ABSTRACT
Background: Dysfunctional breathing (DB) is increasingly recognized in long COVID. Associated symptoms, functional impact and quality of life (QoL) have not been systematically studied. Objective(s): We aimed to measure symptoms, functional impact and QoL in long COVID patients with new onset DB. Method(s): We included 55 patients (47.9 yr (14.4), female sex 72.7%) from our long COVID clinic with DB diagnosis based on compatible symptoms and abnormal breathing pattern during CPET. Questionnaires including mMRC scale, Nijmegen, short form 36 (SF-36), hospital anxiety and depression scale (HADS), post COVID functional scale (PFCS) and specific long COVID symptoms were administered. Result(s): Most patients had mild acute COVID-19 (admission rate 16.4%). Median time from SARS-CoV-2 diagnosis to CPET was 213 days (IQR 127), mean V'O2 was 90.4% (SD 20.2) pred. Hyperventilation, periodic sigh breathing and mixed types of DB were diagnosed in respectively 21.8%, 47.3%, 30.9% of patients. Mean (SD) Nijmegen score, PCFS and global HADS were 27.9 (11.9), 2.1 (0.8) and 16.6 (7.8) respectively. In addition to dyspnoea, most frequent symptoms on Nijmegen scale (cut-off >=3) were: faster or deeper breath (75.6%), unable to breath deeply (48.9%), sighs (53.5%), yawning (46.5%) and tight feeling in the chest (40.0%). SF36 scores were lower than population reference value. Conclusion(s): Long COVID patients living with DB have a high burden of symptom, functional impact and a low QoL despite normal exercise capacity.
ABSTRACT
Background: Cardio-pulmonary exercise test (CPET) can differentiate causes of persistent dyspnea beyond cardiopulmonary limitation. Dysfunctional breathing (DB) has been increasingly identified in long COVID in two main forms, hyperventilation [HV] or periodic deep sighing [PDS]. Aims and objectives: We aimed to contrast the CPET ventilatory parameters in post COVID patients without cardiopulmonary limitations. Four groups were compared a) normal CPET, b) PDS, c) HV and d) mixed pattern (PDS & HV). Method(s): CPET patterns (N, HV, PDS and mixed) were determined in 76 SARS-CoV2 patients [Mean age 48.2 (SD15.0), women (n=49, 64%)]. We compared breath by breath ventilatory parameters using raw data and coefficients of variation focusing on breathing frequency, tidal volume, VE/VCO2 and ins- and expiratory time. Result(s): Normal CPET were found in 26 (30%), HV in 12 (16%), PDS in 25 (33%) and mixed in 16 (21%)., dyspnea level and timing of evaluation between COVID and CPET (mean 230 days) were similar between groups. See figure for ventilatory parameters at rest and exercise. Conclusion(s): In long COVID patients with normal lung function and normal oxygen consumption but persistent dyspnea, assessment of the variability of ventilation at rest and exercise using CPET can reliably identify DB and differentiate its main forms (PDS or HV), thus offering a physiological explanation for dyspnea and allowing targeted therapy.
ABSTRACT
Somatic or psychological sequelae after a SARS-CoV-2 infection are common. Specific organ damage should be investigated to explain persistent symptomatology and propose a treatment. A specialized consultation for the follow-up of patients after a SARS-CoV-2 infection is useful to clinically assess the patient, organized further investigations, offer treatment options and refer the patient to other specialists or to a rehabilitation program. Such a consultation is also intended to reduce the public health burden of long Covid and to collect data that can improve our management in the future.