A 33-year-old man with a history of intermittent asthma presented with 3 months of dyspnea on exertion, which developed approximately 2 weeks after infection with SARS-CoV-2. His acute COVID-19 symptoms resolved after 5 days and did not require hospitalization. At presentation, his physical examination findings were normal and peripheral oxygen saturation was 97% at rest. Laboratory testing, chest radiographic imaging, chest computed tomographic scan, echocardiography, and pulmonary function testing results were normal. To further evaluate his dyspnea on exertion, the patient underwent cardiopulmonary exercise testing (CPET) on a cycle ergometer with arterial blood gas samples obtained from an indwelling radial artery catheter. Continuous 12-lead electrocardiogram (ECG) findings showed no evidence of arrythmia or ischemia, and the patient stopped exercise due to leg fatigue after 15 minutes. Select exercise data are presented in the Table and Figure.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Michael P. Mohning, MD, National Jewish Health, 1400 Jackson St, Building G07a, Denver, CO 80206 (firstname.lastname@example.org).
Published Online: March 10, 2022. doi:10.1001/jama.2022.2037
Conflict of Interest Disclosures: Dr Petrache reported receiving personal fees from Allinaire and Ceramedix outside the submitted work. Dr Mohning reported receiving consulting fees from Diffusion Pharmaceuticals outside the submitted work. No other disclosures were reported.
Funding/Support: Dr Petrache reported receipt of financial support from the Wollowick Chair in COPD Research.
Role of the Funder/Sponsor: The funder had no role in the preparation, review, or approval of the manuscript and decision to submit the manuscript for publication.
Additional Contribution: We thank Iñigo San-Millán, PhD (University of Colorado School of Medicine), for his contributions, including discussion and review of the manuscript. He did not receive compensation for his contributions. We also thank the patient for granting permission to publish this information.
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