There are increasing reports of persisting exertional dyspnea several months after acute SARS-CoV-2 infection. The aim of this study was to evaluate pulmonary, cardiac, and functional capacity of SARS-CoV-2 survivors at 3 months after initial diagnosis by performing cardio-pulmonary exercise testing (CPET).

CPET was proposed to all patients who were treated both in and out of hospital settings at a tertiary university hospital at 3 months (±1 month) after the diagnosis of SARS-CoV-2 infection.

A total of 114 patients were included in the study. The median age was 57 [48–66] and 30% were women. 91% required in-hospital treatment during the initial SARS-CoV-2 infection and 22% needed intensive care unit (ICU) admission. At 3-month follow-up, 51% of patients were still symptomatic and 40% reported dyspnea at exertion. During CPET, 71% of patients had impairment of exercise capacity, mostly due to muscle deconditioning (43%) and/or hyperventilation (16%). In multivariable-adjusted analysis, age (β=0.4, P=0.002), ICU stay (β=−10.27, P=0.017), endotracheal intubation and mechanical ventilation (β=−12.63, P=0.004) and total hospital length of stay (β=−0.24, P=0.009) were independently associated with % predicted oxygen uptake (peak VO₂) (Figure 1).

The majority of SARS-CoV-2 survivors had impairment of exercise capacity at 3 months after initial illness, mostly due to muscle deconditioning and exercise hyperventilation. Age and factors related to initial disease severity such as ICU stay and mechanical ventilation were predictive of worse performance during CPET.