ABSTRACT
To observe the effects of COVID-19 infection on ANS function over a follow-up period in young adults. Observational prospective case-control study. Subjects were evaluated at baseline and in a follow-up visit six weeks following the first shot of SARS-CoV-2 immunization. Private Physical Therapy ambulatory. Male and female subjects aged 20-40 years with, a diagnosis of mild or moderate clinical COVID-19 with a positive PCR test and slight clinical symptoms, and who were not admitted to intensive care unit. Participants were recruited after a minimum of 15 and a maximum of 120 days of diagnosis (PCOV). An age-matched heathy control group (CG) that was negative for COVID-19 was also recruited. Autonomic nervous system function was measured through heart rate variability (HRV). Heart rate was recorded beat-to-beat to evaluate cardiac autonomic modulation. We used a cardio-frequency meter (Polar RS800CX). Participants were equipped with a chest strap and monitor and remained at rest for 25 minutes. Sympathetic and Parasympathetic indexes through HRV. 57 subjects were evaluated at baseline. After 19 exclusions, 38 subjects with complete data were included in the baseline analysis where 18 subjects were in CT and 20 in the PCOV group. Regarding sympathetic nervous system activity, there was no difference between baseline and follow-up moments within CT or PCOV groups (p>0.05). For intergroup analysis, we observed that PCOV group presents significant higher reductions in sympathetic activity over time when compared to CT demonstrated by HR (p=0.0088) and SNS index (p=0.0068). Observations of parasympathetic nervous system activity reveals a statistical increase between baseline and follow up in Mean RR (p=0.0312) and pNN50 (p=0.0312) for PCOV group. The intergroup analysis revealed that PCOV group presented a significant higher increase in parasympathetic activity overtime demonstrated by mean RR (-44.54±32.38 vs. 60.36±55.35;p= 0.0097) and PNS index (-0.32±0.20 vs. 0.54 ± 0.35;p= 0.0091) when compared to CT. Sympathetic activity decreased in PCOV after infection and over the follow up period. Authors declare no conflicts.
ABSTRACT
To observe the effects of COVID-19 infection on ANS function over a follow-up period in young adults. Observational prospective case-control study. Subjects were evaluated at baseline and in a follow-up visit six weeks following the first shot of SARS-CoV-2 immunization. Private Physical Therapy ambulatory. Male and female subjects aged 20-40 years with, a diagnosis of mild or moderate clinical COVID-19 with a positive PCR test and slight clinical symptoms, and who were not admitted to intensive care unit. Participants were recruited after a minimum of 15 and a maximum of 120 days of diagnosis (PCOV). An age-matched heathy control group (CG) that was negative for COVID-19 was also recruited. Autonomic nervous system function was measured through heart rate variability (HRV). Heart rate was recorded beat-to-beat to evaluate cardiac autonomic modulation. We used a cardio-frequency meter (Polar RS800CX). Participants were equipped with a chest strap and monitor and remained at rest for 25 minutes. Sympathetic and Parasympathetic indexes through HRV. 57 subjects were evaluated at baseline. After 19 exclusions, 38 subjects with complete data were included in the baseline analysis where 18 subjects were in CT and 20 in the PCOV group. Regarding sympathetic nervous system activity, there was no difference between baseline and follow-up moments within CT or PCOV groups (p>0.05). For intergroup analysis, we observed that PCOV group presents significant higher reductions in sympathetic activity over time when compared to CT demonstrated by HR (p=0.0088) and SNS index (p=0.0068). Observations of parasympathetic nervous system activity reveals a statistical increase between baseline and follow up in Mean RR (p=0.0312) and pNN50 (p=0.0312) for PCOV group. The intergroup analysis revealed that PCOV group presented a significant higher increase in parasympathetic activity overtime demonstrated by mean RR (-44.54±32.38 vs. 60.36±55.35;p= 0.0097) and PNS index (-0.32±0.20 vs. 0.54 ± 0.35;p= 0.0091) when compared to CT. Sympathetic activity decreased in PCOV after infection and over the follow up period. Authors declare no conflicts.
ABSTRACT
Coronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = -24.67--3.26; SNS index: p = 0.0068, CI = -2.50--0.32) and increase in parasympathetic (PNS) activity (mean RR: p = 0.0097, CI = 33.72-225.51; PNS index: p = 0.0091, CI = -0.20-1.47) were observed. At follow-up, HRV was not different between groups (p > 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.
Subject(s)
COVID-19 , Humans , Young Adult , Recovery of Function , Case-Control Studies , Follow-Up Studies , SARS-CoV-2 , Autonomic Nervous System , Exercise/physiology , Immunization , Heart Rate/physiologyABSTRACT
Research Objectives To prospectively analyze functional capacity of young adults in relation to after COVID-19 infection and follow up these individuals after COVID-19 immunization. Design Observational prospective cohort study (partial results from FIT-COVID Study). After a minimum of 6 weeks from the second shot of COVID-19 vaccine participants were once again recruited to follow up evaluations. Setting Evaluations were performed at a public Physical Therapy outpatient clinic in Brazil. Participants We included male and female participants, aged 20–40 years after mild or moderate clinical COVID-19 with a previous positive PCR test that were not admitted to intensive care unit (COV). Participants were recruited after a minimum of 15 and maximum of 180 days of diagnosis by positive PCR test. An age-matched healthy control group (CT) that was negative for COVID-19 was also recruited. Interventions At baseline and follow up evaluation, functional capacity was assessed using the six-minute walk test (6MWT) and the 30-second stand from chair test (SC). Next, habitual physical activity (HPA) levels were assessed using accelerometry data. Finally, body composition (BC) was assessed using bioelectric impedance. Main Outcome Measures Meters walked during 6MWT, repetitions during SC. Secondarily, sedentary time in minutes, and body composition (lean mass in kilograms). Results Evaluations included Control Group (n=39) and Post-COVID-19 group (n=32). At baseline Post-COVID-19 group presented 626.69±100.68 meters and during the follow-up analysis (626.69±100.685 meters) with no significant difference between moments (p=0.698). No significant differences were observed between groups for 6MWT (p=0.698). In SC, there were no differences between moments (p=0.333) or groups (p=0.26). In the Post-COVID-19 group there was a significant reduction in sedentary time over the follow-up period (4070.36±1524.614 vs 3298.82±786.085;p=0.044). However, no differences were observed between groups (p=0.928). Finally, no differences were observed in body composition between groups or moments (p>0.05). Conclusions Functional capacity in young adults was not affected Post-COVID-19 infection and no changes were observed following immunization. Similar results, were observed for physical activity levels and body composition. Author(s) Disclosures None of the authors have any conflicts of interests.
ABSTRACT
Research Objectives To prospectively analyze respiratory function outcomes of young adults post-COVID-19 infection and follow up these individuals after COVID-19 immunization. Design Observational prospective cohort study (partial results from FIT-COVID Study). Participants were recruited after a minimum of 15 and maximum of 180 days of diagnosis by positive PCR test. After a minimum of 6 weeks from the second shot of COVID-19 vaccine participants were once again recruited to evaluations. The Ethical Institutional Review Board approved the study (number: 38701820.0.0000.5402). Setting a Physical Therapy public outpatient clinic in Brazil. Participants We included male and female participants, aged 20–40 years after mild or moderate clinical COVID-19 and infection including slight clinical symptoms, fever, or respiratory symptoms, with previous positive PCR test and that were not admitted to intensive care unit (n=31). An age-matched healthy control group that was negative for COVID-19 was also recruited (n=39). Interventions Dyspnea was measured by the Modified Medical Research Council (MRC). Saccharin transit time test (STT) was performed to evaluate mucociliary transportability. Spirometry was performed using a digital spirometer. Main Outcome Measures Primary outcomes included pulmonary function evaluated by Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC) FEV1/FVC ratio. Secondary outcomes included STT (in minutes) and MRC score. Results Post-COVID19 group increased FEV1% between baseline and follow up (77.37%±17.6 vs 87.44%±10.28;p=0.003) and presented significant lower values than CG (86.47%±11.433 vs 87.68%±9.29). For STT no differences were observed between groups (p=0.257). Dyspnea scores decreased for Post-COVID19 group between baseline and follow up (0.44±0.61 vs 0.17±0.38;p=0.042) but no differences between groups were observed (p=0.57). Conclusions Pulmonary function was reduced in young adults Post-COVID-19 but improved over follow up analysis. Mucolciliary clearance and dyspnea was not impaired in young adults Post-COVID-19 and did not suffered changes after immunization. Author(s) Disclosures None of the authors have any conflicts of interests.
ABSTRACT
The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with SARS-CoV-2 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with SARS-CoV-2 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken, and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in the post-COVID-19 group was increased (stress index; p = 0.0273). They also presented lower values of parasympathetic activity (p < 0.05). Overweight/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p < 0.05). Physically inactive subjects in the post-COVID-19 group presented significantly higher sympathetic activity than active subjects in the control group. Parasympathetic activity was significantly increased in physically active subjects in the control group compared to the physically inactive post-COVID-19 group (p < 0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by overweight/obesity and physical activity levels.
Subject(s)
COVID-19 , Autonomic Nervous System/physiology , COVID-19/epidemiology , Cross-Sectional Studies , Exercise/physiology , Heart Rate/physiology , Humans , SARS-CoV-2 , Young AdultABSTRACT
Background: This proposal aims to explain some of the gaps in scientific knowledge on the natural history of coronavirus disease (COVID-19), with a specific focus on immune, inflammatory, and metabolic markers, in parallel with temporal assessment of clinical and mental health in patients with COVID-19. The study will explore the temporal modulatory effects of physical activity and body composition on individual trajectories. This approach will provide a better understanding of the survival mechanisms provided by the immunomodulatory role of physical fitness. Methods: We will conduct a prospective observational cohort study including adult patients previously infected with the SARS-CoV-2 virus who have expressed a mild to moderate COVID-19 infection. Procedures will be conducted for all participants at baseline, six weeks after vaccination, and again at 12 months. At each visit, a venous blood sample will be collected for immune phenotypic characterization and biochemistry assays (inflammatory and metabolic parameters). Also, body composition, physical activity level, cardiovascular and pulmonary function, peripheral and respiratory muscle strength, functional exercise capacity, and mental health will be evaluated. Using the baseline information, participants will be grouped based on physical activity levels (sedentary versus active), body composition (normal weight versus overweight or obese), and SARS-CoV-2 status (positive versus negative). A sub-study will provide mechanistic evidence using an in-vitro assay based on well-trained individuals and age-matched sedentary controls who are negative for SARS-CoV-2 infection. Whole blood will be stimulated using recombinant human coronavirus to determine the cytokine profile. Peripheral blood mononuclear cells (PBMCs) from healthy well-trained participants will be collected and treated with homologous serum (from the main study; samples collected before and after the vaccine) and recombinant coronavirus (inactive virus). The metabolism of PBMCs will be analyzed using Respirometry (Seahorse). Data will be analyzed using multilevel repeated-measures ANOVA. Conclusions: The data generated will help us answer three main questions: (1) Does the innate immune system of physically active individuals respond better to viral infections compared with that of sedentary people? (2) which functional and metabolic mechanisms explain the differences in responses in participants with different physical fitness levels? and (3) do these mechanisms have long-term positive modulatory effects on mental and cardiovascular health? Trial registration number: Brazilian Registry of Clinical Trials: RBR-5dqvkv3. Registered on 21 September 2021.