{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T02:36:41Z","timestamp":1774492601742,"version":"3.50.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>After mild COVID-19, a subgroup of patients reported post\u2013acute-phase sequelae of COVID-19 (PASC) in which exertional dyspnea and perceived exercise intolerance were common. Underlying pathophysiological mechanisms remain incompletely understood. The purpose of this study was to examine outcomes from cardiopulmonary exercise testing (CPET) in these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this observational study, participants were patients who were referred for the analysis of PASC after mild COVID-19 and in whom CPET was performed after standard clinical workup turned out unremarkable. Cardiocirculatory, ventilatory, and metabolic responses to and breathing patterns during exercise at physiological limits were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-one patients (76% women; mean age\u2009=\u200940\u00a0years) who reported severe disability in physical functioning underwent CPET at 32\u00a0weeks (interquartile range\u2009=\u200922\u201352) after COVID-19. Mean peak O2 uptake was 99% of predicted with normal anaerobic thresholds. No cardiovascular or gas exchange abnormalities were detected. Twenty of the 21 patients (95%) demonstrated breathing dysregulation (ventilatory inefficiency [29%], abnormal course of breathing frequency and tidal volume [57%], absent increase of end-tidal Pco2 [57%], and abnormal resting blood gases [67%]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Breathing dysregulation may explain exertional dyspnea and perceived exercise intolerance in patients with PASC after mild COVID-19 and can be present in the absence of deconditioning. This finding warrants further study on the levels of neural control of breathing and muscle function, and simultaneously provides a potential treatment opportunity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>This study contributes to the understanding of persistent exertional dyspnea and perceived exercise intolerance following mild COVID-19, which is vital for the development of effective rehabilitation strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzac105","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T12:19:09Z","timestamp":1659010749000},"source":"Crossref","is-referenced-by-count":30,"title":["Persistent Exertional Dyspnea and Perceived Exercise Intolerance After Mild COVID-19: A Critical Role for Breathing Dysregulation?"],"prefix":"10.1093","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2273-2870","authenticated-orcid":false,"given":"Esther L","family":"van Voorthuizen","sequence":"first","affiliation":[{"name":"Radboud University Medical Center Nijmegen Department of Pulmonary Diseases, , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanneke A C","family":"van Helvoort","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Nijmegen Department of Pulmonary Diseases, , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanette B","family":"Peters","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Nijmegen Department of Pulmonary Diseases, , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel M","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Nijmegen Department of Pulmonary Diseases, , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bram","family":"van den Borst","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Nijmegen Department of Pulmonary Diseases, , the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"2022102115084344700_ref1","volume-title":"WHO Coronavirus Disease (COVID-19) Dashboard","author":"WHO","year":"2022"},{"key":"2022102115084344700_ref2","doi-asserted-by":"crossref","first-page":"100208","DOI":"10.1016\/j.lanwpc.2021.100208","article-title":"Recovery after Covid-19","volume":"12","author":"Borst","year":"2021","journal-title":"Lancet Reg Health West Pac"},{"key":"2022102115084344700_ref3","volume-title":"A Clinical Case Definition of Post Covid-19 Condition by a Delphi 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