Monitoring the clinical evolving stages and cardiopulmonary sequelae, in terms of organ injury and functional response, of elderly individuals infected with SARS-CoV-2 is of utmost importance for our times, placing gas exchange and functional capacity evaluation in the forefront of the clinical decision-making process, i.e., for staging, prognostication and for establishing the most appropriate therapeutic strategies tailored for the elderly population that is the most impacted by this pandemic. From a geriatric point of view, the assessment of clinical and functional outcomes, such as mobility of the elderly individuals, their daily energy expenditure and other indices of physical function and quality of life coupled with the determination of the maximal aerobic capacity, one of the most important predictors of independence, offers a multidimensional evaluation-tool useful for monitoring the COVID-19 effects in the elderly population. Historically, cardiopulmonary exercise test (CPET) evaluation has multifold goals, such as providing a thorough and objective definition of physical limitation and garnering information on how interventions may impact the limiting steps in the symptoms cascade and along the natural course of disease. This information and the step-by-step analyses on differential diagnosis of organ-driven origin of symptoms are generally accomplished by performing preliminary static pulmonary function tests (spirometry) and alveolar gas diffusion for carbon monoxide (DLco) evaluation. Most of the evidence so far accumulating on COVID- 19 patients suggests that: (a) the lung organ injury is sustained, persistent, expectedly irreversible in many patients [1] and is predicted to become the main clinical issue on the long term; (b) cardiovascular comorbidities are highly represented, and a very frequent background for associated complications; (c) myocarditis or acute coronary syndrome may complicate the acute phase. Irrespective of documented myocarditis, the values of the convectional biomarkers of myocardial injury, especially cardiac troponins, may considerably increase. These COVID-19 complications may occur in previously asymptomatic or symptomatic subjects, without or with lung and/or cardiac pre-existing diseases.

Maximal aerobic capacity exercise testing protocols for elderly individuals in the era of COVID-19

Baldari, Carlo;
2021-01-01

Abstract

Monitoring the clinical evolving stages and cardiopulmonary sequelae, in terms of organ injury and functional response, of elderly individuals infected with SARS-CoV-2 is of utmost importance for our times, placing gas exchange and functional capacity evaluation in the forefront of the clinical decision-making process, i.e., for staging, prognostication and for establishing the most appropriate therapeutic strategies tailored for the elderly population that is the most impacted by this pandemic. From a geriatric point of view, the assessment of clinical and functional outcomes, such as mobility of the elderly individuals, their daily energy expenditure and other indices of physical function and quality of life coupled with the determination of the maximal aerobic capacity, one of the most important predictors of independence, offers a multidimensional evaluation-tool useful for monitoring the COVID-19 effects in the elderly population. Historically, cardiopulmonary exercise test (CPET) evaluation has multifold goals, such as providing a thorough and objective definition of physical limitation and garnering information on how interventions may impact the limiting steps in the symptoms cascade and along the natural course of disease. This information and the step-by-step analyses on differential diagnosis of organ-driven origin of symptoms are generally accomplished by performing preliminary static pulmonary function tests (spirometry) and alveolar gas diffusion for carbon monoxide (DLco) evaluation. Most of the evidence so far accumulating on COVID- 19 patients suggests that: (a) the lung organ injury is sustained, persistent, expectedly irreversible in many patients [1] and is predicted to become the main clinical issue on the long term; (b) cardiovascular comorbidities are highly represented, and a very frequent background for associated complications; (c) myocarditis or acute coronary syndrome may complicate the acute phase. Irrespective of documented myocarditis, the values of the convectional biomarkers of myocardial injury, especially cardiac troponins, may considerably increase. These COVID-19 complications may occur in previously asymptomatic or symptomatic subjects, without or with lung and/or cardiac pre-existing diseases.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11389/41417
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