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Klin Padiatr 2023; 235(05): 290-296
DOI: 10.1055/a-1906-1187
Original Article

COPHYD (Corona Owed Physical Deficiency): The Impact of Lockdown on Cardiopulmonary Function in Paediatric Cardiology Patients

COPHYD (Corona Owed Physical Deficiency): Der Einfluss des Lockdown auf die kardiopulmonare Funktion bei kinderkardiologischen Patienten
Tim Stäbler 
1   Department of Paediatric Cardiology, FAU, Erlangen, Germany
,
Annika Weigelt
2   Pediatric Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
,
Kathrin Rottermann
3   Pediatric cardiology, FAU, Erlangen, Germany
,
Wolfgang Wällisch
3   Pediatric cardiology, FAU, Erlangen, Germany
,
Matthias Hübner
3   Pediatric cardiology, FAU, Erlangen, Germany
,
Sven Dittrich
4   Pediatric Cardiology, University Hospital, Erlangen, Germany
,
Isabelle Schöffl
5   Kinderkardiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg Medizinische Fakultät, Erlangen, Germany
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Abstract

Introduction Due to the Corona-lockdowns the closure of sports facilities and schools has led to a decline in physical activity (PA) for months. PA is essential for maintaining cardiopulmonary function assessed by peak oxygen uptake. Since peak oxygen uptake represents the best predictor for mortality and morbidity in children with congenital heart disease the impact of lockdowns on this parameter is vital.

Methods We evaluated retrospectively cardiopulmonary exercise data from our patient collective from before lockdown with twin-paired data from during lockdown. The twin-pairing was achieved by matching patients with similar heart disease, age, sex, and test method. Cardiopulmonary exercise testing was achieved on either the treadmill or the bicycle.

Results We were able to twin-pair 90 cases (26 twins with heart disease and 19 healthy twins). There was a significant decrease of cardiopulmonary function (V̇O2peak: 35.7±9.8 vs.30.4±10.6) in the heart disease cohort along with a significant decrease in peak oxygen pulse (13.3±4.1 vs. 11.4±4.5), and peak minute ventilation (V ̇E: 83.05±29.08 vs.71,49±24.96). The healthy children improved over the timeframe, but this only reached significance for peak minute ventilation (81.72±25.79 vs.97.94±31.4).

Conclusion We observed a significant decline of peak oxygen uptake during lockdown in the group of congenital heart disease (CHD) patients. This involved a loss of cardiac function as well as pulmonary function. This could be explained by limited access to sports facilities and restriction of regular daily movement due to school closure and overprotection. Healthy children improved their pulmonary function. This might be an indication of an improvement of exercise during confinement.

Zusammenfassung

Aufgrund des Corona-Lockdowns hat die Schließung von Sportanlagen und Schulen über Monate zu einem Rückgang der körperlichen Aktivität geführt. Körperliche Aktivität ist für die Aufrechterhaltung der kardiopulmonalen Funktion, bewertet durch die maximale Sauerstoffaufnahme, unerlässlich. Da die maximale Sauerstoffaufnahme der beste Prädiktor für Mortalität und Morbidität bei Kindern mit angeborenen Herzerkrankungen ist, sind die Auswirkungen des Lockdowns auf diesen Parameter von entscheidender Bedeutung. Spiroergometriedaten unseres Patientenkollektivs aus der Zeit vor dem Lockdown wurde mit Daten von statistischen Zwillingen aus dem gleichen Kollektiv während des Lockdowns verglichen. Die Zwillingspaarung wurde erreicht, indem Patienten mit ähnlichen Herzerkrankungen, Alter, Geschlecht und Testmodalitäten verglichen wurden. Die Spiroergometrie wurde entweder auf dem Laufband oder auf dem Fahrrad durchgeführt. Insgesamt wurden 90 Datensätze verbunden (26 Zwillinge mit Herzkrankheit und 19 gesunde Zwillinge). In der Kohorte der Herzerkrankten konnte eine signifikante Verschlechterung der kardiopulmonalen Funktion (V̇O2peak: 35,7±9,8 vs. 30,4±10,6), des Spitzensauerstoffpulses (O2puls: 13,3±4,1 vs. 11,4±4,5) und der Spitzenminutenventilation (VE: 83,05 ± 29,08 vs. 71,49 ± 24,96) beobachtet werden. Die gesunden Kinder verbesserten sich im Laufe der Zeit, wobei der Anstieg nur bei der Spitzenminutenventilation (81,72±25,79 vs. 97,94 ± 31,4) signifikant war. in der Kohorte der Patienten mit angeborenen Herzerkrankungen (CHD) beobachteten wir einen deutlichen Rückgang der maximalen Sauerstoffaufnahme während des Lockdowns. Dies liegt begründet in einer Verschlechterung der Herz-, sowie der Lungenfunktion. Erklärung dafür könnte der begrenzte Zugang zu Sporteinrichtungen, sowie Einschränkungen der täglichen Bewegungsfreiheit durch Schulschließungen und Überbehütung sein. Gesunde Kinder konnten ihr Atemminutenvolumen während dem Lockdown steigern und zeigten einen Trend zu besserer Belastbarkeit. Dies könnte auf eine Zunahme der körperlichen Bewegung während des Lockdowns hindeuten.

Key words

V̇O2 peak - physical activity - cardiopulmonary exercise testing - O2pulse - ventilation - COVID-19

Schlüsselwörter

COVID-19 - physische Aktivität - V̇O2 peak - kardiopulmonale Belastungstests - O2 pulse - Ventilation


Publication History

Article published online:
29 September 2022

© 2022. Thieme. All rights reserved.

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