The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals, 2025, Russell+

[SNT Gatchaman]

The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals
Sophie L. Russell; Nduka C. Okwose; Mushidur Rahman; Ben J Lee; Gordon McGregor; Stuart M. Raleigh; Hardip Sandhu; Laura C. Roden; Prithwish Banerjee; Djordje G. Jakovljevic

AIMS
Coronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.

METHODS
This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.

RESULTS
There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12%, non-COVID-19: 29.2 ± 8.44%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m2, non-COVID-19: 2.79 ± 0.37 L/min/m2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m2, non-COVID-19: 47.0 ± 7.59 mL/m2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m2, p = 0.028).

CONCLUSION
Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise.

Link | PDF (Scandinavian Cardiovascular Journal) [Open Access]

 

[SNT Gatchaman]

This case-control study […] recruited participants who had no history of chronic cardiovascular or respiratory diseases but recovered from acute COVID-19 infection and were not severely impaired when they were infected (i.e. they were not hospitalised or ventilated during their acute infection phase). The findings of the present study indicate that there is likely no clinically significant long-term effects of COVID-19 infection on cardiovascular and respiratory function at rest, but that differences are apparent in response to a cardiopulmonary exercise stress test. Oxygen consumption at anaerobic threshold was lower by almost 10% […] At peak exercise, cardiac function, represented by cardiac index and stroke volume index, was also lower in people with a history of COVID-19 by 8% and 17% respectively.

(non-COVID-19 group) demonstrated a higher relative oxygen consumption at AT and achieved a higher percent of predicted oxygen consumption at AT. This finding agrees with that of a previous study in younger individuals, which reported lower aerobic capacity following COVID-19 infection [25]. Interestingly, at peak exercise there was no significant difference in oxygen consumption between COVID-19 and non-COVID-19 participants.

differences observed between COVID-19 and non-COVID-19 groups in AT shows that submaximal exercise capacity is not effort - or motivation-dependent but rather dependent on ability to undertake sub -maximal exercise test [5]. […] peak respiratory exchange ratio was 1.13 in the COVID-19 and 1.10 in the nonCOVID-19 group

Hemodynamically, COVID-19 participants achieved a significantly lower peak cardiac index and stroke volume index compared to the non-COVID-19 group. On the other hand, peak oxygen extraction (arteriovenous oxygen difference) was ~9% higher in the COVID-19 group. Reduced peak cardiac function (cardiac index) but higher oxygen extraction in the COVID-19 group resulted in non-significant differences in peak exercise tolerance (peak oxygen consumption)

 

[forestglip]

Is there any reason to think this isn't just people who are less fit are more likely to get COVID?

Edit: Yeah, unless I'm missing something, I think they imply they are showing that COVID caused these changes without evidence to support this:

The findings of the present study indicate that there is likely no clinically significant long-term effects of COVID-19 infection on cardiovascular and respiratory function at rest, but that differences are apparent in response to a cardiopulmonary exercise stress test.

It's worded strangely, but I think the most obvious way to interpret this is they say there are no long term effects from COVID at rest, but COVID does cause effects in the response to CPET.

 

[Utsikt]

COVID-19 participants however demonstrated lower O2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m2, p = 0.028).

Are these differences clinically significant?

The p-values are quite high and they tested many things, could the results be due to variance?
https://xkcd.com/882/