Evidence map›Paper›PMID 34311011›Full record

ArticleInternational journal of cardiology2021

Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up.

Piero Clavario, Vincenzo De Marzo, Roberta Lotti, Cristina Barbara, Annalisa Porcile, Carmelo Russo, Federica Beccaria, Marco Bonavia, Luigi Carlo Bottaro, Marta Caltabellotta and 7 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 7 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 7 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Pooled it
  2. Global prevalence of post-COVID-19 condition: a systematic review and meta-analysis of prospective evidence.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2025
    Pooled it
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  4. SARS-CoV-2 post-acute sequelae in previously hospitalised patients: systematic literature review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023
    Pooled it
  5. Pooled it
  6. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 2 countries.

Piero ClavarioCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Vincenzo De MarzoCardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.
Roberta LottiCardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.
Cristina BarbaraCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Annalisa PorcileCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Carmelo RussoCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Federica BeccariaCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Marco BonaviaCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Luigi Carlo BottaroCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Marta CaltabellottaCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Flavia ChioniCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Monica SantangeloCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Arto J HautalaFaculty of Sports and Health Sciences, University of Jyväskylä, Finland.
Raffaele GriffoCardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy.
Gianfranco ParatiDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Ugo CorràIRCCS, Istituti Clinici Scientifici Maugeri, Care and Research Institute, Department of Cardiac Rehabilitation, Veruno-Novara, Italy.
Italo PortoCardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy. Electronic address: italo.porto@unige.it.
Azienda Mobilità e Trasporti · ITASL Roma · ITOspedale Policlinico San Martino · ITIstituti Clinici Scientifici Maugeri · ITUniversity of Genoa · ITUniversity of Jyväskylä · FIUniversity of Milano-Bicocca · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-term effects of Coronavirus Disease of 2019 (COVID-19) are of utmost relevance. We aimed to determine: 1) the functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET); 2) the characteristics associated with cardiopulmonary exercise testing (CPET) performance; 3) the safety and tolerability of CPET.

methodsWe prospectively enrolled consecutive patients with laboratory-confirmed COVID-19 from Azienda Sanitaria Locale 3, Genoa. Three months after hospital discharge a complete clinical evaluation, trans-thoracic echocardiography, CPET, pulmonary function tests, and dominant leg extension (DLE) maximal strength measurement were performed.

resultsFrom the 225 patients discharged alive from March to November 2020, we excluded 12 incomplete/missing cases and 13 unable to perform CPET, leading to a final cohort of 200. Median percent-predicted peak oxygen uptake (%pVO2) was 88% (78.3-103.1). Ninety-nine (49.5%) patients had %pVO2 below, whereas 101 (50.5%) above the 85% predicted value. Among the 99 patients with reduced %pVO2, 61 (61%) had a normal anaerobic threshold: of these, 9(14.8%) had respiratory, 21(34.4%) cardiac, and 31(50.8%) non-cardiopulmonary reasons for exercise limitation. Inerestingly, 80% of patients experienced at least one disabling symtpom, not related to %pVO2 or functional capacity. Multivariate linear regression showed percent-predicted forced expiratory volume in one-second(β = 5.29,p = 0.023), percent-predicted diffusing capacity of lungs for carbon monoxide(β = 6.31,p = 0.001), and DLE maximal strength(β = 14.09,p = 0.008) to be independently associated with pVO2. No adverse event was reported during or after CPET, and no involved health professional developed COVID-19.

conclusionsAt three months after discharge, about 1/3rd of COVID-19 survivors show functional limitations, mainly explained by muscular impairment, calling for future research to identify patients at higher risk of long-term effects that may benefit from careful surveillance and targeted rehabilitation.

Indexed as

COVID-19Exercise TestEchocardiographyExercise ToleranceFollow-Up StudiesHumansOxygen ConsumptionSARS-CoV-2Cardiopulmonary exercise testingCoronavirusCoronavirus infectionCOVID-19Lung diseasesSevere acute respiratory syndrome

Identifiers

PMID34311011
PMCPMC8302817
OpenAlexW3184463770

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.