{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:27:19Z","timestamp":1786688839399,"version":"build-2736575974"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Objective<\/jats:title>\n This retrospective study aimed to observe the cardiopulmonary function and lingering symptoms in previously healthy individuals with Long COVID using Cardiopulmonary Exercise Testing (CPET), the gold standard for evaluating integrated human physiological function.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective analysis was conducted on 73 subjects who completed CPET at Beijing Hospital of Traditional Chinese Medicine from January 2023 to April 2023. Participants were consecutively included and comprised 42 patients with confirmed SARS-CoV-2 infection and persistent symptoms (Long COVID group) and 31 healthy controls with no history of COVID-19 (Normal control group). The sample size was determined by the total number of eligible patients who consecutively underwent CPET during the study period, and a post-hoc power analysis confirmed sufficient power (&gt;80%) to detect the observed differences in the primary endpoint (peak\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n %pred). General clinical data and CPET parameters were retrospectively collected and compared between the two groups. The chi-square test was used for sex distribution, the independent\n t<\/jats:italic>\n -test IS for normally distributed continuous variables, and the Mann\u2013Whitney\n U<\/jats:italic>\n test for non-normally distributed variables. Linear regression analysis was performed to explore correlations between peak oxygen uptake (peak\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n ) and other core CPET indicators.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were 13 males and 18 females in the normal control group and12 males and 30 females in the Long COVID group. No statistical differences were observed in age, sex, height, or weight between the two groups (\n p<\/jats:italic>\n \u202f&gt;\u202f0.05 for all). (2) In the Long COVID group, core CPET indicators were significantly reduced compared to the normal group: peak\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O2 was78.3\u202f\u00b1\u202f20.7% pred; anaerobic threshold (AT) was 77.9\u202f\u00b1\u202f19.6% pred; peak oxygen pulse (peakO\u2082pulse) was 100.5 (82.4,110.3)% pred; and Oxygen Uptake Efficiency Plateau (OUEP) was 104.6\u202f\u00b1\u202f12.9% pred (all\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). (3) Other indicators in the Long COVID group also showed significant differences compared to the normal group, including forced vital capacity (FVC) [3.2(2.8,3.8)L], resting heart rate (rest HR) (87.1\u202f\u00b1\u202f9.3\u202fbpm), peak tidal volume (peak VT) [1.4(1.2,1.9)L], Cardiac Power (CP) [3643.8(2868.7,4522.2)], and the slope of oxygen uptake to work rate (\u03c1\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O2\/\u03c1 WR) [9.6(9.0, 10.54)] (all\n p<\/jats:italic>\n \u202f&lt;\u202f0.05). However, no significant differences were found in maximal voluntary ventilation (MVV) or peak heart rate (peak HR) between the two groups (\n p<\/jats:italic>\n \u202f&gt;\u202f0.05). (4) In the Long COVID group, peak\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O\n 2<\/jats:sub>\n showed a significant positive linear correlation with AT (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.63,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), peakO\u2082pulse (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.92,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and CP (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.44,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), but not with \u03c1\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O2\/\u03c1 WR (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.04,\n p<\/jats:italic>\n \u202f=\u202f0.357). (5) Among the Long COVID group, the most frequently reported persistent symptoms were: decreased exercise endurance (19.1%), palpitations (16.1%), chest tightness and shortness of breath (12.6%), fatigue (16.9%), insomnia (7.8%), anxiety (7.3%), and cough (4.8%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n This retrospective analysis confirms that SARS-CoV-2 infection has a significant and not merely short-term impact on the integrated cardiopulmonary and musculoskeletal function. Even after turning negative, individuals exhibit a wide range of symptoms affecting the respiratory, circulatory, and nervous systems. The observed reduction in peak systolic blood pressure, cardiac power, and the \u03c1\n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:math>\n <\/jats:inline-formula>\n O2\/\u03c1 WR slope, coupled with compensatory resting tachycardia, suggests the possibility of multiple underlying mechanisms, including subclinical myocardial functional impairment, autonomic nervous system dysfunction, and\/or peripheral deconditioning. CPET proved to be a safe and valuable tool for objectively evaluating the overall functional limitations in Long COVID patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1916898","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:33:23Z","timestamp":1786685603000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A retrospective study on the impact of SARS-CoV-2 infection on cardiopulmonary function in a healthy Chinese cohort: a focus on \u201clong COVID\u201d"],"prefix":"10.3389","volume":"13","author":[{"given":"Yingzhe","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref1","volume-title":"COVID-19 Rapid Guideline: Managing the Long-Term Effects of COVID-19","year":"2022"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1016\/j.cmi.2022.04.004","article-title":"ESCMID rapid guidelines for assessment and management of long COVID","volume":"28","author":"Yelin","year":"2022","journal-title":"Clin Microbiol Infect"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1242\/jeb.100.1.175","article-title":"Cardiopulmonary coupling during exercise","volume":"100","author":"Whipp","year":"1982","journal-title":"J Exp Biol"},{"key":"ref4","volume-title":"Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications","author":"Wasserman","year":"2012"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1378\/chest.11-2042","article-title":"Oxygen uptake efficiency plateau best predicts early death in heart failure","volume":"141","author":"Sun","year":"2012","journal-title":"Chest"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.healun.2015.10.019","article-title":"The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: a 10-year update","volume":"35","author":"Mehra","year":"2016","journal-title":"J Heart Lung Transplant"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e694","DOI":"10.1161\/CIR.0000000000000406","article-title":"2016 focused update: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations","volume":"133","author":"Guazzi","year":"2016","journal-title":"Circulation"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.31829\/2691-5391\/jhp2020-3(1)-106","article-title":"From cardiopulmonary resuscitation, cardiopulmonary exercise test and cardiopulmonary coupling to new theory of holistic integrative physiology and medicine","volume":"3","author":"Chen","year":"2020","journal-title":"J Hum Physiol Rev Article"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1002\/ejhf.24","article-title":"Cardiovascular mortality and chronotropic incompetence in systolic heart failure: the importance of a reappraisal of current cut-off criteria","volume":"16","author":"Magr\u00ec","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"65","DOI":"10.12047\/j.cjap.0095.2021.107","article-title":"The characteristics of core parameters during cardiopulmonary exercise testing in patients with hypertrophy cardiomyopathy","volume":"37","author":"Chen","year":"2021","journal-title":"Chin. 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