{"id":"https://openalex.org/W7224093845","doi":"https://doi.org/10.1186/s12931-026-03943-5","title":"Multimodal physiological determinants of persistent dyspnea nearly four years after COVID-19 hospitalization","display_name":"Multimodal physiological determinants of persistent dyspnea nearly four years after COVID-19 hospitalization","publication_year":2026,"publication_date":"2026-10-28","ids":{"openalex":"https://openalex.org/W7224093845","doi":"https://doi.org/10.1186/s12931-026-03943-5"},"language":"en","primary_location":{"id":"doi:10.1186/s12931-026-03943-5","doi":"https://doi.org/10.1186/s12931-026-03943-5","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12931-026-03943-5","pdf_url":null,"source":{"id":"https://openalex.org/S186153782","display_name":"Respiratory Research","issn_l":"1465-9921","issn":["1465-9921","1465-993X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-2","ki-jl-2","medline","norway-2","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Respiratory Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12931-026-03943-5","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5010301863","display_name":"Pauliane Vieira Santana","orcid":"https://orcid.org/0000-0002-2278-4788","observed_orcids":["https://orcid.org/0000-0002-2278-4788"]},"institutions":[{"id":"https://openalex.org/I17974374","display_name":"Universidade de S\u00e3o Paulo","ror":"https://ror.org/036rp1748","country_code":"BR","type":"education","lineage":["https://openalex.org/I17974374"]},{"id":"https://openalex.org/I4210145268","display_name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo","ror":"https://ror.org/03se9eg94","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I4210145268"]},{"id":"https://openalex.org/I4405258467","display_name":"Instituto do Cora\u00e7\u00e3o - HCFMUSP","ror":"https://ror.org/00q3jak84","country_code":"BR","type":"facility","lineage":["https://openalex.org/I4210145268","https://openalex.org/I4405258467"]}],"countries":["BR"],"is_corresponding":true,"raw_author_name":"Pauliane Vieira Santana","raw_affiliation_strings":["Pulmonary Division, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), Av. Dr. En\u00e9as de Carvalho Aguiar, 45, S\u00e3o Paulo, SP, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-2278-4788","affiliations":[{"raw_affiliation_string":"Pulmonary Division, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), Av. Dr. En\u00e9as de Carvalho Aguiar, 45, S\u00e3o Paulo, SP, Brazil","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268","https://openalex.org/I4405258467"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5043040686","display_name":"Pedro Caruso","orcid":"https://orcid.org/0000-0002-1051-8458","observed_orcids":["https://orcid.org/0000-0002-1051-8458"]},"institutions":[{"id":"https://openalex.org/I17974374","display_name":"Universidade de S\u00e3o Paulo","ror":"https://ror.org/036rp1748","country_code":"BR","type":"education","lineage":["https://openalex.org/I17974374"]},{"id":"https://openalex.org/I3019035496","display_name":"AC Camargo Hospital","ror":"https://ror.org/03025ga79","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I3019035496"]},{"id":"https://openalex.org/I4210145268","display_name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo","ror":"https://ror.org/03se9eg94","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I4210145268"]},{"id":"https://openalex.org/I4405258467","display_name":"Instituto do Cora\u00e7\u00e3o - HCFMUSP","ror":"https://ror.org/00q3jak84","country_code":"BR","type":"facility","lineage":["https://openalex.org/I4210145268","https://openalex.org/I4405258467"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Pedro Caruso","raw_affiliation_strings":["Intensive Care Unit, AC Camargo Cancer Center, S\u00e3o Paulo, SP, Brazil","Pulmonary Division, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), Av. Dr. En\u00e9as de Carvalho Aguiar, 45, S\u00e3o Paulo, SP, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-1051-8458","affiliations":[{"raw_affiliation_string":"Intensive Care Unit, AC Camargo Cancer Center, S\u00e3o Paulo, SP, Brazil","institution_ids":["https://openalex.org/I3019035496"]},{"raw_affiliation_string":"Pulmonary Division, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), Av. Dr. En\u00e9as de Carvalho Aguiar, 45, S\u00e3o Paulo, SP, Brazil","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268","https://openalex.org/I4405258467"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5037340676","display_name":"Carlos Roberto Ribeiro de Carvalho","orcid":"https://orcid.org/0000-0002-1618-8509","observed_orcids":["https://orcid.org/0000-0002-1618-8509"]},"institutions":[{"id":"https://openalex.org/I17974374","display_name":"Universidade de S\u00e3o Paulo","ror":"https://ror.org/036rp1748","country_code":"BR","type":"education","lineage":["https://openalex.org/I17974374"]},{"id":"https://openalex.org/I4210145268","display_name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo","ror":"https://ror.org/03se9eg94","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I4210145268"]},{"id":"https://openalex.org/I4405258467","display_name":"Instituto do Cora\u00e7\u00e3o - HCFMUSP","ror":"https://ror.org/00q3jak84","country_code":"BR","type":"facility","lineage":["https://openalex.org/I4210145268","https://openalex.org/I4405258467"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Carlos Roberto Ribeiro de Carvalho","raw_affiliation_strings":["N\u00facleo de Inova\u00e7\u00e3o Tecnol\u00f3gica (InovaHC), Saude Digital, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), S\u00e3o Paulo, SP, Brazil","Pulmonary Division, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), Av. Dr. En\u00e9as de Carvalho Aguiar, 45, S\u00e3o Paulo, SP, Brazil","\u201cHCFMUSP Long-COVID PASC Initiative\u201d: Hospital das Cl\u00ednicas Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), S\u00e3o Paulo, SP, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-1618-8509","affiliations":[{"raw_affiliation_string":"N\u00facleo de Inova\u00e7\u00e3o Tecnol\u00f3gica (InovaHC), Saude Digital, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), S\u00e3o Paulo, SP, Brazil","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268"]},{"raw_affiliation_string":"Pulmonary Division, Heart Institute (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), Av. Dr. En\u00e9as de Carvalho Aguiar, 45, S\u00e3o Paulo, SP, Brazil","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268","https://openalex.org/I4405258467"]},{"raw_affiliation_string":"\u201cHCFMUSP Long-COVID PASC Initiative\u201d: Hospital das Cl\u00ednicas Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP), S\u00e3o Paulo, SP, Brazil","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5010301863"],"corresponding_institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268","https://openalex.org/I4405258467"],"apc_list":{"value":3490,"currency":"USD","value_usd":3490},"apc_paid":{"value":3490,"currency":"USD","value_usd":3490},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.82288955,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11368","display_name":"Long-Term Effects of COVID-19","score":0.9746000170707703,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11368","display_name":"Long-Term Effects of COVID-19","score":0.9746000170707703,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10041","display_name":"COVID-19 Clinical Research Studies","score":0.021800000220537186,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11209","display_name":"Cardiovascular and exercise physiology","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/covid-19","display_name":"COVID-19 pandemic","score":0.7919999957084656},{"id":"https://openalex.org/keywords/persistent-dyspnea","display_name":"persistent dyspnea","score":0.8679999709129333},{"id":"https://openalex.org/keywords/long-covid","display_name":"long COVID","score":0.8019999861717224},{"id":"https://openalex.org/keywords/hospitalization","display_name":"hospitalization","score":0.3370000123977661}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7451000213623047},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.450300008058548},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.4147000014781952},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3578999936580658},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.35010001063346863},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.29600000381469727},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.28700000047683716},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.2863999903202057},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.2590999901294708},{"id":"https://openalex.org/C2779951463","wikidata":"https://www.wikidata.org/wiki/Q7268788","display_name":"Quality of life (healthcare)","level":2,"score":0.25780001282691956}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12931-026-03943-5","doi":"https://doi.org/10.1186/s12931-026-03943-5","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12931-026-03943-5","pdf_url":null,"source":{"id":"https://openalex.org/S186153782","display_name":"Respiratory Research","issn_l":"1465-9921","issn":["1465-9921","1465-993X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-2","ki-jl-2","medline","norway-2","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Respiratory Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12931-026-03943-5","doi":"https://doi.org/10.1186/s12931-026-03943-5","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12931-026-03943-5","pdf_url":null,"source":{"id":"https://openalex.org/S186153782","display_name":"Respiratory Research","issn_l":"1465-9921","issn":["1465-9921","1465-993X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-2","ki-jl-2","medline","norway-2","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Respiratory Research","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320320997","display_name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","ror":"https://ror.org/02ddkpn78"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4388612021","https://openalex.org/W7204539026","https://openalex.org/W7135735097","https://openalex.org/W3135208565","https://openalex.org/W4384341572","https://openalex.org/W3138441338","https://openalex.org/W2414663109","https://openalex.org/W7084860381","https://openalex.org/W4401121631","https://openalex.org/W6977222516"],"abstract_inverted_index":{"Dyspnea":[0,64,195],"is":[1,270],"a":[2,32,37,79,219,273,288],"frequent":[3],"and":[4,9,15,62,75,84,99,113,121,130,176,210,225,235,269,285],"disabling":[5],"symptom":[6],"following":[7],"COVID-19":[8,41,263],"may":[10],"persist":[11],"despite":[12],"preserved":[13],"pulmonary":[14,59],"cardiac":[16],"function.":[17],"The":[18],"physiological":[19,275],"mechanisms":[20],"underlying":[21],"persistent":[22,258],"dyspnea":[23,139,151,259],"at":[24],"long-term":[25,292],"follow-up":[26],"remain":[27],"incompletely":[28],"characterized.":[29],"We":[30],"conducted":[31],"cross-sectional":[33],"analysis":[34],"nested":[35],"within":[36],"prospective":[38],"cohort":[39],"of":[40,191,291],"survivors":[42,264],"evaluated":[43],"41\u201347":[44],"months":[45],"after":[46,256],"hospitalization.":[47],"Participants":[48],"with":[49,155,165,200,230,248,272,281],"identifiable":[50],"structural":[51,266],"cardiopulmonary":[52,267],"disease":[53,268],"were":[54,125],"excluded":[55],"based":[56],"on":[57],"comprehensive":[58],"function":[60],"testing":[61],"echocardiography.":[63],"was":[65,90,143,152,216],"assessed":[66],"using":[67,127],"the":[68],"modified":[69],"Medical":[70],"Research":[71],"Council":[72],"(mMRC)":[73],"scale":[74],"analyzed":[76],"as":[77,92],"both":[78],"binary":[80],"(mMRC":[81,140],"\u2265":[82,141],"2)":[83,142],"ordinal":[85,131],"outcome.":[86],"Inspiratory":[87,212],"muscle":[88,115,157,173,179,202,205,213,233,241,278,283],"weakness":[89,158,214,242],"defined":[91],"concomitant":[93],"reductions":[94],"in":[95,145],"maximal":[96],"inspiratory":[97,102,156,240],"pressure":[98,103],"sniff":[100],"nasal":[101],"(<":[104],"70%":[105],"predicted).":[106],"A":[107],"standardized":[108],"multimodal":[109],"assessment":[110],"included":[111],"respiratory":[112,172,201],"peripheral":[114,178,204,232,282],"function,":[116],"ultrasonography,":[117],"functional":[118,208],"capacity":[119],"testing,":[120],"fatigue":[122,170],"evaluation.":[123],"Associations":[124],"examined":[126],"hierarchical":[128,149,186],"logistic":[129],"regression":[132],"models.":[133],"Among":[134],"270":[135],"participants,":[136],"clinically":[137],"relevant":[138],"present":[144],"34.4%.":[146],"In":[147],"multivariable":[148],"models,":[150,187],"independently":[153],"associated":[154,271],"(OR":[159],"8.86,":[160],"95%":[161],"CI":[162],"6.33\u201312.41),":[163],"along":[164],"female":[166],"sex,":[167],"obesity,":[168],"higher":[169],"burden,":[171],"ultrasound":[174],"abnormalities,":[175],"reduced":[177,207,231],"strength.":[180,236],"Model":[181],"discrimination":[182],"improved":[183],"stepwise":[184],"across":[185],"reaching":[188],"an":[189],"AUC":[190,249],"0.89":[192],"for":[193],"dyspnea.":[194,293],"severity":[196],"showed":[197],"graded":[198],"associations":[199],"dysfunction,":[203,279],"impairment,":[206],"capacity,":[209],"fatigue.":[211],"(23.4%)":[215],"characterized":[217],"by":[218],"distinct":[220],"muscular":[221],"profile":[222],"involving":[223],"diaphragmatic":[224],"parasternal":[226],"intercostal":[227],"abnormalities":[228],"together":[229],"mass":[234],"Hierarchical":[237],"models":[238],"predicting":[239],"also":[243],"demonstrated":[244],"strong":[245],"discriminative":[246],"performance,":[247],"up":[250],"to":[251],"0.92.":[252],"Nearly":[253],"four":[254],"years":[255],"hospitalization,":[257],"remains":[260],"common":[261],"among":[262],"without":[265],"multidimensional":[274],"profile.":[276],"Respiratory":[277],"integrated":[280],"impairment":[284],"fatigue,":[286],"represents":[287],"key":[289],"correlate":[290]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-29T00:00:00"}
