Autonomic and vascular function testing in collegiate athletes following SARS-CoV-2 infection: an exploratory study, 2023, J Carter Luck et al

[Mij]

Introduction: Recent studies suggest that SARS-CoV-2 infection alters autonomic and vascular function in young, otherwise healthy, adults. However, whether these alterations exist in young competitive athletes remains unknown. This study aimed to assess the effects of COVID-19 on cardiac autonomic control and vascular function in collegiate athletes who tested positive for COVID-19, acknowledging the limitations imposed by the early stages of the pandemic.

Methods: Sixteen collegiate athletes from various sports underwent a battery of commonly used autonomic and vascular function tests (23 ± 9, range: 12–44 days post-infection). Additionally, data from 26 healthy control participants were included.

Results: In response to the Valsalva maneuver, nine athletes had a reduced early phase II blood pressure response and/or reduced Valsalva ratio. A depressed respiratory sinus arrhythmia amplitude was observed in three athletes. Three athletes became presyncopal during standing and did not complete the 10-min orthostatic challenge. Brachial artery flow-mediated dilation, when allometrically scaled to account for differences in baseline diameter, was not different between athletes and controls (10.0% ± 3.5% vs. 7.1% ± 2.4%, p = 0.058). Additionally, no differences were observed between groups when FMD responses were normalized by shear rate (athletes: 0.055% ± 0.026%/s-1, controls: 0.068% ± 0.049%/s-1, p = 0.40
Discussions: Few atypical and borderline responses to autonomic function tests were observed in athletes following an acute SARS-CoV-2 infection. The most meaningful autonomic abnormality being the failure of three athletes to complete a 10-min orthostatic challenge. These findings suggest that some athletes may develop mild alterations in autonomic function in the weeks after developing COVID-19, while vascular function is not significantly impaired.

https://www.frontiersin.org/article...14/full?utm_source=dlvr.it&utm_medium=twitter

 

[rvallee]

Uh, I guess it's a "mild alteration" for 1/3 not being able to remain standing up for 10 minutes.

It's not like being to stand up for 10 minutes is something common in every day life and has further implications. No siree. All perfectly mild.

 

[Hutan]

(Not on the study itself, but quoting some of the text in the paper)

Initial uncertainty regarding the cardiovascular outcomes following a SARS-CoV-2 infection (Puntmann et al., 2020) prompted a rapid response by the Big Ten Conference early in the pandemic, which required each of its 14 institutions to screen all student-athletes that tested positive for COVID-19 using a comprehensive cardiac evaluation, before returning to competition. The Big Ten Conference later published its registry data of 1,597 athletes, which identified that 2.3% of athletes infected with SARS-CoV-2 developed clinical and subclinical myocarditis

There's no controls for that finding, but it sounds significant.

Identifying alterations in autonomic function in athletes with an acute SARS-CoV-2 infection may be particularly interesting for several reasons. Importantly, it is recognized that individuals with vagal dysfunction may experience a reduction in exercise capacity(Machhada et al., 2017). Moreover, it is a topic of ongoing debate whether regular physical activity could have a protective impact against severe COVID-19 outcomes (da Silveira et al., 2021; Steenkamp et al., 2022). Indeed, the cardio-protective benefits of regular exercise have been meticulously documented for years (Blair, 1995; Joyner and Green, 2009), and evidence suggests that regular physical activity could also benefit the immune system (Nieman and Wentz, 2019). Therefore, the possibility that regular exercise could lead to less severe outcomes in athletes, who presumably engaged in consistent physical activity before a SARS-CoV-2 infection, is particularly intriguing

Indeed, if young athletes are developing myocarditis at unusual rates, it raises the question of how protective high levels of exercise are. Did young non-athletes develop myocarditis at higher rates? Or lower rates?