{
  "abstract": "Introduction Post-COVID syndrome (PCS) is defined as the persistence of physical symptoms 3-months after an initial COVID-19 infection that cannot be explained by alternative causes. Nearly half of young people with PCS experience breathlessness, 1 which may be linked to breathing pattern disorders (BrPDs) caused by autonomic nervous system disturbances.2 Aims To determine incidence of BrPD diagnosis at rest and during exercise and explore the impact of breathing retraining on BrPDs in teenagers with PCS.Methods Prospective analysis as part of a broader study in PCS (IRAS: 315063). Participants underwent cardiopulmonary exercise testing (CPET) with perceived breathlessness scores (BORG), spirometry, gas transfer and breathing pattern assessment by a physiotherapist at baseline (T1) and invited for breathing pattern retraining intervention. Assessments were repeated after six-months (T2). To assess the impact of number of physiotherapy appointments, participants were classified in two groups: ≤2 or ≥3 appointments. BrPDs on CPET were diagnosed if there was evidence of hyperventilation (increased breathing frequency or tidal volumes), stunted increase in tidal volume or erratic breathing pattern in response to exercise. Improvement in any of these BrPD parameters was assessed at T2. Parametric and non-parametric statistical analysis were undertaken as appropriate.Results 32 teenagers were recruited, 21 (66%) female, mean age 15.3 (SD 1.73) with mean BMI 21.2 (SD 4.2). All had normal spirometry and gas transfer. Assessment at rest confirmed BrPD in 27 (84%) participants via physiotherapy assessment and 29 (91%) via CPET at T1. BrPD was agreed in 26 (82%) participants via both assessments. Only one participant completed 6 physiotherapy appointments, the median 3 (range 0–6) appointments.Nijmegen scores (p<0.001) and improvement in CPET parameters (p<0.05). Reduced resting breath frequency, pre-test BORG scores and increased CPET duration were observed in all subjects but did not reach significance in those who had more physiotherapy appointments (table 1).Abstract P145 Table 1Participant demographics and assessment data Total n = 32 Group 1: ≤2 physiotherapy appointments = 12 Group 2: 3≤ physiotherapy appointments = 18 Demographics Sex (male)11 (34.4%)3 (25%)8 (44.4%) Mean (SD) Mean (SD) Mean (SD) Age15.31 (1.73)14.85 (1.82)15.61 (1.5)BMI21.16 (4.17)22.04 (4.61)20.53 (3.83)FEV1 (% predicted)94.20 (11.99)92.39 (10.41)90.66 (14.63)FVC91.39 (20.29)96.04 (12.24)87.80 (24.59)Gas transfer (TLCO SB % predicted)94.54 (13.17)96.59 (15.75)92.01 (12.39) Physiotherapy assessment T1 Diagnosis of DB by physiotherapist27 (84.4%)11 (91.6%)16 (88.9%) Mean (SD) Mean (SD) Mean (SD) T1 Nijmegen score33.13 (9.78)34.17 (10.77)32.44 (9.33)T2 Nijmegen score25.60 (8.25)26.58 (9.86)24.94 (7.22) CPET data T1 diagnosis of DB at rest 29 (90.6%)12 (100%)17 (94.4%)T1 diagnosis of DB during exercise 24 (75%)9 (75%)15 (83.3%) Mean (SD) Mean (SD) Mean (SD) T1 breath frequency at rest 19.31 (4.71)18.5 (5.75)19.78 (4.22)T2 breath frequency at rest 17.9 (4.72)18.5 (5.65)17.5 (4.12)T1 resting BORG 1.1 (1.07)1.25 (1.11)1.15 (1.07)T2 resting BORG 1.11 (1.06)1.60 (1.34)0.89 (0.82)T1 CPET duration9.32 (2.51)9.33 (2.90)9.28 (2.37)T2 CPET duration9.8 (2.62)9.33 (2.64)10.11 (2.63)Improvements seen during CPET on breathing pattern from T1 to T221 (65.6%)10 (83.3%)11 (61.1%)Conclusions BrPDs are a predominant cause of breathlessness in teenagers with PCS. Further studies are required to determine whether the improvement seen after 6 months is due to BrPD intervention or effect of time.References Brackel: Pediatr Pulmonol. 2021; 56(8):2495–502.Dani: https://doi.org/10.7861/clinmed.2020-0896",
  "authors": [
    {
      "affiliations": [
        "University of Suffolk, Ipswich, UK"
      ],
      "name": "C Wells"
    },
    {
      "affiliations": [
        "The Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK"
      ],
      "name": "C Richardson"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "T Segal"
    },
    {
      "affiliations": [
        "The Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK"
      ],
      "name": "S Sonnappa"
    }
  ],
  "title": "P145 Impact of breathing pattern interventions on breathing pattern disorders in teenagers with post-COVID syndrome",
  "uid": "d6a72f78-583d-53bd-bec4-75411d6fb199"
}