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Mild hyperventilation with preserved exercise capacity in patients with self-reported long-term dyspnea after COVID-19-a prospective cohort study in a primary healthcare setting

Stenberg, Henning LU ; Tufvesson, Ellen LU orcid ; Mosén, Henrik LU and Skarping, Ida LU orcid (2026) In Scandinavian Journal of Primary Health Care 44(1).
Abstract

BACKGROUND: Post COVID-19 condition remains a complex and challenging issue, with diverse manifestations, despite accumulating research and clinical experience. Dyspnea is one of the most common symptoms reported in post COVID-19 condition. Cardiopulmonary exercise testing (CPET) offers a cohesive assessment of dyspnea and exercise limitations. The Nijmegen questionnaire is a form for assessment of dysfunctional breathing.

AIM: The aim was to explore relationships between self-reported post COVID-19 respiratory symptoms, assessed by Nijmegen questionnaire, and the results of a 6-minute walk test (6MWT) and CPET, in patients with mild primary infection of COVID-19, managed within primary healthcare.

METHODS: A total of 15... (More)

BACKGROUND: Post COVID-19 condition remains a complex and challenging issue, with diverse manifestations, despite accumulating research and clinical experience. Dyspnea is one of the most common symptoms reported in post COVID-19 condition. Cardiopulmonary exercise testing (CPET) offers a cohesive assessment of dyspnea and exercise limitations. The Nijmegen questionnaire is a form for assessment of dysfunctional breathing.

AIM: The aim was to explore relationships between self-reported post COVID-19 respiratory symptoms, assessed by Nijmegen questionnaire, and the results of a 6-minute walk test (6MWT) and CPET, in patients with mild primary infection of COVID-19, managed within primary healthcare.

METHODS: A total of 15 participants with long-term dyspnea after a mild COVID-19 infection were prospectively included at primary healthcare facilities between July 2021 and April 2022. At inclusion, all subjects performed a 6MWT and answered the Nijmegen questionnaire. All subjects underwent CPET within 4 months of study inclusion. We estimated correlations between Nijmegen score (both total score and a subset of the questionnaire focusing on respiratory symptoms), and the 6MWT and CPET derived variables, respectively.

RESULTS: Nijmegen scores (both total and particularly a respiratory subset) were inversely correlated to 6MWT walking distance, but not to spirometric parameters. Subjects with more self-reported symptoms had higher end-tidal O2 and lower end-tidal CO2, indicating mild hyperventilation. Nijmegen scores also correlated with CPET variables reflecting breathing pattern.

CONCLUSIONS: Nijmegen score was associated with CPET variables and walking distance at 6MWT. Post COVID-19 condition could be associated with mild hyperventilation, also in subjects without overt dysfunctional breathing pattern.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, COVID-19/complications, Dyspnea/physiopathology, Female, Male, Prospective Studies, Middle Aged, Exercise Tolerance, Self Report, Primary Health Care, Hyperventilation/physiopathology, Aged, SARS-CoV-2, Walk Test, Exercise Test, Surveys and Questionnaires, Adult
in
Scandinavian Journal of Primary Health Care
volume
44
issue
1
article number
2623877
publisher
Informa Healthcare
external identifiers
  • pmid:41875257
ISSN
0281-3432
DOI
10.1080/02813432.2026.2623877
language
English
LU publication?
yes
id
86084d23-5486-4742-94f6-e9fa6d184f49
date added to LUP
2026-03-26 08:34:15
date last changed
2026-03-26 13:57:26
@article{86084d23-5486-4742-94f6-e9fa6d184f49,
  abstract     = {{<p>BACKGROUND: Post COVID-19 condition remains a complex and challenging issue, with diverse manifestations, despite accumulating research and clinical experience. Dyspnea is one of the most common symptoms reported in post COVID-19 condition. Cardiopulmonary exercise testing (CPET) offers a cohesive assessment of dyspnea and exercise limitations. The Nijmegen questionnaire is a form for assessment of dysfunctional breathing.</p><p>AIM: The aim was to explore relationships between self-reported post COVID-19 respiratory symptoms, assessed by Nijmegen questionnaire, and the results of a 6-minute walk test (6MWT) and CPET, in patients with mild primary infection of COVID-19, managed within primary healthcare.</p><p>METHODS: A total of 15 participants with long-term dyspnea after a mild COVID-19 infection were prospectively included at primary healthcare facilities between July 2021 and April 2022. At inclusion, all subjects performed a 6MWT and answered the Nijmegen questionnaire. All subjects underwent CPET within 4 months of study inclusion. We estimated correlations between Nijmegen score (both total score and a subset of the questionnaire focusing on respiratory symptoms), and the 6MWT and CPET derived variables, respectively.</p><p>RESULTS: Nijmegen scores (both total and particularly a respiratory subset) were inversely correlated to 6MWT walking distance, but not to spirometric parameters. Subjects with more self-reported symptoms had higher end-tidal O2 and lower end-tidal CO2, indicating mild hyperventilation. Nijmegen scores also correlated with CPET variables reflecting breathing pattern.</p><p>CONCLUSIONS: Nijmegen score was associated with CPET variables and walking distance at 6MWT. Post COVID-19 condition could be associated with mild hyperventilation, also in subjects without overt dysfunctional breathing pattern.</p>}},
  author       = {{Stenberg, Henning and Tufvesson, Ellen and Mosén, Henrik and Skarping, Ida}},
  issn         = {{0281-3432}},
  keywords     = {{Humans; COVID-19/complications; Dyspnea/physiopathology; Female; Male; Prospective Studies; Middle Aged; Exercise Tolerance; Self Report; Primary Health Care; Hyperventilation/physiopathology; Aged; SARS-CoV-2; Walk Test; Exercise Test; Surveys and Questionnaires; Adult}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Primary Health Care}},
  title        = {{Mild hyperventilation with preserved exercise capacity in patients with self-reported long-term dyspnea after COVID-19-a prospective cohort study in a primary healthcare setting}},
  url          = {{http://dx.doi.org/10.1080/02813432.2026.2623877}},
  doi          = {{10.1080/02813432.2026.2623877}},
  volume       = {{44}},
  year         = {{2026}},
}