ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1638317
This article is part of the Research TopicFundamentals and Advances in Cardiopulmonary RehabilitationView all 5 articles
Recovery from COVID-19: A 12-Month Follow-Up Study on Cardiorespiratory Fitness and Pulmonary Function
Provisionally accepted
Cássia da Luz Goulart1*
Vinícius Maldaner1Carla Cristina Araújo Alves1Mauricio Milani1Juliana Milani1Ana Clara Gonçalves Da Costa1Marcela Lopes Alves1Robson Fernando Borges1Claudia Cristina Conde Holanda Sobral1Letícia Araújo Moraes1Jean Carlos Coutinho1Nádia Oliveira Gomes1Leandro Tolfo Franzoni2Filipe Ferrari2Audrey Borghi-Silva3Lawrence P Cahalin4Graziella França1Gerson Cipriano Junior1Ricardo Stein2*- 1Universidade de Brasilia, Brasília, Brazil
- 2Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- 3Universidade Federal de Sao Carlos, São Carlos, Brazil
- 4University of Miami, Coral Gables, United States
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Introduction and Aim: Long COVID, characterized by persistent symptoms after acute infection, poses a major public health challenge. Understanding its long-term effects is crucial, particularly in relation to cardiorespiratory recovery. This study aimed to assess changes in cardiorespiratory fitness (CRF) and pulmonary function (PF) over 12 months following acute COVID-19, addressing a significant gap in current knowledge about the disease's lasting impact. Methods: This prospective cohort study included 29 individuals previously diagnosed with post-acute COVID-19. The baseline data were collected during the acute phase of infection. Participants underwent clinical evaluation, cardiopulmonary exercise testing (CPET), spirometry, and maximal inspiratory pressure (MIP) measurement at baseline and again after 12 months. Results: After oneyear, significant improvements were observed across several CPET parameters, including VE/MVV ratio (Cohen's D = 0.66), peak oxygen uptake (VO2peak) in both absolute and relative terms (ml/min: d = 0.67; and ml/kg/min: d = 0.45), oxygen uptake efficiency slope (OUES; D = 0.47) and a reduction in VE/VCO2 slope (D = 0.80). Pulmonary function improved with increases in % predicted forced expiratory volume in 1 second (FEV1; d = 0.67) and forced vital capacity (FVC; D = 0.67). MIP improved significantly (D = 0.67), and the prevalence of inspiratory muscle weakness decreased from 20.7% at baseline to 3.5% at follow-up. Conclusion: Despite the severity of their initial illness, patients demonstrated substantial recovery in CRF, PF, and inspiratory muscle strength over 12 months.
Keywords: COVID-19, Exercise Tolerance, Respiratory Function Tests, Long Covid, CpEt
Received: 30 May 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Goulart, Maldaner, Alves, Milani, Milani, Gonçalves Da Costa, Alves, Borges, Sobral, Moraes, Coutinho, Gomes, Tolfo Franzoni, Ferrari, Borghi-Silva, Cahalin, França, Cipriano Junior and Stein. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Cássia da Luz Goulart, Universidade de Brasilia, Brasília, Brazil
Ricardo Stein, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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