patients recovering from COVID-19 commonly report persistence of dyspnea, exertional fatigue, and difficulties in carrying out their daily activities. However, the nature of these symptoms is still unknown. The purpose of the study was to identify limiting causes of cardiopulmonary origin for the performance of physical exercise in post-COVID-19 condition that could explain the symptomatic persistence of dyspnea or fatigue-related symptoms. Thirty-two non-hospitalized patients with post-COVID-19 condition (i.e., still presenting a chronic symptomatic phase lasting >90 days since debut of symptoms that lasted for at least 2 months and cannot be explained by an alternative diagnosis) completed a clinical examination including echocardiography, submaximal and maximal cardiorespiratory fitness tests (Ekblom-Bak and Bruce’s protocols), and a battery of validated questionnaires about fatigue and exercise intolerance. Four participants (12.5%) reported an abnormal cardiac response to exercise during the submaximal test, which aroused suspicion of the presence of chronotropic incompetence. All of them were confirmed with a positive diagnosis maximal exercise test after cardiology screening, even with a comprehensive clinical examination, resting ECG, and echocardiogram, without other findings. No statistical differences were found in any physiological variables or questionnaire values, between patients with positive and negative diagnoses. Chronotropic incompetence and other autonomic disorders may appear in patients with mild forms of COVID-19 presentation and may persist in the long term, being responsible for exercise intolerance after resolution of acute infection. Clinicians should be aware that chronotropic incompetence and other autonomic disorders may be a complication of COVID-19 and should consider appropriate diagnostic and therapeutic interventions in these patients, especially when early exercise-related fatigability is reported.
format	article
author	Amaya Jimeno-Almazán Jesús G. Pallarés Ángel Buendía-Romero Alejandro Martínez-Cava Javier Courel-Ibáñez
author_facet	Amaya Jimeno-Almazán Jesús G. Pallarés Ángel Buendía-Romero Alejandro Martínez-Cava Javier Courel-Ibáñez
author_sort	Amaya Jimeno-Almazán
title	Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome
title_short	Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome
title_full	Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome
title_fullStr	Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome
title_full_unstemmed	Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome
title_sort	chronotropic incompetence in non-hospitalized patients with post-covid-19 syndrome
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2f5f90ffdf6e4f918952896f2389012e
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Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome

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