Cardiopulmonary Profiling of Athletes with Post-Exertional Malaise after COVID-19 Infection—A Single-Center Experience

Wernhart, Simon; Weihe, Eberhard; Totzeck, Matthias; Balcer, Bastian; Rassaf, Tienush; Luedike, Peter

doi:10.3390/jcm12134348

Cited by 2 publications

(2 citation statements)

References 44 publications

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“…A previous study has also supported a cardioprotective effect of a higher physical activity level as they found a significantly greater ventilatory efficient and tissue oxygen uptake in elite athletes than recreational athletes (48). Interestingly, the meta-analysis in this study failed to identify lower CRF in patients with severe symptoms when compared to the non-COVID-19 group.…”

Section: Discussionsupporting

confidence: 62%

“…In the context of current review, sufficient physical activity (≥150 min a week of moderate intensity) can impede viral entry to the targeted cell by increase in plasma soluble angiotensin-converting enzyme 2 (sACE2), which can bind to SARS-CoV-2 ( 43 ). A previous study has also supported a cardioprotective effect of a higher physical activity level as they found a significantly greater ventilatory efficient and tissue oxygen uptake in elite athletes than recreational athletes ( 48 ). Interestingly, the meta-analysis in this study failed to identify lower CRF in patients with severe symptoms when compared to the non-COVID-19 group.…”

Section: Discussionmentioning

confidence: 67%

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Long-term impact of SARS-CoV-2 infection on cardiorespiratory fitness: a meta-analysis

Chuatrakoon,

Konghakote,

Sa-nguanmoo

et al. 2023

Front. Public Health

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BackgroundDespite surviving Coronavirus disease 2019 (COVID-19), its long-term impact is of concern. Low cardiorespiratory fitness is a strong predictor of all-cause mortality, and likely affected by multisystem impairments following COVID-19 infection. Accumulating evidence has identified the impact of COVID-19 on cardiorespiratory fitness level. However, the findings have been controversial. Conclusive evidence is still needed.ObjectivesThis review aimed to systematically summarize and synthesize whether the SARS-CoV-2 infection diminishes cardiorespiratory fitness in COVID-19 survivors.DesignThe study design was a systematic review and meta-analysis.MethodsA search was carried out using PubMed, CINAHL, Scopus, Embase and the Cochrane Library, together with reference lists (searching from their inception to January 2023). Observational studies investigating the impact of COVID-19 on outcomes relevant to cardiorespiratory fitness (i.e., peak oxygen uptake) were included. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to identify a pooled effect estimate. Use of a random effects model was considered as the main method. Grading of Recommendation Assessment, Development and Evaluation approach was employed to determine the certainty of evidence. This meta-analysis was registered with PROSPERO (registration number: CRD42023393108).ResultsSeven eligible studies (4 cross-sectional, 2 cohort, and 1 case–control studies) involving 4,773 participants were included in this meta-analysis. A pooled effect estimates showed that patients in the surviving COVID-19 group had a significant reduction in peak oxygen uptake when compared to their counterparts in the non-COVID-19 group (WMD −6.70, 95%CI −9.34 to −4.06, low certainty). A subgroup analysis by age found that COVID-19 survivors in the young- to middle-aged and middle- to older-aged subgroups had significant reductions in peak oxygen uptake when compared to their counterparts in the non-COVID-19 group (WMD −5.31, 95%CI −7.69 to −2.94, low certainty; WMD −15.63, 95%CI −28.50 to −2.75, very low certainty, respectively). Subgroup analyses by symptom found that patients with moderate to severe symptoms in the surviving COVID-19 group had significantly lower peak oxygen uptake than their counterparts in the non-COVID-19 group (WMD −15.63, 95%CI −28.50 to −2.75, very low certainty).ConclusionThe current meta-analysis concluded that patients in the COVID-19 survivors had poorer cardiorespiratory fitness than their counterparts in the non-COVID-19 group, but there is considerable uncertainty of evidence. Poorer cardiorespiratory fitness is likely to be more pronounced in COVID-19 survivors who are getting older and had severe symptoms, but it is uncertain whether such finding has a valuable in clinical context.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42023393108.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 67%

Long-term impact of SARS-CoV-2 infection on cardiorespiratory fitness: a meta-analysis

Chuatrakoon,

Konghakote,

Sa-nguanmoo

et al. 2023

Front. Public Health

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Hyperaemia during dynamic handgrip exercise is preserved in healthy young subjects after recovery from COVID‐19

Prodel,

Souza,

Divino

et al. 2024

Experimental Physiology

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We sought to investigate possible impaired hyperaemia during dynamic handgrip exercise (HGE) in young healthy individuals who had recovered from COVID‐19. We tested the vascular function in individuals recovered from COVID‐19 using a nitric oxide donor (i.e., sodium nitroprusside; SNP), which could revert a possible impaired endothelial function during HGE. Further, we tested whether individuals who recovered from COVID‐19 would present exaggerated brachial vascular resistance under an adrenergic agonist (i.e., phenylephrine; PHE) stimuli during HGE. Participants were distributed into two groups: healthy controls (Control; men: n = 6, 30 ± 3 years, 26 ± 1 kg/m2; and women: n = 5, 25 ± 1 years, 25 ± 1 kg/m2) and subjects recovered from COVID‐19 (post‐COVID; men: n = 6, 29 ± 3 years, 25 ± 1 kg/m2; and women: n = 10, 32 ± 4 years, 22 ± 1 kg/m2). Participants in the post‐COVID group tested positive (RT‐PCR) 12–14 weeks before the protocol. Heart rate (HR), brachial blood pressure (BP), brachial blood flow (BBF) and vascular conductance (BVC) at rest were not different between groups. The HGE increased HR (Control: Δ9 ± 0.4 bpm; and post‐COVID: Δ11 ± 0.4 bpm) and BP (Control: Δ6 ± 1 mmHg; and post‐COVID: Δ12 ± 0.6 mmHg) in both groups. Likewise, BBF (Control: Δ632 ± 38 ml/min; and post‐COVID: Δ620 ± 27 ml/min) and BVC (Control: Δ6.6 ± 0.4 ml/min/mmHg; and post‐COVID: Δ6.1 ± 0.3 ml/min/mmHg) increased during HGE. SNP did not change HGE‐induced hyperaemia but did decrease BP, which induced a reflex‐related increase in HR. PHE infusion also did not change the HGE‐induced hyperaemia but raised BP and reduced HR. In conclusion, exercise‐induced hyperaemia is preserved in healthy young subjects 12–14 weeks after recovery from COVID‐19 infection.

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Cardiopulmonary Profiling of Athletes with Post-Exertional Malaise after COVID-19 Infection—A Single-Center Experience

Cited by 2 publications

References 44 publications

Long-term impact of SARS-CoV-2 infection on cardiorespiratory fitness: a meta-analysis

Long-term impact of SARS-CoV-2 infection on cardiorespiratory fitness: a meta-analysis

Hyperaemia during dynamic handgrip exercise is preserved in healthy young subjects after recovery from COVID‐19

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