Does wearing a facemask decrease arterial blood oxygenation and impair exercise tolerance?

https://doi.org/10.1016/j.resp.2021.103765Get rights and content

Highlights

  • COVID-19 face have been suggested to cause arterial hypoxemia and hypercapnia during exercise.

  • We demonstrate that arterial oxygenation and peak exercise capacity is not altered with mask wearing.

  • Despite the intransigence of arterial O2 saturation, subjects rated their dyspnea significantly higher during mask wearing.

Abstract

Introduction

Concerns have been raised that COVID-19 face coverings compromise lung function and pulmonary gas exchange to the extent that they produce arterial hypoxemia and hypercapnia during high intensity exercise resulting in exercise intolerance in recreational exercisers. This study therefore aimed to investigate the effects of a surgical, flannel or vertical-fold N95 masks on cardiorespiratory responses to incremental exercise.

Methods

This investigation studied 11 adult males and females at rest and while performing progressive cycle exercise to exhaustion. We tested the hypotheses that wearing a surgical (S), flannel (F) or horizontal-fold N95 mask compared to no mask (control) would not promote arterial deoxygenation or exercise intolerance nor alter primary cardiovascular variables during submaximal or maximal exercise.

Results

Despite the masks significantly increasing end-expired peri-oral %CO2 and reducing %O2, each ∼0.8−2% during exercise (P < 0.05), our results supported the hypotheses. Specifically, none of these masks reduced sub-maximal or maximal exercise arterial O2 saturation (P = 0.744), but ratings of dyspnea were significantly increased (P = 0.007). Moreover, maximal exercise capacity was not compromised nor were there any significant alterations of primary cardiovascular responses (mean arterial pressure, stroke volume, cardiac output) found during sub-maximal exercise.

Conclusion

Whereas these results are for young healthy recreational male and female exercisers and cannot be applied directly to elite athletes, older or patient populations, they do support that arterial hypoxemia and exercise intolerance are not the obligatory consequences of COVID-19-indicated mask-wearing at least for cycling exercise.

Keywords

COVID-19 facemask
N95
Surgical facemask
Cycle exercise
Submaximal
Maximal
Exhaustion
Exercise-induced arterial hypoxemia
Cardiovascular responses
Rating of perceived exertion
Dyspnea

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