Impaired cardiorespiratory fitness and endothelial function after SARS-CoV-2 infection in a sample of mainly immunocompromised youth

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Astley, Camilla ; do Prado, Danilo Marcelo Leite ; Sieczkowska, Sofia Mendes ; Esteves, Gabriel P. ; Suguita, Priscila ; Fink, Thais ; Lindoso, Livia ; Matsuo, Olivia ; Martins, Fernanda ; Bain, Vera ; Badue Pereira, Maria Fernanda ; Marques, Heloisa Helena ; Malluf, Adriana ; Leal, Gabriela Nunes ; Silva, Clovis Artur ; Roschel, Hamilton ; Gualano, Bruno

• Document type: Journal article
• Source: Journal of Applied Physiology; v. 135, n. 6, p. 7-pg., 2023-12-02.

Abstract

This study aimed to compare cardiopulmonary fitness and endothelial function 6 months after hospital diagnosis in a sample mainly comprising immunocompromised patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection versus noninfected controls. Youth (n = 30; age: 14 yr; 60% females) with confirmed SARS-CoV-2 seen in a tertiary hospital of Sao Paulo, Brazil, were matched by propensity score based on BMI, age, sex, and pre-existing diseases with a control group who had not been tested positive for SARS-CoV-2 infection (n = 30; age: 15 yr; 50% females). Cardiopulmonary fitness (by means of a cardiopulmonary exercise test: CPET) and brachial flow-mediated dilation (%b-FMD) were assessed 3-6 mo after diagnosis. Patients were matched by propensity score based on BMI, age, sex and pre-existing diseases, if any, with a control group who had not been tested positive for SARS-CoV-2. Compared with controls, patients with COVID-19 showed reduced ventilatory anaerobic threshold (VAT) and peak exercise time and minute ventilation/maximum voluntary ventilation (V_E/MVV) (all P < 0.01). Brachial endothelial function variables were all adjusted for body surface area (BSA). Patients with COVID-19 had decreased %b-FMD (3.6 vs. 5.4; P = 0.03) mean and positive flow (P = 0.02 and P = 0.03, respectively) versus controls. Adjusted linear regression models exploring associations between CPET variables, %b-FMD and the potential predictors post-COVID-19 syndrome, number of symptoms, hospitalization, and COVID severity did not detect significant associations, except for total shear rate in hospitalization (coefficient: -65.07 [95%CI -119.5;-10.5], P = 0.02). Immunocompromised and previously healthy children and adolescents with COVID-19 presented with impaired exercise capacity and endothelial dysfunction when compared with their noninfected counterparts, but the mechanisms remain unknown. (AU)

• FAPESP's process: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study
• Grantee: Bruno Gualano
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 21/02742-0 - Effect of exercise training on the quality of life and overall health in children and adolescents after COVID-19 and Multisystem Inflammatory Syndrome in children
• Grantee: Camilla Astley Amaral Pedroso
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 19/15231-4 - Promotion of healthy lifestyle in patients with Systemic Erythematosus Lupus: effects on cardiometabolic risks factors the randomized and controlled clinical trial living well with Lupus
• Grantee: Sofia Mendes Sieczkowska
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 20/07860-9 - The influence of exercise training on bone health in patients taking high doses of glucocorticoids
• Grantee: Gabriel Perri Esteves
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)