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  1. Article ; Online: Exercise tolerance, fatigue, mental health, and employment status at 5 and 12 months following COVID-19 illness in a physically trained population.

    Ladlow, Peter / Holdsworth, David A / O'Sullivan, Oliver / Barker-Davies, Robert M / Houston, Andrew / Chamley, Rebecca / Rogers-Smith, Kasha / Kinkaid, Victoria / Kedzierski, Adam / Naylor, Jon / Mulae, Joseph / Cranley, Mark / Nicol, Edward D / Bennett, Alexander N

    Journal of applied physiology (Bethesda, Md. : 1985)

    2023  Volume 134, Issue 3, Page(s) 622–637

    Abstract: Failure to recover following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may have a profound impact on individuals who participate in high-intensity/volume exercise as part of their occupation/recreation. The aim of this study was to ... ...

    Abstract Failure to recover following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may have a profound impact on individuals who participate in high-intensity/volume exercise as part of their occupation/recreation. The aim of this study was to describe the longitudinal cardiopulmonary exercise function, fatigue, and mental health status of military-trained individuals (up to 12-mo postinfection) who feel recovered, and those with persistent symptoms from two acute disease severity groups (hospitalized and community-managed), compared with an age-, sex-, and job role-matched control. Eighty-eight participants underwent cardiopulmonary functional tests at baseline (5 mo following acute illness) and 12 mo; 25 hospitalized with persistent symptoms (hospitalized-symptomatic), 6 hospitalized and recovered (hospitalized-recovered); 28 community-managed with persistent symptoms (community-symptomatic); 12 community-managed, now recovered (community-recovered), and 17 controls. Cardiopulmonary exercise function and mental health status were comparable between the 5 and 12-mo follow-up. At 12 mo, symptoms of fatigue (48% and 46%) and shortness of breath (SoB; 52% and 43%) remain high in hospitalized-symptomatic and community-symptomatic groups, respectively. At 12 mo, COVID-19-exposed participants had a reduced capacity for work at anaerobic threshold and at peak exercise levels of deconditioning persist, with many individuals struggling to return to strenuous activity. The prevalence considered "fully fit" at 12 mo was lowest in symptomatic groups (hospitalized-symptomatic, 4%; hospitalized-recovered, 50%; community-symptomatic, 18%; community-recovered, 82%; control, 82%) and 49% of COVID-19-exposed participants remained medically nondeployable within the British Armed Forces. For hospitalized and symptomatic individuals, cardiopulmonary exercise profiles are consistent with impaired metabolic efficiency and deconditioning at 12 mo postacute illness. The long-term deployability status of COVID-19-exposed military personnel is uncertain.
    MeSH term(s) Humans ; COVID-19 ; Exercise Tolerance ; SARS-CoV-2 ; Fatigue ; Dyspnea ; Employment ; Mental Fatigue
    Language English
    Publishing date 2023-02-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 219139-8
    ISSN 1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
    ISSN (online) 1522-1601
    ISSN 0021-8987 ; 0161-7567 ; 8750-7587
    DOI 10.1152/japplphysiol.00370.2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The effect of medium-term recovery status after COVID-19 illness on cardiopulmonary exercise capacity in a physically active adult population.

    Ladlow, Peter / O'Sullivan, Oliver / Bennett, Alexander N / Barker-Davies, Robert / Houston, Andrew / Chamley, Rebecca / May, Samantha / Mills, Daniel / Dewson, Dominic / Rogers-Smith, Kasha / Ward, Christopher / Taylor, John / Mulae, Joseph / Naylor, Jon / Nicol, Edward D / Holdsworth, David A

    Journal of applied physiology (Bethesda, Md. : 1985)

    2022  Volume 132, Issue 6, Page(s) 1525–1535

    Abstract: A failure to fully recover following coronavirus disease 2019 (COVID-19) may have a profound impact on high-functioning populations ranging from frontline emergency services to professional or amateur/recreational athletes. The aim of the study is to ... ...

    Abstract A failure to fully recover following coronavirus disease 2019 (COVID-19) may have a profound impact on high-functioning populations ranging from frontline emergency services to professional or amateur/recreational athletes. The aim of the study is to describe the medium-term cardiopulmonary exercise profiles of individuals with "persistent symptoms" and individuals who feel "recovered" after hospitalization or mild-moderate community infection following COVID-19 to an age, sex, and job-role matched control group. A total of 113 participants underwent cardiopulmonary functional tests at a mean of 159 ± 7 days (∼5 mo) following acute illness; 27 hospitalized with persistent symptoms (hospitalized-symptomatic), 8 hospitalized and now recovered (hospitalized-recovered); 34 community managed with persistent symptoms (community-symptomatic); 18 community managed and now recovered (community-recovered); and 26 controls. Hospitalized groups had the least favorable body composition (body mass, body mass index, and waist circumference) compared with controls. Hospitalized-symptomatic and community-symptomatic individuals had a lower oxygen uptake (V̇o
    MeSH term(s) Adult ; COVID-19 ; Exercise Test ; Exercise Tolerance ; Heart Failure ; Humans ; Oxygen ; Oxygen Consumption
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2022-05-19
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 219139-8
    ISSN 1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
    ISSN (online) 1522-1601
    ISSN 0021-8987 ; 0161-7567 ; 8750-7587
    DOI 10.1152/japplphysiol.00138.2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Dysautonomia following COVID-19 is not associated with subjective limitations or symptoms but is associated with objective functional limitations.

    Ladlow, Peter / O'Sullivan, Oliver / Houston, Andrew / Barker-Davies, Robert / May, Samantha / Mills, Daniel / Dewson, Dominic / Chamley, Rebecca / Naylor, Jon / Mulae, Joseph / Bennett, Alexander N / Nicol, Edward D / Holdsworth, David A

    Heart rhythm

    2021  Volume 19, Issue 4, Page(s) 613–620

    Abstract: Background: Individuals who contract coronavirus disease 2019 (COVID-19) can suffer with persistent and debilitating symptoms long after the initial acute illness. Heart rate (HR) profiles determined during cardiopulmonary exercise testing (CPET) and ... ...

    Abstract Background: Individuals who contract coronavirus disease 2019 (COVID-19) can suffer with persistent and debilitating symptoms long after the initial acute illness. Heart rate (HR) profiles determined during cardiopulmonary exercise testing (CPET) and delivered as part of a post-COVID recovery service may provide insight into the presence and impact of dysautonomia on functional ability.
    Objective: Using an active, working-age, post-COVID-19 population, the purpose of this study was to (1) determine and characterize any association between subjective symptoms and dysautonomia; and (2) identify objective exercise capacity differences between patients classified "with" and those "without" dysautonomia.
    Methods: Patients referred to a post-COVID-19 service underwent comprehensive clinical assessment, including self-reported symptoms, CPET, and secondary care investigations when indicated. Resting HR >75 bpm, HR increase with exercise <89 bpm, and HR recovery <25 bpm 1 minute after exercise were used to define dysautonomia. Anonymized data were analyzed and associations with symptoms, and CPET outcomes were determined.
    Results: Fifty-one of the 205 patients (25%) reviewed as part of this service evaluation had dysautonomia. There were no associations between symptoms or perceived functional limitation and dysautonomia (P >.05). Patients with dysautonomia demonstrated objective functional limitations with significantly reduced work rate (219 ± 37 W vs 253 ± 52 W; P <.001) and peak oxygen consumption (V̇o
    Conclusion: Dysautonomia is associated with objective functional limitations but is not associated with subjective symptoms or limitation.
    MeSH term(s) COVID-19/complications ; COVID-19/diagnosis ; Exercise ; Exercise Test ; Heart Failure ; Humans ; Oxygen Consumption/physiology ; Primary Dysautonomias/diagnosis ; Primary Dysautonomias/etiology
    Language English
    Publishing date 2021-12-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2021.12.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Cardiopulmonary, Functional, Cognitive and Mental Health Outcomes Post-COVID-19, Across the Range of Severity of Acute Illness, in a Physically Active, Working-Age Population.

    O'Sullivan, Oliver / Holdsworth, David A / Ladlow, Peter / Barker-Davies, Robert M / Chamley, Rebecca / Houston, Andrew / May, Samantha / Dewson, Dominic / Mills, Daniel / Pierce, Kayleigh / Mitchell, James / Xie, Cheng / Sellon, Edward / Naylor, Jon / Mulae, Joseph / Cranley, Mark / Talbot, Nick P / Rider, Oliver J / Nicol, Edward D /
    Bennett, Alexander N

    Sports medicine - open

    2023  Volume 9, Issue 1, Page(s) 7

    Abstract: Background: The COVID-19 pandemic has led to significant morbidity and mortality, with the former impacting and limiting individuals requiring high physical fitness, including sportspeople and emergency services.: Methods: Observational cohort study ... ...

    Abstract Background: The COVID-19 pandemic has led to significant morbidity and mortality, with the former impacting and limiting individuals requiring high physical fitness, including sportspeople and emergency services.
    Methods: Observational cohort study of 4 groups: hospitalised, community illness with on-going symptoms (community-symptomatic), community illness now recovered (community-recovered) and comparison. A total of 113 participants (aged 39 ± 9, 86% male) were recruited: hospitalised (n = 35), community-symptomatic (n = 34), community-recovered (n = 18) and comparison (n = 26), approximately five months following acute illness. Participant outcome measures included cardiopulmonary imaging, submaximal and maximal exercise testing, pulmonary function, cognitive assessment, blood tests and questionnaires on mental health and function.
    Results: Hospitalised and community-symptomatic groups were older (43 ± 9 and 37 ± 10, P = 0.003), with a higher body mass index (31 ± 4 and 29 ± 4, P < 0.001), and had worse mental health (anxiety, depression and post-traumatic stress), fatigue and quality of life scores. Hospitalised and community-symptomatic participants performed less well on sub-maximal and maximal exercise testing. Hospitalised individuals had impaired ventilatory efficiency (higher VE/V̇CO
    Conclusion: Symptomatically recovered individuals who suffered mild-moderate acute COVID-19 do not differ from an age-, sex- and job-role-matched comparison population five months post-illness. Individuals who were hospitalised or continue to suffer symptoms may require a specific comprehensive assessment prior to return to full physical activity.
    Language English
    Publishing date 2023-02-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2809942-4
    ISSN 2198-9761 ; 2199-1170
    ISSN (online) 2198-9761
    ISSN 2199-1170
    DOI 10.1186/s40798-023-00552-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Comprehensive clinical assessment identifies specific neurocognitive deficits in working-age patients with long-COVID.

    Holdsworth, David A / Chamley, Rebecca / Barker-Davies, Rob / O'Sullivan, Oliver / Ladlow, Peter / Mitchell, James L / Dewson, Dominic / Mills, Daniel / May, Samantha L J / Cranley, Mark / Xie, Cheng / Sellon, Edward / Mulae, Joseph / Naylor, Jon / Raman, Betty / Talbot, Nick P / Rider, Oliver J / Bennett, Alexander N / Nicol, Edward D

    PloS one

    2022  Volume 17, Issue 6, Page(s) e0267392

    Abstract: Introduction: There have been more than 425 million COVID-19 infections worldwide. Post-COVID illness has become a common, disabling complication of this infection. Therefore, it presents a significant challenge to global public health and economic ... ...

    Abstract Introduction: There have been more than 425 million COVID-19 infections worldwide. Post-COVID illness has become a common, disabling complication of this infection. Therefore, it presents a significant challenge to global public health and economic activity.
    Methods: Comprehensive clinical assessment (symptoms, WHO performance status, cognitive testing, CPET, lung function, high-resolution CT chest, CT pulmonary angiogram and cardiac MRI) of previously well, working-age adults in full-time employment was conducted to identify physical and neurocognitive deficits in those with severe or prolonged COVID-19 illness.
    Results: 205 consecutive patients, age 39 (IQR30.0-46.7) years, 84% male, were assessed 24 (IQR17.1-34.0) weeks after acute illness. 69% reported ≥3 ongoing symptoms. Shortness of breath (61%), fatigue (54%) and cognitive problems (47%) were the most frequent symptoms, 17% met criteria for anxiety and 24% depression. 67% remained below pre-COVID performance status at 24 weeks. One third of lung function tests were abnormal, (reduced lung volume and transfer factor, and obstructive spirometry). HRCT lung was clinically indicated in <50% of patients, with COVID-associated pathology found in 25% of these. In all but three HRCTs, changes were graded 'mild'. There was an extremely low incidence of pulmonary thromboembolic disease or significant cardiac pathology. A specific, focal cognitive deficit was identified in those with ongoing symptoms of fatigue, poor concentration, poor memory, low mood, and anxiety. This was notably more common in patients managed in the community during their acute illness.
    Conclusion: Despite low rates of residual cardiopulmonary pathology, in this cohort, with low rates of premorbid illness, there is a high burden of symptoms and failure to regain pre-COVID performance 6-months after acute illness. Cognitive assessment identified a specific deficit of the same magnitude as intoxication at the UK drink driving limit or the deterioration expected with 10 years ageing, which appears to contribute significantly to the symptomatology of long-COVID.
    MeSH term(s) Acute Disease ; Adult ; COVID-19/complications ; Fatigue/etiology ; Female ; Humans ; Lung ; Male ; Post-Acute COVID-19 Syndrome
    Language English
    Publishing date 2022-06-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0267392
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Cardiac biomarkers and high altitude pulmonary edema.

    Boos, Christopher J / Holdsworth, David A / Woods, David R / Green, Kevin / Naylor, Jon / Mellor, Adrian

    International journal of cardiology

    2013  Volume 167, Issue 3, Page(s) e65–6

    MeSH term(s) Adult ; Altitude ; Altitude Sickness/blood ; Altitude Sickness/diagnosis ; Altitude Sickness/physiopathology ; Biomarkers/blood ; Blood Pressure/physiology ; Heart Rate/physiology ; Humans ; Hypertension, Pulmonary/blood ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/physiopathology ; Male ; Mountaineering/physiology ; Natriuretic Peptide, Brain/blood ; Troponin C/blood
    Chemical Substances Biomarkers ; Troponin C ; Natriuretic Peptide, Brain (114471-18-0)
    Language English
    Publishing date 2013-08-10
    Publishing country Netherlands
    Document type Case Reports ; Letter
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2013.03.119
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Successful combined bilateral lung volume reduction and coronary artery bypass grafting surgery: implications and advantages.

    Choong, Cliff K / Naylor, Jon / Vuylsteke, Alain / Hardy, Ian / Screaton, Nicholas / Porter, Jo / Davies, Michael

    The Journal of thoracic and cardiovascular surgery

    2009  Volume 137, Issue 6, Page(s) 1552–1554

    MeSH term(s) Coronary Artery Bypass ; Coronary Artery Disease/complications ; Coronary Artery Disease/surgery ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Pulmonary Emphysema/complications ; Pulmonary Emphysema/surgery
    Language English
    Publishing date 2009-06
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2008.09.052
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Determinants of summiting success and acute mountain sickness on Mt Kilimanjaro (5895 m).

    Davies, Andrew J / Kalson, Nicholas S / Stokes, Suzy / Earl, Mark D / Whitehead, Adam G / Frost, Hannah / Tyrell-Marsh, Ian / Naylor, Jon

    Wilderness & environmental medicine

    2009  Volume 20, Issue 4, Page(s) 311–317

    Abstract: Objective: To determine the incidence of acute mountain sickness (AMS), the frequency of summiting success, and the factors that affect these in trekkers on Kilimanjaro, one of the world's most summitted high-altitude peaks.: Methods: The study group ...

    Abstract Objective: To determine the incidence of acute mountain sickness (AMS), the frequency of summiting success, and the factors that affect these in trekkers on Kilimanjaro, one of the world's most summitted high-altitude peaks.
    Methods: The study group comprised 312 trekkers attempting Mt Kilimanjaro summit by the Marango Route. Trekkers ascended over 4 or 5 days along a fixed ascent profile, stopping at 3 huts on ascent (2700 m, 3700 m, and 4700 m) before attempting the summit. Researchers were stationed at each hut for 16 days. Each night we measured heart rate, respiratory rate, blood pressure, oxygen saturation, and Lake Louise Score. We recorded the highest altitude that trekkers reached on the mountain.
    Results: Of 181 complete sets of data, 111 (61%) trekkers reached the summit, and 139 (77%) developed AMS. Physiological results were not related to summit success. The incidence of AMS and summiting success were similar in those on the 4- or 5-day route. Trekkers on the 5-day route who used acetazolamide were less likely to develop AMS and more likely to summit than were those not taking acetazolamide (P = <.05); this difference was not present with trekkers on the 4-day route.
    Conclusions: The risk of developing AMS is high on Mt Kilimanjaro. Although taking an extra day to acclimatize with the use of acetazolamide did provide some protection against AMS, ideally trekkers need a more gradual route profile for climbing this mountain.
    MeSH term(s) Acclimatization/physiology ; Acetazolamide/therapeutic use ; Acute Disease ; Altitude Sickness/epidemiology ; Altitude Sickness/prevention & control ; Carbonic Anhydrase Inhibitors/therapeutic use ; Humans ; Kenya/epidemiology ; Risk Factors ; Time Factors
    Chemical Substances Carbonic Anhydrase Inhibitors ; Acetazolamide (O3FX965V0I)
    Language English
    Publishing date 2009
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1238909-2
    ISSN 1545-1534 ; 1080-6032
    ISSN (online) 1545-1534
    ISSN 1080-6032
    DOI 10.1580/1080-6032-020.004.0311
    Database MEDical Literature Analysis and Retrieval System OnLINE

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