Cardiopulmonary exercise testing during the COVID-19 pandemic

The outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has presented a global public health emergency. Although predominantly a pandemic of acute respiratory disease, corona virus infectious disease-19 (COVID-19) results in multi-organ damage that impairs cardiopulmonary function and reduces cardiorespiratory fitness.

As such, cardiopulmonary exercise testing (CPET) plays an important role in clinical assessments of convalescent COVID-19 patients as well as research aimed at understanding the long-term health effects of SARS-CoV-2 infection.

However, due to the ventilatory expired gas analysis involved with CPET, the procedure is considered an aerosol generating procedure. This paper provides recommendations for CPET testing during the COVID-19 pandemic.

Guidelines for aerosolizing procedures may vary by institution, however, each institution should incorporate the guidance set forth by the Centers for Disease Control and Prevention (CDC) and European Respiratory Society (ERS) for optimal safety.

The value of CPETs for diagnostic and prognostic evaluation of cardiovascular diseases, as well as assessing interventional efficacy, justifies the importance of continuing these tests during the SARS-CoV-2 pandemic.

Article details:

- Title: Cardiopulmonary exercise testing during the COVID-19 pandemic
- Authors: Virginia L. Mihalick, Justin M. Canada, Ross Arena, Antonio Abbate, Danielle L. Kirkman
- Published in: Progress in Cardiovascular Diseases - 6 May 2021
- Link: https://doi.org/10.1016/j.pcad.2021.04.005