Dysfunctional breathing after COVID-19: symptoms, functional impact and quality of life

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.