There is emerging evidence of prolonged recovery in survivors of coronavirus disease 2019 (COVID-19), even in those with mild COVID-19. In this paper, we report a case of a 39-year-old male with excessive body weight and a history of borderline values of arterial hypertension without therapy, who was mainly complaining of progressive dyspnea after being diagnosed with mild COVID-19. According to the recent guidelines on the holistic assessment and management of patients who had COVID-19, all preferred diagnostic procedures, including multidetector computed tomography (CT), CT pulmonary angiogram, and echocardiography, should be conducted. However, in our patient, no underlying cardiopulmonary disorder has been established. Therefore, considering all additional symptoms our patient had beyond dyspnea, our initial differential diagnosis included anxiety-related dysfunctional breathing. However, psychiatric evaluation revealed that our patient had only a mild anxiety level, which was unlikely to provoke somatic complaints. We decided to perform further investigations considering that cardiopulmonary exercise test (CPET) represents a reliable diagnostic tool for patients with unexplained dyspnea. Finally, the CPET elucidated the diastolic dysfunction of the left ventricle, which was the most probable cause of progressive dyspnea in our patient. We suggested that, based on uncontrolled cardiovascular risk factors our patient had, COVID-19 triggered a subclinical form of heart failure (HF) with preserved ejection fraction (HFpEF) to become clinically manifest. Recently, the new onset, exacerbation, or transition from subclinical to clinical HFpEF has been associated with COVID-19. Therefore, in addition to the present literature, our case should warn physicians on HFpEF among survivors of COVID-19.

有新的证据表明 2019 年冠状病毒病 (COVID-19) 的幸存者可以延长康复时间，即使是轻度 COVID-19 患者也是如此。在本文中，我们报告了一例 39 岁男性体重过重且未经治疗的动脉高血压临界值病史，他在被诊断为轻度 COVID-19 后主要主诉进行性呼吸困难。根据最近关于 COVID-19 患者整体评估和管理的指南，应进行所有首选的诊断程序，包括多排计算机断层扫描 (CT)、CT 肺血管造影和超声心动图。然而，在我们的患者中，尚未确定潜在的心肺疾病。因此，考虑到我们的患者除了呼吸困难之外的所有其他症状，我们最初的鉴别诊断包括与焦虑相关的呼吸功能障碍。然而，精神病学评估显示，我们的患者只有轻度焦虑水平，不太可能引起躯体不适。考虑到心肺运动试验 (CPET) 是对不明原因呼吸困难患者的可靠诊断工具，我们决定进行进一步调查。最后，CPET 阐明了左心室舒张功能障碍，这是我们患者进行性呼吸困难的最可能原因。我们建议，基于我们患者不受控制的心血管危险因素，COVID-19 引发了一种亚临床形式的射血分数保留的心力衰竭 (HF)，使其临床表现出来。最近，新的发作、加重、或从亚临床到临床 HFpEF 的转变与 COVID-19 相关。因此，除了目前的文献外，我们的案例还应警告医生在 COVID-19 幸存者中使用 HFpEF。