RT Journal Article
SR Electronic
T1 Reduced athletic performance post-COVID-19 is associated with reduced anaerobic threshold
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e250191
DO 10.1136/bcr-2022-250191
VO 16
IS 2
A1 Robert M Barker-Davies
A1 Peter Ladlow
A1 Rebecca Chamley
A1 Edward Nicol
A1 David A Holdsworth
YR 2023
UL http://casereports.bmj.com/content/16/2/e250191.abstract
AB Detailed characterisation of cardiopulmonary limitations in patients post-COVID-19 is currently limited, particularly in elite athletes. A male elite distance runner in his late 30s experienced chest pain following confirmed COVID-19. He underwent cardiopulmonary exercise testing (CPET) at 5 months postacute illness. Subjective exercise tolerance was reduced compared with normal, he described inability to ‘kick’ (rapidly accelerate). His CPET was compared with an identical protocol 15 months prior to COVID-19. While supranormal maximal oxygen uptake was maintained (155% of peak predicted V̇O2) anaerobic threshold (AT), a better predictor of endurance performance, reduced from 84% to 71% predicted peak V̇O2 maximum. Likewise, fat oxidation at AT reduced by 21%, from 0.35 to 0.28 g/min. Focusing exclusively on V̇O2 maximum risks missing an impairment of oxidative metabolism. Reduced AT suggests a peripheral disorder of aerobic metabolism. This finding may result from virally mediated mitochondrial dysfunction beyond normal ‘deconditioning’, associated with impaired fat oxidation.