SARS-CoV-2 infection sequelae on exercise response: persistent or reversible? A 2-year perspective

SARS-CoV2 and the related disease COVID-19 had a dramatic impact on global healthcare system since its appearance in December 2019 [1]. The evidence of long-lasting sequelae in COVID-19 survivors have rapidly grown, leading to the current definition of “long COVID”, an entity defined as the persistence or development of new symptoms 3 months after the acute infection lasting at least 2 months [2]. Nevertheless, recent literature showed how a share of patients still presented SARS-CoV2 sequelae with clinical and functional impairment even at a 2-year follow-up [3]. Cardiopulmonary exercise test (CPET), which is the gold standard for the evaluation of pathophysiological response during exercise [4], allowed to unveil mechanisms of exercise intolerance in the early post-acute phase, mainly involving deconditioning and peripheral oxygen utilisation impairment, but also alteration of the breathing pattern and possibly chronotropic incompetence [5, 6]. However, data on the long-term outcome of patients presenting altered exercise capacity as post-acute sequelae of COVID-19 are still lacking. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflict of interest: The authors have nothing to disclose.