COVID Recovery – The Other Part of the Story

The data regarding recovery from a severe COVID infection is still in its nascent stages. We know that exercise intolerance, even months after a case of COVID-19, is common.1

A recent study out of Switzerland adds to what we know about the lingering effects of COVID months after a hospital discharge.²

Long-lasting Exercise Impairment from COVID-19

Kathleen Jahn and colleagues followed 44 of their patients discharged alive after severe pneumonia. Surprisingly, even after receiving physiotherapy in the hospital and more physiotherapy on an outpatient basis, more than half (54%) of patients continued to demonstrate mild-to-moderate exercise intolerance three months after hospital discharge.

Muscle Deconditioning is the Most Common Source of Post-COVID Exercise Intolerance

The other surprise was what was causing the exercise intolerance. All patients received cardio-pulmonary exercise testing (CPET). This consisted of various measurements of breathing and gases while using a cycle ergometer. CPET enabled investigators to determine the source of exercise impairment. Despite the severity of COVID -19 pneumonia, only 14% of survivors experienced lung and breathing impairment after three months. Fourteen percent of survivors equates to 26% of those with ongoing exercise impairment. Among those with exercise impairment, limitations stemmed from cardiovascular challenges for another 26%. The largest source of exercise impairment proved to be resistant muscle deconditioning – 47%.

The Importance of Overcoming Exercise Impairment

Measurements used by the researchers included peak oxygen uptake (VO2max). This clinical measurement charts the highest value of oxygen uptake attained in a high-intensity exercise test that brings a person to the limit of tolerance.³VO2max stands out as a strong predictor of future health, all-cause mortality, and cardiovascular risk.⁴

Takeaway Message

The authors of the current study state that this data underscores the importance of rehabilitation following a severe case of COVID. Bouncing back to normal function may be harder than one might imagine, and extended time spent with reduced exercise capacity may invite future risk. If a disease leaves you with exercise intolerance, ask for inpatient and outpatient physiotherapy. At Advanced Physiotherapy, we have the added advantage of a patient-only gym to facilitate your ongoing recovery.

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References

Paneroni M, Simonelli C, Saleri M, Bertacchini L, Venturelli M, Troosters T, Ambrosino N, Vitacca M. Muscle strength and physical performance in patients without previous disabilities recovering from COVID-19 pneumonia. American Journal of Physical Medicine & Rehabilitation. 2021 Feb 1;100(2):105-9.
Jahn K, Sava M, Sommer G, Schumann DM, Bassetti S, Siegemund M, Battegay M, Stolz D, Tamm M, Khanna N, Hostettler KE. Exercise capacity impairment after COVID-19 pneumonia is mainly caused by deconditioning. European Respiratory Journal. 2022 Jan 1;59(1).
Cade WT, Bohnert KL, Reeds DN, Peterson LR, Bittel AJ, Bashir A, Byrne BJ, Taylor CL. Peak oxygen uptake (VO2peak) across childhood, adolescence and young adulthood in Barth syndrome: Data from cross-sectional and longitudinal studies. PLoS One. 2018 May 24;13(5):e0197776.
DeFina LF, Haskell WL, Willis BL, Barlow CE, Finley CE, Levine BD, Cooper KH. Physical activity versus cardiorespiratory fitness: two (partly) distinct components of cardiovascular health?. Progress in Cardiovascular Diseases. 2015 Jan 1;57(4):324-9.