Associations between symptoms and functional capacity in patients after COVID‐19 infection and community controls

Abstract

AbstractBackgroundPost‐acute sequelae of COVID‐19 (PASC or ‘long COVID’) reflect ongoing symptoms, but these are non‐specific and common in the wider community. Few reports of PASC have been compared with a control group.AimsTo compare symptoms and objective impairment of functional capacity in patients with previous COVID‐19 infection with uninfected community controls.MethodsIn this community‐based, cross‐sectional study of functional capacity, 562 patients from Western Melbourne who had recovered from COVID‐19 infections in 2021 and 2022 were compared with controls from the same community and tested for functional capacity pre‐COVID‐19. Functional impairment (<85% of the predicted response) was assessed using the Duke Activity Status Index (DASI) and 6‐min walk distance (6MWD) test. A subgroup underwent cardiopulmonary exercise testing before and after exercise training.ResultsOf 562 respondents (age 54 ± 12 years, 69% women), 389 were symptomatic. Functional impairment (<85% predicted metabolic equivalent of tasks) was documented by DASI in 149 participants (27%), and abnormal 6MWD (<85% predicted) was observed in 14% of the symptomatic participants. Despite fewer risk factors and younger age, patients with COVID‐19 had lower functional capacity by 6MWD (P < 0.001) and more depression (P < 0.001) than controls. In a pilot group of seven participants (age 58 ± 12 years, two women, VO2 18.9 ± 5.7 mL/kg/min), repeat testing after exercise training showed a 20% increase in peak workload.ConclusionsAlthough most participants (69%) had symptoms consistent with long COVID, significant subjective functional impairment was documented in 27% and objective functional impairment in 14%. An exercise training programme might be beneficial for appropriately selected patients.