{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:43:39Z","timestamp":1787586219479,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about the mechanisms of exercise intolerance and exertional symptoms in children with long COVID. Through utilization of cardiopulmonary exercise testing (CPET), this study is the first of its kind to evaluate exertional symptoms and attempt to identify potential mechanism of long COVID\u201019 in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if CPET will uncover potential reasons for persistent symptoms of long COVID when there is no indication of cardiopulmonary or upper airway disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective chart review study involving children 6\u201317\u2009years of age with symptoms of long COVID at Phoenix Children''s Hospital from January 1, 2021, to June 1, 2022. Symptoms included but were not limited to exercise intolerance, fatigue, shortness of breath, dyspnea on exertion, and chest pain. We recorded any measurable abnormalities present on CPET after comparing it to established normal reference ranges. Range, median, and SD of data points were calculated and <jats:italic>p<\/jats:italic> values were determined using the Mann\u2013Whitney <jats:italic>U<\/jats:italic> and Fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three children with exertional symptoms consistent with long COVID were identified. The most frequent symptoms reported during exercise include dyspnea on exertion (35%), followed by chest pain (30%) and dizziness (13%). Nearly half of the children (47%) demonstrated decreased exercise capacity with 30% displaying limitations due to deconditioning, 22% limited by body habitus, and 13% due to bronchospasm. Other contributing factors include ventilation to perfusion mismatch and volitional hyperventilation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Decreased aerobic activity due to multiple factors was found in 47% of children with a history of COVID\u201019. This study illustrates the importance of ongoing research into this phenomenon to elucidate its mechanism and assist physicians in making decisions regarding referral to specialists for further testing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.13263","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T09:18:48Z","timestamp":1727342328000},"page":"246-253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Use of cardiopulmonary exercise testing to identify mechanisms of exertional symptoms in children with long <scp>COVID<\/scp>"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7794-4071","authenticated-orcid":false,"given":"Adam","family":"Lowe","sequence":"first","affiliation":[{"name":"Phoenix Children's Hospital  Phoenix Arizona USA"},{"name":"Department of Graduate Medical Education University of Arizona College of Medicine\u2010Phoenix  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Sabati","sequence":"additional","affiliation":[{"name":"Phoenix Children's Hospital  Phoenix Arizona USA"},{"name":"Division of Cardiology, Department of Pediatrics Phoenix Children's Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Phoenix Children's Hospital  Phoenix Arizona USA"},{"name":"Division Chief, Pulmonary, Department of Pediatrics Phoenix Children's Hospital  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.WHO Coronavirus Disease (COVID\u201019) Dashboard. 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