Acute Covid-19 Diagnosis is Associated with Greater Submaximal Ventilation in Runners

COVID-19 remains an emerging clinical problem with a paucity of data describing its acute physiological effects, particularly in athletic populations. As COVID-19 largely impacts the cardiovascular system via respiratory dysfunction, cardiopulmonary exercise testing (CPET) is useful to measure performance outcomes. However, acute CPET data on runners following a diagnosis is scarce. PURPOSE: Determine if CPET measures are influenced by recent COVID-19 diagnosis in runners compared to healthy controls. METHODS: 48 (24f/24 m) runners who performed maximal graded CPET following a recent COVID-19 diagnosis (<3 months) were selected from a lager cohort in an ongoing study. Control-matched athletes with no history of COVID-19 diagnosis from the cohort were also included (n = 48; 24f/24 m). No demographic differences (p > 0.05) existed between CONTROL (CN) and COVID (COV) groups, (age = CN: 36.9 ± 11, COV: 36.3 ± 11; weight (kg) = 69.1 ± 11, 70.8 ± 15; race pace (min/mile) = 8:25, 8:03). CPET protocol selection was based on participants’ self-selected half-marathon race pace (RP) with 1 kph speed increments every 3 minutes until volitional fatigue. Submaximal/threshold data were recorded at RP, 1 kph slower, and 1 kph faster. Subsequent CPET data were analyzed using two-tailed paired T-tests: VO2max, anaerobic threshold (AT), maximal/submaximal ventilation (VE), and ventilatory efficiency slope at AT (VE/VCO2). RESULTS: Mean time between COVID-19 diagnosis and in-lab testing was 51 ± 24 days. Submax VE was higher in the COV group when compared to CN at each submax speed (p < 0.001, p = 0.002, p = 0.01, respectively). Despite disparities in VE, no differences in ventilatory efficiency at AT or peak VE were found between groups (VE/VCO2: CN: 27.3 ± 4, COV: 27.7 ± 3, p = 0.6; VE at peak: 119.6 ± 2, 125.8 ± 32, p = 0.06). Compared with CN runners, COV was not statistically different at peak exercise and AT (VO2max: CN: 50.2 ± 8, COV: 48.9 ± 8, p = 0.25; AT: CN: 34 ± 6, COV: 33.1 ± 6, p = 0.27). CONCLUSIONS: Post-COVID-19 runners, compared to healthy controls, exhibited an exaggerated hyperventilation response during submaximal running without a reduced peak exercise capacity. Funding source: This study received funding from Apple Inc. The funding source had no role in the analysis and interpretation of the data or in the submission of this abstract.