A75-18 Peak VO2 Is Strongly Associated With Both Cognitive And Respiratory 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 and patient-reported outcome questionnaires remains incompletely characterized.

Methods

A cross-sectional analysis of patients with temporally-aligned (within 6 months) cardiopulmonary exercise test (CPET) and Patient-Reported Outcomes Measurement Information System (PROMIS) assessments at an academic referral center. Patients were diagnosed with long COVID by CDC criteria and referred for CPET for the evaluation of dyspnea and/or chronic fatigue. Spearman correlations between three body weight-adjusted CPET variables peak oxygen update (peak VO₂), oxygen uptake at anerobic threshold (VO₂@AT), and respiratory efficiency at anerobic threshold (VE/VCO₂@AT), and 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 36 comparisons.

Results

48 patients were included. 20 of 36 correlations reached FDR-corrected significance (q < 0.05). Peak VO₂ showed the strongest associations: inversely correlated with Dyspnea T-Score (ρ=-0.64, 95% CI -0.79 to -0.42, q < 0.001) and positively correlated with Global Physical Health T-Score (ρ = 0.64, 95% CI 0.42-0.79, q < 0.001). Both peak VO₂ (ρ = 0.36, q = 0.037) and VO₂@AT (ρ = 0.33, q = 0.045) significantly correlated with Cognitive Function T-Score (Fig 1). Findings were robust across sensitivity analyses.

Conclusions

Cardiopulmonary fitness measures demonstrate strong correlations with patient-reported physical health and cognitive outcomes, supporting the clinical relevance of CPET in understanding patient-perceived functional status.

This abstract is funded by: None