Impact of 3-months COVID-19 lockdown on exercise capacity in stable pulmonary arterial hypertension

<bold>Background:</bold> Between March and June 2020, patients with pulmonary arterial hypertension (PAH) were invited to self-isolation in response to the COVID-19 pandemic. This may have led to physical deconditioning and reduced exercise capacity. <bold>Aim:</bold> To evaluate the impact of COVID-19 lockdown on 6-minutes walking distance (6MWD) in PAH. <bold>Methods:</bold> We included stable PAH patients who underwent at least two tests before and after the lockdown period. Patients with hospitalization within 12 months, clinical worsening and/or therapeutic modifications were excluded. To reduce 6MWD variability, the difference between the last test performed before and the first test after the lockdown (D1) was compared with the difference between the last test before the lockdown and the last test of 2019 (D2). D1 and D2 were compared using paired T-test. A sub-analysis including only patients with an intra-individual variability <10% between 3 tests performed before the lockdown was also realized. <bold>Results:</bold> Seventy-four stable PAH patients were included (50% with idiopathic PAH). The lockdown was associated with a trend to a greater difference in 6MWD (D2: -2±43 m vs D1: -15±40, p=0.061). A significant decrease in 6MWD was observed in the 43 patients with an intra-individual variability <10% between the tests preceding the lockdown (D2: 0±20 m vs D1: -16±34, p<0.01) (Table). <table-wrap><object-id>erj;58/suppl_65/PA3589/table1</object-id><object-id>T1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>D2, m</td><td>D1, m</td><td>p-value</td></tr><tr><td>N=74</td></tr><tr><td>6MWD, m</td><td>-15±40</td><td>-2±43</td><td>0.061</td></tr><tr><td>N=43</td></tr><tr><td>6MWD, m</td><td>-16±34</td><td>0±20</td><td><0.01</td></tr></tbody></table></table-wrap> <bold>Conclusions:</bold> The marginal but significant differences observed suggest that the lockdown period might have resulted in physical deconditioning, which could influence 6MWD interpretation in patients with PAH during the COVID-19 pandemic.