Cardiopulmonary, functional, cognitive and mental health outcomes post COVID, across the range of severity of acute illness, in a physically active working age population

Abstract Objectives: To investigate cardiopulmonary, functional, cognitive, and mental health post-COVID-19 outcomes in a young, physically active working-age population, across the spectrum of acute COVID-19 severity. Methods: Observational cohort study of 4 groups; hospitalised, community illness with on-going symptoms (community-symptomatic), community illness now recovered (community-recovered) and controls. Participants underwent extensive clinical assessment involving cardiopulmonary imaging, submaximal and maximal exercise testing, pulmonary function, cognitive assessment, blood tests, electrocardiogram and questionnaires on mental health and physical function. Results: 113 participants (aged 39±9 and 86% male) were recruited into four groups, Hospitalised (n=35), community-symptomatic (n=34), community-recovered (n=18) and control (n=26), at 159±72days following acute illness. Hospitalized and community-symptomatic groups were older, with a higher body mass index, and worse mental health, fatigue, and quality of life scores. Hospitalised and community-symptomatic participants also performed less well on sub-maximal and maximal exercise testing. Hospitalised individuals had impaired ventilatory efficiency (higher VE/V̇CO2 slope), achieved less work at the anaerobic threshold and at peak than other groups and had a significantly reduced forced vital capacity. Clinically significant abnormal cardiopulmonary imaging findings were present in 6% of hospitalised participants. Those who recovered from COVID-19 had no significant differences when compared with controls.Conclusion: Recovered individuals who suffered mild-moderate COVID-19 do not differ from an age, sex and job-role matched control population. Individuals who were hospitalised or continue to suffer symptoms require a specific, comprehensive assessment prior to a return to full physical activity.