Exercise testing in COVID-19 era: Clinical profile, results and feasibility wearing a facemask

Eur J Clin Invest. 2021 Apr;51(4):e13509. doi: 10.1111/eci.13509. Epub 2021 Feb 15.


Background: No data are available about whether Coronavirus disease 2019 (COVID-19) pandemic have led to changes in clinical profiles or results of exercise testing once the usual activity was reassumed, as well as if wearing a facemask has any impact on the tests. The aim of this study is to evaluate differences in the patients referred to exercise stress testing in the context of COVID-19 pandemic and analyse the feasibility and results of these tests wearing a facemask.

Methods: We included all patients referred for an exercise test from 1 June to 30 September 2020 and compared them with the patients attended within the same period in 2019 before and after propensity score matching. All patients referred in 2020 wore a facemask.

Results: A total of 854 patients were included: 398 in the 2020 group and 456 in 2019. No significant differences in baseline characteristics of the patients were observed, with the exception of dyspnoea, which was nearly twice as high in 2020 as compared with 2019. Regarding the results of the tests, no differences were observed, with almost 80% of maximal tests, similar functional capacity and over a 20% of positive exercise tests in both groups. These results remained after propensity score matching.

Conclusion: COVID-19 pandemic has not changed the clinical profile of patients referred to exercise testing. In addition, performing exercise testing wearing a facemask is feasible, with no influence in functional capacity and clinical results.

Keywords: COVID-19; exercise testing; facemask; functional capacity; ischaemic cardiomyopathy.

MeSH terms

  • Aged
  • COVID-19 / prevention & control*
  • Echocardiography, Stress / methods*
  • Electrocardiography*
  • Exercise Test / methods*
  • Exercise Tolerance
  • Female
  • Humans
  • Male
  • Masks*
  • Metabolic Equivalent
  • Middle Aged
  • Myocardial Ischemia / diagnosis*
  • Myocardial Ischemia / physiopathology
  • Physical Functional Performance
  • Propensity Score
  • Referral and Consultation
  • SARS-CoV-2
  • Spain