Cardiopulmonary function in pediatric post-COVID-19 A Controlled Clinical Trial

Purpose: Recently the importance of post-COVID-19 in children has been recognized in surveys and retrospective chart analysis. However, objective data in the form of CPET as performed in adults suffering from this condition are still lacking. This study aims to investigate the cardiopulmonary effects of post-COVID-19 on children and adolescents. Methods: In this cross-sectional study (the FASCINATE study) children fulfilling the criteria of post-COVID-19 and an age- and sex-matched control group underwent cardiopulmonary exercise testing on a treadmill and completed a questionnaire with regards to physical activity before, during and after the infection with SARS-CoV-2. Results: We were able to recruit 20 children suffering from post-COVID-19 (mean age: 12.8 ± 2.4 years, 60% females) and 28 control children (mean age: 11.7 ± 3.5 years, 50% females). All participants completed a maximal treadmill test with a significantly lower ( V̇O 2 peak ) in the post-COVID-19 group (37.4 ± 8.8 ml/kg/min vs. 43.0 ± 6.7 ml/kg/min). This significance did not persist when comparing the achieved ( V̇O 2 peak ) percent of predicted norms. There were no significant differences for oxygen pulse, heart rate, minute ventilation or breathing frequency. Conclusions: This is the first study to investigate post-COVID-19 in children using CPET. Although there was a significantly reduced ( V̇O 2 peak ) in the post-COVID-19 group, this was not true for the percent of predicted values. No pathological findings with respect to cardiac or pulmonary functions could be discerned. Deconditioning remained as the only plausible cause for the symptoms experienced.