Corona-consequences: The impact of lockdown on cardiopulmonary function of children with congenital heart disease

ABSTRACT

Background: As a consequence of the COVID-19 lockdown physical activity (PA) was difficult to access. PA is essential for improving and maintaining cardiopulmonary function, assessed by cardiopulmonary exercise testing (CPET) as VO2 peak. VO2 peak is the best predictor for mortality and morbidity in patients with congenital heart disease (CHD). The question arises whether the COVID-19-lockdown led to a loss of cardiopulmonary function in typical cardiopediatric patients. Method: We conducted a retrospective study in which CPETs from before lockdown were compared with twin-paired tests during lockdown. The matching of the twins consisted of similar heart disease, comparable age, sex, and test method. The patients consisted of typical patients from our hospital. All tests were performed on either a treadmill or a bicycle. Results: We were able to twin-pair 90 tests leading to 45 twins. Overall, there were 38 healthy and 52 patients with CHD. A mean RER of more than 1.1 was achieved in both groups with comparable exercise times. There was a significant decrease of cardiopulmonary function in patients with CHD along with peak O2pulse and peak VEs ([Table]). Healthy children showed a nonsignificant increase of cardiopulmonary function. Conclusion: During lockdown cardiopulmonary function declined in our patients with CHD. Causes for this decline could be the lack of availability of sports facilities, restriction of regular daily movement, and the closing of schools and curricular PA. Interestingly, healthy children did not show this loss of cardiopulmonary function. Maybe this could point to more movement-oriented school concepts in the future.