Evaluation of Exertional Dyspnea During Recovery From SARS‐CoV‐2 Infection in Young Adults

Province, Valesha; Augenreich, Marc; Stute, Nina; Stickford, Abigail; Ratchford, Steve; Stickford, Jonathon

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection can result in severe physiological impairments to cardiovascular and respiratory function. Further, a hallmark symptom of SARS‐CoV‐2 infection is shortness of breath, even at rest, which may be exaggerated during periods of exertion. However, the lasting effects of COVID‐19 on quantitative measures of exertional breathlessness in otherwise healthy individuals is unknown. PURPOSE: The purpose of this study was to examine the sensory and affective dimensions of exertional dyspnea (i.e., shortness of breath during exercise) in otherwise healthy, young adults who had previously tested positive for SARS‐CoV‐2 over a period of three months. METHODS: Otherwise healthy, young adults (4M/3F, age: 21 ± 1 y, body mass index: 24.1±1.4 kgᐧm(‐2), aerobic fitness: 35.7± 11.3 mL·kg(‐1)·min(‐1)) who tested positive for SARS‐CoV‐2 completed an incremental exercise test to voluntary exhaustion on a cycle ergometer three‐to‐four weeks after the positive SARS‐CoV‐2 test result (BL), as well as one and two months following baseline testing (1M and 2M, respectively). Subjective ratings of perceived breathlessness (RPB) and unpleasantness of breathing (RPU) were collected at rest and during each stage of exercise. Following exercise completion, subjects rated the unpleasantness and accompanying negative emotions (depression, anxiety, frustration, anger, and fear) associated with their exertional dyspnea using a visual analog scale (VAS). RESULTS: RPB at rest, during cycling at 60W, and at peak exercise were similar across visits (p > 0.05). RPB during cycling at 120W tended to decrease across time (BL: 2.9±0.9; 1M: 2.1±1.1; 2M: 2.0±1.4; p = 0.06). RPU at rest, during cycling at 60W, 120W, and at peak exercise were not different between visits (p > 0.05). VAS ratings of anxiety (BL: 1.8±2.1 cm; 1M: 3.1±3.2 cm; 2M: 0.8±0.7 cm; p = 0.05), but not those of depression, unpleasantness, anger, frustration, or fear differed across visits (p > 0.05). CONCLUSION: These data suggest that the sensory dimension of exertional dyspnea during moderate intensity exercise improves (i.e., decreases) during recovery from SARS‐CoV‐2 infection. In contrast, the affective dimension of exertional dyspnea appears to be largely maintained throughout recovery, as only anxious emotions related to exertional dyspnea fluctuated over the three‐month time period.