Cardiorespiratory fitness as a vital sign of CVD risk in the COVID-19 era

Harber, Matthew P.; Peterman, James E.; Imboden, Mary T.; Kaminsky, Leonard A.; Ashton, Ruth; Arena, Ross; Faghy, Mark A

doi:10.1016/j.pcad.2022.12.001

Cited by 13 publications

(2 citation statements)

References 56 publications

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“…Several studies have shown that individuals with high levels of cardiorespiratory fitness have a reduced risk of severe illness and death from COVID-19 [58,59]. This may be because exercise can improve immune function, making it easier for the body to fight off infections [60][61][62]. The COVID-19 confinement is well documented in the literature to delay the normal development of VO 2 max in teenagers, and alternative ways to minimize this delay must be created [63,64].…”

Section: Covid-19 Cardiorespiratory Fitness and Immune Responsementioning

confidence: 99%

Associations between Coronavirus and Immune Response, Cardiorespiratory Fitness Rehabilitation and Physical Activity: A Brief Report

Silva-Santos

Monteiro

Barbosa

et al. 2023

IJERPH

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COVID-19 has serious effects on cardiorespiratory capacity. In this sense, physical activity has been identified as beneficial in the treatment of cardiorespiratory diseases due to its anti-inflammatory and immunosuppressive benefits. To date, no study has been found on cardiorespiratory capacity and rehabilitation in patients cured after COVID-19. Thus, this brief report aims to relate the benefits of physical activity to cardiorespiratory function after COVID-19. It is important to know how different levels of physical activity can be related to the different symptoms of COVID-19. In view of this, the objectives of this brief report were to: (1) explore the theoretical associations between COVID-19 symptoms and physical activity; (2) compare the cardiorespiratory function of non-COVID-19 participants and post-COVID-19 patients; and (3) propose a physical activity program to improve the cardiorespiratory fitness of post-COVID-19 patients. Thus, we note that moderate-intensity physical activity (i.e., walking) has a greater beneficial effect on immune function, whereas vigorous activity (i.e., marathon running) tends to temporarily reduce immune function through an imbalance of cytokine types I and II in the hours and days after exercise. However, there is no consensus in the literature in this regard, since other investigations suggest that high-intensity training can also be beneficial, not causing clinically relevant immunosuppression. Physical activity has been shown to be beneficial in improving the clinical conditions most frequently associated with severe COVID-19. Thus, it is possible to infer that physically active individuals seem to be less exposed to the dangers of severe COVID-19 compared to non-active individuals through the benefits of physical activity in strengthening the immune system and fighting infections. The current study demonstrates that physical activity appears to be beneficial in improving the clinical conditions most often associated with severe COVID-19.

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Section: Covid-19 Cardiorespiratory Fitness and Immune Responsementioning

confidence: 99%

Associations between Coronavirus and Immune Response, Cardiorespiratory Fitness Rehabilitation and Physical Activity: A Brief Report

Silva-Santos

Monteiro

Barbosa

et al. 2023

IJERPH

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“…Both obesity and physical inactivity with poor CRF established early in life are known to be persistent traits over the course of a lifetime, 13,14 probably representing unfavorable long-term lifestyle with negative impact on cardiovascular health and the ability to cope with viral infections such as COVID-19. [1][2][3][4][20][21][22][23][24][25][26] Our research group has previously found high BMI in late adolescence to be associated with severe COVID-19 many years later, with an elevated risk starting already at BMI ≥22.5 and with a gradual risk increase with increasing BMI. 11 Additionally, high CRF at a young age seems to protect from severe COVID-19 with OR 0.76 (95% CI 0.67-0.85) for hospitalization, and 0.61 (0.48-0.78) for intensive care.…”

Section: Crf In Late Adolescence and Overall Death After Covid-19mentioning

confidence: 99%

Body mass index and fitness in late adolescence and risk of cardiovascular disease, respiratory disease, and overall death after COVID‐19

Robertson,

Muszta,

Lindgren

et al. 2023

Obesity Science & Practice

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ObjectiveSince obesity and poor fitness appear to be unfavorable for both cardiovascular health and coping with viral infections such as COVID‐19, they are of specific interest in light of the increased risk of cardiovascular and respiratory events now seen after infection with SARS‐CoV‐2. Therefore, the aim of the present study was to investigate how body mass index (BMI) and cardiorespiratory fitness (CRF) in late adolescence are associated with the risk of cardiovascular disease (CVD), respiratory disease, and mortality after COVID‐19.MethodsIn this study, 1.5 million 18‐year‐old Swedish men with BMI and CRF measured during enlistment for military service 1968–2005 were included. Hospitalized and non‐hospitalized COVID‐19 cases were identified through the Patient Register or positive polymerase chain reaction tests, and age‐matched with non‐infected controls. CVD, respiratory disease, and mortality after COVID‐19 were divided into <60days, 60‐180days, >180days post‐infection. Cox regression models were used.ResultsHospitalized COVID‐19 cases (n = 9839), compared to controls, had >10‐fold, 50 to 70‐fold, and >70‐fold hazards of CVD, respiratory disease, and mortality over the initial 60 days post‐infection with little variation across BMI or CRF categories. The elevated risks persisted at declining levels >180 days. For non‐hospitalized COVID‐19 cases (n = 181,822), there was a 4‐ to 7‐fold increased acute mortality risk, and high CRF was associated with lower risk of post‐infectious respiratory disease.ConclusionsThe high hazards of adverse outcomes during the first two months after COVID‐19 hospitalization, and across BMI and CRF categories, declined rapidly but were still elevated after six months. Adolescent CRF was associated with respiratory disease after COVID‐19 without hospitalization, which gives further support to the health benefits of physical activity.

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