Long-haul COVID-19 associated with chronic fatigue syndrome, breathing irregularities

Long-haul COVID-19 patients face an elevated risk of developing chronic fatigue syndrome (CFS) and an assortment of other breathing complications, according to new data published in JACC: Heart Failure.

In what is believed to be a first-of-its-kind study designed to identify the correlation between long-haul COVID-19 and CFS, the study's authors examined 41 patients between the ages of 23 and 69 years old. 

The patients had normal pulmonary function tests, chest X-rays, chest CT scans and echocardiograms. They also had been previously diagnosed with acute COVID-19 infection for a period of three to 15 months before they underwent a cardiopulmonary exercise test (CPET) and continued to experience unexplained shortness of breath.

“Recovery from acute COVID infection can be associated with residual organ damage,” lead author Donna M. Mancini, MD, a professor in the department of cardiology at the Icahn School of Medicine at Mount Sinai, said in a press release. “Many of these patients reported shortness of breath, and the cardiopulmonary exercise test is often used to determine its underlying cause. The CPET results demonstrate several abnormalities including reduced exercise capacity, excessive ventilatory response and abnormal breathing patterns which would impact their normal daily life activities.”

Patients were evaluated for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and were questioned about how fatigue had impacted their activities over the previous six months.


They were also queried about whether they experienced sore throat, tender lymph nodes, headache, muscle aches, joint stiffness, unrefreshing sleep, difficulty concentrating or worsening of symptoms after mild exertion.

In the study, 46% of patients met the criteria for ME/CFS. They were also measured for peak oxygen consumption, production and ventilatory rate and volume.

Eighty-eight percent of the patients showed abnormal breathing patterns or dysfunctional breathing.

Also, patients presented with low CO2 values at rest and with exercise, signifying chronic hyperventilation.

In addition, 58% of patients showed proof of circulatory damage to peak exercise performance from either cardiac dysfunction and/or abnormal pulmonary or peripheral perfusion.

“These findings suggest that in a subgroup of long haulers, hyperventilation and/or dysfunctional breathing may underlie their symptoms," Mancini added. "This is important as these abnormalities may be addressed with breathing exercises or ‘retraining.'"

Read the full study here.

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