A75-17 Ventilatory Inefficiency And VO2 Are Associated With Trajectory Of Cognitive And Physical Health Symptoms In Long Covid

Rationale

Long COVID remains a post-viral sequela with high prevalence (5-7%) despite the decrease in hospitalizations and mortality after the widespread availability of effective vaccines. Prominent symptoms include neurocognitive or memory issues (“brain fog”), chronic fatigue, and exercise intolerance. The relationship between measurable cardiopulmonary fitness in long COVID on longitudinal changes in patient-reported outcome questionnaires is unknown.

Methods

We performed a longitudinal analysis of patients with available baseline cardiopulmonary exercise testing (CPET) and two or more Patient-Reported Outcomes Measurement Information System (PROMIS) assessments followed at an academic referral center for long COVID. Patients were diagnosed with long COVID using CDC criteria and evaluated with CPET for dyspnea and/or chronic fatigue. Spearman correlations between three baseline weight-adjusted CPET variables: peak oxygen uptake (Peak VO₂), oxygen uptake at anaerobic threshold (VO₂@AT), and ventilatory efficiency at anaerobic threshold (VE/VCO₂@AT), and change in three PROMIS T-scores and individual items (CAT v1.0 Dyspnea Severity, CAT v2.0 Cognitive Function, and CAT Scale v.1.2 Global Health), were computed with Benjamini-Hochberg FDR correction for 39 comparisons. Partial correlations controlling for baseline PROMIS score were computed as a sensitivity analysis.

Results

44 patients were identified with a median follow-up of 308 days. VE/VCO₂@AT was significantly associated with Global Physical Health T-Score change (ρ=-0.68, 95% CI -0.86 to -0.35, q = 0.029). Patients in the highest VE/VCO₂ tertile experienced a decline in Physical Health T-score (-2.0 points) while those in the lowest tertile improved (+5.0 points) (Fig 1). Partial correlations revealed significant associations between Peak VO₂ and improvement in general health (GLOBAL01, partial ρ = 0.68, p < 0.001) and between VO₂@AT and cognitive function change (partial ρ = 0.49, p = 0.003)

Conclusions

Baseline ventilatory inefficiency is associated with longitudinal trajectory of patient-reported physical health. Cardiopulmonary fitness also predicts improvements in self-reported general health and cognitive function after controlling for baseline status.

This abstract is funded by: None