Abstract

Introduction: Patients who have recovered from COVID-19 demonstrate a marked intolerance symptoms during exercise. However, cardiorrespiratory responses during exercise may be different between men and women affected by COVID-19. Objective: To contrast ventilatory, cardiovascular and metabolic responses during cardiopulmonary exercise testing (CPET) after recovery of critically ill patients after SARS-CoV-2 infection stratified by sex. Methods and results: This were a cross-sectional study with 31 patients after recovery of severe COVID-19, according to the classification of the WHO, divided into women (n=17, 55%) and male (n=14, 45%). Patients underwent to a CPET (ramp incremental protocol on a cycloergometer) 60 days after hospital discharge. Dyspnea was still reported by 90% of the subjects (mMRC ?1). The patients were matched by age (women: 46±6 vs male: 50±8 years, p=0.17) and weight (women: 80±18 vs male: 84±17kg, p=0.60). Women showed a lower peak oxygen uptake (mlO2.kg-1.min-1) (13.5±2.3 vs. male 15.0±2.9, p=0.02), ventilatory inefficiency V?E/V?CO2 slope (35±10 vs. male 29±4, p=0.04) and reduced load (99±28 vs. male 131±42 W, p=0.03). All patients experienced lower V?O2?peak (<80% predicted) after 60 days after hospital discharge for COVID-19. Patients had similar peak symptoms (Dyspnea 5±2 vs. male 6±2, p=0.22) and leg fatigue (7±2 vs. male 7±2, p=0.73). Conclusion: After 60 days of hospital discharge from severe COVID-19, aerobic capacity was markedly reduced in both sexes, however, excessive ventilatory response was observed more expressively in women, suggesting greater ventilatory inefficiency during exercise.