Objectives Persistent or late-onset cardiopulmonary symptoms following COVID-19 may occur in athletes despite a benign initial course. We examined the yield of cardiac evaluation, including cardiopulmonary exercise testing (CPET), in athletes with cardiopulmonary symptoms after COVID-19, compared CPETs in these athletes and those without COVID-19 and evaluated longitudinal changes in CPET with improvement in symptoms. Methods This prospective cohort study evaluated young (18–35 years old) athletes referred for cardiopulmonary symptoms that were present>28 days from COVID-19 diagnosis. CPET findings in post-COVID athletes were compared with a matched reference group of healthy athletes without COVID-19. Post-COVID athletes underwent repeat CPET between 3 and 6 months after initial evaluation. Results Twenty-one consecutive post-COVID athletes with cardiopulmonary symptoms (21.9±3.9 years old, 43% female) were evaluated 3.0±2.1 months after diagnosis. No athlete had active inflammatory heart disease. CPET reproduced presenting symptoms in 86%. Compared with reference athletes (n=42), there was similar peak VO2 but a higher prevalence of abnormal spirometry (42%) and low breathing reserve (42%). Thirteen athletes (62%) completed longitudinal follow-up (4.8±1.9 months). The majority (69%) had reduction in cardiopulmonary symptoms, accompanied by improvement in peak VO2 and oxygen pulse, and reduction in resting and peak heart rate (all p<0.05). Conclusion Despite a high burden of cardiopulmonary symptoms after COVID-19, no athlete had active inflammatory heart disease. CPET was clinically useful to reproduce symptoms with either normal testing or identification of abnormal spirometry as a potential therapeutic target. Improvement in post-COVID symptoms was accompanied by improvements in CPET parameters. Data are available upon reasonable request.

中文翻译：

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COVID-19 后出现持续症状的年轻运动员的诊断评估和心肺运动测试结果


目标 尽管初始病程良性，但运动员在感染 COVID-19 后可能会出现持续性或迟发性心肺症状。我们检查了 COVID-19 后出现心肺症状的运动员的心脏评估结果，包括心肺运动试验 (CPET)，比较了这些运动员和未患 COVID-19 的运动员的 CPET，并评估了 CPET 随着症状改善的纵向变化。方法 这项前瞻性队列研究评估了年轻（18-35 岁）运动员的心肺症状，这些症状在 COVID-19 诊断后 28 天以上出现。将新冠肺炎后运动员的 CPET 结果与未患新冠肺炎 (COVID-19) 的健康运动员的匹配参考组进行比较。新冠肺炎后运动员在初次评估后 3 至 6 个月内接受了重复 CPET。结果 21 名连续出现心肺症状的新冠肺炎后运动员（21.9±3.9 岁，43% 女性）在诊断后 3.0±2.1 个月进行了评估。没有运动员患有活动性炎症性心脏病。 CPET 再现症状的比例为 86%。与参考运动员 (n=42) 相比，峰值摄氧量相似，但肺量测定异常 (42%) 和呼吸储备低 (42%) 的发生率较高。 13 名运动员（62%）完成了纵向随访（4.8±1.9 个月）。大多数人 (69%) 心肺症状减轻，峰值摄氧量和氧脉搏改善，静息心率和峰值心率降低（全部 p<0.05）。结论 尽管 COVID-19 后心肺症状负担很重，但没有运动员患有活动性炎症性心脏病。 CPET 在临床上可用于通过正常测试或识别异常肺量测定作为潜在治疗目标来重现症状。 新冠肺炎后症状的改善伴随着 CPET 参数的改善。数据可根据合理要求提供。