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1.
Cardiovasc Res ; 118(10): 2253-2266, 2022 Jul 27.
Article in English | MEDLINE | ID: covidwho-2032022

ABSTRACT

Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.


Subject(s)
Cardiorespiratory Fitness , Cardiovascular Diseases , Cardiorespiratory Fitness/physiology , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/prevention & control , Exercise/physiology , Humans , Risk Factors
2.
Crit Care Med ; 50(11): 1555-1565, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2018223

ABSTRACT

OBJECTIVES: The aim of the current study was to investigate the level of cardiorespiratory fitness and neuromuscular function of ICU survivors after COVID-19 and to examine whether these outcomes are related to ICU stay/mechanical ventilation duration. DESIGN: Prospective nonrandomized study. SETTING: Patients hospitalized in ICU for COVID-19 infection. PATIENTS: Sixty patients hospitalized in ICU (mean duration: 31.9 ± 18.2 d) were recruited 4-8 weeks post discharge from ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients visited the laboratory on two separate occasions. The first visit was dedicated to quality of life questionnaire, cardiopulmonary exercise testing, whereas measurements of the knee extensors neuromuscular function were performed in the second visit. Maximal oxygen uptake (V o2 max) was 18.3 ± 4.5 mL·min -1 ·kg -1 , representing 49% ± 12% of predicted value, and was significantly correlated with ICU stay/mechanical ventilation (MV) duration ( R = -0.337 to -0.446; p < 0.01 to 0.001), as were maximal voluntary contraction and electrically evoked peak twitch. V o2 max (either predicted or in mL· min -1 ·kg -1 ) was also significantly correlated with key indices of pulmonary function such as predicted forced vital capacity or predicted forced expiratory volume in 1 second ( R = 0.430-0.465; p ≤ 0.001) and neuromuscular function. Both cardiorespiratory fitness and neuromuscular function were correlated with self-reported physical functioning and general health status. CONCLUSIONS: V o2 max was on average only slightly above the 18 mL·min -1 ·kg -1 , that is, the cut-off value known to induce difficulty in performing daily tasks. Overall, although low physical capacities at admission in ICU COVID-19 patients cannot be ruled out to explain the association between V o2 max or neuromuscular function and ICU stay/MV duration, altered cardiorespiratory fitness and neuromuscular function observed in the present study may not be specific to COVID-19 disease but seem applicable to all ICU/MV patients of similar duration.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Aftercare , COVID-19/therapy , Humans , Intensive Care Units , Oxygen , Patient Discharge , Prospective Studies , Quality of Life , Respiration, Artificial
4.
J Appl Physiol (1985) ; 133(3): 622-628, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-1973940

ABSTRACT

Physical activity was reduced during the COVID-19 pandemic, especially when lockdowns were mandated; however, little is known about the impact of these lifestyle changes on objective measures of cardiorespiratory fitness. To address this knowledge gap, we evaluated the cardiorespiratory fitness of 14 young healthy adults (4 women, age: 27 ± 6 yr) just before the pandemic and after ∼1 yr of public health measures being in place. During fitness assessments, participants performed submaximal pseudorandom cycling exercise to assess cardiorespiratory kinetics, and a 25 W·min-1 ramp-incremental cycling test to determine peak oxygen uptake (V̇o2). Cluster analysis identified two subgroups of participants: those who had reduced peak V̇o2 at the 1-yr follow-up (-0.50 ± 0.17 L·min-1) and those whose peak V̇o2 was maintained (0.00 ± 0.10 L·min-1). Participants with reduced peak V̇o2 also exhibited slower heart rate kinetics (interaction: P = 0.01), reduced peak O2 pulse (interaction: P < 0.001), and lower peak work rate (interaction: P < 0.001) after 1 yr of the pandemic, whereas these variables were unchanged in the group of participants who maintained peak V̇o2. Regardless of changes in peak V̇o2, both subgroups of participants gained body mass (main effect: P = 0.002), which was negatively correlated with participants' level of self-reported physical activity level at the follow-up assessment (mass: ρ = -0.59, P = 0.03) These findings suggest that some young healthy individuals lost cardiorespiratory fitness during the pandemic, whereas others gained weight, but both changes could potentially increase the risk of adverse health outcomes and disease later in life if left unaddressed.NEW & NOTEWORTHY Some young healthy adults experienced cardiovascular deconditioning during the COVID-19 pandemic, with measurable reductions in cardiorespiratory fitness, whereas others experienced no change in fitness but gained body mass, which was related to self-reported physical activity during the pandemic.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Adult , Communicable Disease Control , Exercise Test , Female , Humans , Oxygen Consumption/physiology , Pandemics , Physical Fitness/physiology , Young Adult
5.
Braz J Med Biol Res ; 55: e12118, 2022.
Article in English | MEDLINE | ID: covidwho-1951676

ABSTRACT

The goal of the present study was to compare pulmonary function test (PFT) and cardiopulmonary exercise test (CPET) performance in COVID-19 survivors with a control group (CG). This was a cross-sectional study. Patients diagnosed with COVID-19, without severe signs and symptoms, were evaluated one month after the infection. Healthy volunteers matched for sex and age constituted the control group. All volunteers underwent the following assessments: i) clinical evaluation, ii) PTF; and iii) CPET on a cycle ergometer. Metabolic variables were measured by the CareFusion Oxycon Mobile device. In addition, heart rate responses, peak systolic and diastolic blood pressure, and perceived exertion were recorded. Twenty-nine patients with COVID-19 and 18 healthy control subjects were evaluated. Surviving patients of COVID-19 had a mean age of 40 years and had higher body mass index and persistent symptoms compared to the CG (P<0.05), but patients with COVID-19 had more comorbidities, number of medications, and greater impairment of lung function (P<0.05). Regarding CPET, patients surviving COVID-19 had reduced peak workload, oxygen uptake (V̇O2), carbon dioxide output (V̇CO2), circulatory power (CP), and end-tidal pressure for carbon dioxide (PETCO2) (P<0.05). Additionally, survivors had depressed chronotropic and ventilatory responses, low peak oxygen saturation, and greater muscle fatigue (P<0.05) compared to CG. Despite not showing signs and symptoms of severe disease during infection, adult survivors had losses of lung function and cardiorespiratory capacity one month after recovery from COVID-19. In addition, cardiovascular, ventilatory, and lower limb fatigue responses were the main exercise limitations.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Adult , Carbon Dioxide/metabolism , Cross-Sectional Studies , Exercise Test , Exercise Tolerance/physiology , Humans , Middle Aged , Oxygen Consumption/physiology
6.
BMC Geriatr ; 22(1): 529, 2022 06 28.
Article in English | MEDLINE | ID: covidwho-1910273

ABSTRACT

BACKGROUND: Reduced cardiorespiratory fitness (CRF) is an independent risk factor for dependency, cognitive impairment and premature mortality. High-intensity interval training (HIIT) is a proven time-efficient stimulus for improving both CRF and other facets of cardiometabolic health also known to decline with advancing age. However, the efficacy of equipment-free, unsupervised HIIT to improve the physiological resilience of older adults is not known. METHODS: Thirty independent, community-dwelling older adults (71(SD: 5) years) were randomised to 4 weeks (12 sessions) equipment-free, supervised (in the laboratory (L-HIIT)) or unsupervised (at home (H-HIIT)) HIIT, or a no-intervention control (CON). HIIT involved 5, 1-minute intervals of a bodyweight exercise each interspersed with 90-seconds recovery. CRF, exercise tolerance, blood pressure (BP), body composition, muscle architecture, circulating lipids and glucose tolerance were assessed at baseline and after the intervention period. RESULTS: When compared to the control group, both HIIT protocols improved the primary outcome of CRF ((via anaerobic threshold) mean difference, L-HIIT: +2.27, H-HIIT: +2.29, both p < 0.01) in addition to exercise tolerance, systolic BP, total cholesterol, non-HDL cholesterol and m. vastus lateralis pennation angle, to the same extent. There was no improvement in these parameters in CON. There was no change in diastolic BP, glucose tolerance, whole-body composition or HDL cholesterol in any of the groups. CONCLUSIONS: This is the first study to show that short-term, time-efficient, equipment-free, HIIT is able to elicit improvements in the CRF of older adults irrespective of supervision status. Unsupervised HIIT may offer a novel approach to improve the physiological resilience of older adults, combating age-associated physiological decline, the rise of inactivity and the additional challenges currently posed by the COVID-19 pandemic. TRIAL REGISTRATION: This study was registered at clinicaltrials.gov and coded: NCT03473990 .


Subject(s)
COVID-19 , Cardiorespiratory Fitness , High-Intensity Interval Training , Aged , Glucose , High-Intensity Interval Training/methods , Humans , Pandemics
7.
Int J Environ Res Public Health ; 19(7)2022 03 26.
Article in English | MEDLINE | ID: covidwho-1847307

ABSTRACT

COVID-19 pandemic restrictions might have negatively affected the health-related physical fitness of children and adolescents. The aim of this study was to contrast the body composition and physical fitness data of two independent samples of children and adolescents obtained from an online database (DAFIS project) before (n = 15,287) and during (n = 2101) the first academic year of the COVID-19 pandemic. The results revealed higher values for the body mass index (p = 0.002), waist circumference (p < 0.001), and waist to hip and waist to height ratios (p < 0.001) during than before the pandemic, particularly in the case of boys. On the other hand, lower muscular fitness was observed for girls during the pandemic. Quantitative and qualitative analysis did not detect relevant changes in cardiorespiratory fitness in children or adolescents (p > 0.05). Our data suggested that pandemic constraints might have affected body composition and muscular fitness of children and adolescents. These results might be of interest for designing specific interventions oriented toward counteracting the negative effects of pandemic restrictions on health-related physical fitness.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Adolescent , Body Mass Index , COVID-19/epidemiology , Child , Female , Humans , Male , Pandemics , Physical Fitness
8.
Respir Physiol Neurobiol ; 302: 103898, 2022 08.
Article in English | MEDLINE | ID: covidwho-1763959

ABSTRACT

Fatigue is a common, debilitating, and poorly understood symptom post-COVID-19. We sought to better characterize differences in those with and without post-COVID-19 fatigue using cardiopulmonary exercise testing. Despite elevated dyspnoea intensity ratings, V̇O2peak (ml/kg/min) was the only significant difference in the physiological responses to exercise (19.9 ± 7.1 fatigue vs. 24.4 ± 6.7 ml/kg/min non-fatigue, p = 0.04). Consistent with previous findings, we also observed a higher psychological burden in those with fatigue in the context of similar resting cardiopulmonary function. Our findings suggest that lower cardiorespiratory fitness and/or psychological factors may contribute to post-COVID-19 fatigue symptomology. Further research is needed for rehabilitation and symptom management following SARS-CoV-2 infection.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Cardiorespiratory Fitness/physiology , Exercise Test , Fatigue/etiology , Humans , SARS-CoV-2
9.
PM R ; 14(5): 561-568, 2022 05.
Article in English | MEDLINE | ID: covidwho-1718441

ABSTRACT

INTRODUCTION: Cardiorespiratory fitness (CRF), as one of the most potent prognostic factors in medicine, is followed longitudinally to guide clinical management. Coronavirus disease 2019 (COVID-19) pandemic-related changes in lifestyle stand to influence CRF. OBJECTIVE: To assess the influence of the pandemic on perceived CRF in athlete patients and evaluate how perceived CRF change was related to demographics, pre-pandemic measured CRF, and current physical activity (PA). DESIGN: Prospective cohort study, utilizing electronic survey. SETTING: Tertiary care sports cardiology clinical practice. PARTICIPANTS: Adult athlete patients without COVID-19 with pre-pandemic measured CRF using cardiopulmonary exercise testing. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Perceived change in CRF since pandemic onset; association between perceived CRF change and demographics, PA, health status, and pre-pandemic measured CRF assessed via analysis of variance (ANOVA). RESULTS: Among 62 participants (male: 71%, 50.1 ± 12.1 years old), 40% (25/62) reported no change and 32% (20/62) reported an increase in perceived CRF since pandemic onset. Among the 27% (17/62) who reported a decrease in perceived CRF, in most (12/17), this was characterized as only mild. Demographics and pre-pandemic measured CRF did not differ across groups of perceived CRF change. Participants with a moderate or greater decrease in perceived CRF regarded their overall health (via Euro Quality of Life Visual Analogue Scale) as worse than other groups (ANOVA, p = .001). Although total PA was similar across groups, those who had improvement in perceived CRF reported higher levels of moderate intensity PA (ANOVA, p = .008). CONCLUSIONS: The majority of participants perceived that they had maintained or improved CRF over the pandemic. Findings from this study suggest that a reduction in perceived CRF from pre-pandemic values in athletic patients in clinical practice may not result from population-wide pandemic changes in lifestyle. Worse health status and lower levels of moderate intensity PA were associated with perceived reduction in CRF over the pandemic in athlete patients.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Adult , Athletes , COVID-19/epidemiology , Humans , Male , Middle Aged , Pandemics , Physical Fitness , Prospective Studies , Quality of Life
10.
Endocr Metab Immune Disord Drug Targets ; 21(12): 2213-2219, 2021.
Article in English | MEDLINE | ID: covidwho-1714871

ABSTRACT

AIMS: To investigate the influence of body mass index (BMI) on the association between psychological stress and physical fitness. BACKGROUND: Both obesity and psychological stress reduce exercise performance. OBJECTIVE: It is unknown whether obesity may modify the relationship. METHODS: A population of 4,080 military subjects in Taiwan was divided to three groups according to the BMI ≥27.0 kg/m2 (obesity), 24.0-26.9 kg/m2 (overweight) and 18.5-23.9 kg/m2 (normal weight). Normal, slight, and great psychological stress was evaluated by the Brief Symptoms Rating Scale (BSRS-5) score ≤5, 6-9, and ≥10, respectively. Aerobic and anaerobic fitness were respectively evaluated by time for a 3000-meter run and numbers of 2-minute sit-ups and 2-minute push-ups. Analysis of covariance (ANCOVA) with adjustments for age and sex was used to determine the relationship. RESULTS: The mean time (sec) for a 3000-meter run (standard error) under slight and great stress differed from that under normal stress in the normal weight (881.0 (11.0) and 877.9 (5.8) vs. 862.2 (1.7), p=0.089 and 0.0088, respectively) and in the obesity (928.1 (16.8) and 921.8 (10.7) vs. 895.2 (1.6), p=0.054 and 0.016, respectively), while the differences were not significant in the overweight (877.1 (12.7) and 877.5 (7.1) vs. 867.1 (2.1), both p >0.5). The impacts of the BMI on 2-minute sit-ups had a similar pattern with that on a 3000-meter run whereas the impact of the BMI on 2-minute push-ups was insignificant. CONCLUSIONS: Mental stress may not affect physical fitness in overweight military personnel. The mechanism is not clear and should be further investigated.


Subject(s)
Cardiorespiratory Fitness , Military Personnel , Body Mass Index , Hospitalization , Humans , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology
11.
BMJ Open ; 11(11): e048281, 2021 11 18.
Article in English | MEDLINE | ID: covidwho-1526501

ABSTRACT

INTRODUCTION: COVID-19 is associated with a marked systemic inflammatory response with concomitant cardiac injury and remodelling, but it is currently unknown whether the latter is reversible. Given that high-intensity interval training (HIIT) is a powerful stimulus to improve cardiorespiratory fitness while also eliciting marked anti-inflammatory effects, it may be an important countermeasure of reducing cardiopulmonary morbidity following COVID-19. METHODS AND ANALYSIS: 40 COVID-19 survivors who have been discharged from hospital will be included in this investigator-blinded randomised study with a 12-week HIIT intervention. Patients will be 1:1 block-randomised by sex to either a supervised HIIT exercise group or standard care (control group). The main hypothesis is that a 12-week HIIT scheme is a safe way to improve loss of cardiac mass and associated cardiorespiratory fitness, despite hypothesised limited HIIT-induced changes in conventional lung function indices per se. Ultimately, we hypothesise that the HIIT scheme will reduce post-COVID-19 symptoms and improve quality of life. ETHICS AND DISSEMINATION: This study is approved by the Scientific Ethical Committee at the Capital Region of Denmark (H-20033733, including amendments 75068 and 75799) and registered at ClinicalTrials.gov (NCT04647734, pre-results). The findings will be published in a peer-reviewed journal, including cases of positive, negative and inconclusive results.Trial registration number NCT04549337.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , High-Intensity Interval Training , Humans , Quality of Life , Randomized Controlled Trials as Topic , SARS-CoV-2 , Treatment Outcome
12.
Ital J Pediatr ; 47(1): 221, 2021 Nov 06.
Article in English | MEDLINE | ID: covidwho-1505719

ABSTRACT

BACKGROUND: With the gradual resumption of sports activities after the lock-down period for coronavirus pandemic, a new problem is emerging: Allow all athletes to be able to return to compete after SARS-CoV-2 infection in total safety. Several protocols have been proposed for healed athletes but all of them have been formulated for the adult population. The aim of the present study is to evaluate the adequacy of Italian practical recommendations for return-to-paly, in order to exclude cardiorespiratory complications due to COVID-19 in children and adolescents. METHODS: Between April 2020 and January 2021 the Italian Sports Medical Federation formulated cardiorespiratory protocols to be applied to athletes recovered from SARS-CoV-2 infection. The protocols take into account the severity of the infection. Protocols include lung function tests, cardiopulmonary exercise test, echocardiographic evaluation, blood chemistry tests. RESULTS: From September 2020 to February 2021, 45 children and adolescents (aged from 9 to 18 years; male = 26) with previous SARS-CoV-2 infection were evaluated according to the protocols in force for adult. 55.5% of the subjects (N = 25) reported an asymptomatic infection; 44.5% reported a mild symptomatic infection. Results of lung function test have exceeded the limit of 80% of the theoretical value in all patients. The cardiorespiratory capacity of all patients was within normal limits (average value of maximal oxigen uptake 41 ml/kg/min). No arrhythmic events or reduction in the ejection fraction were highlighted. CONCLUSION: The data obtained showed that, in the pediatric population, mild coronavirus infection does not cause cardiorespiratory complications in the short and medium term. Return to play after Coronavirus infection seems to be safe but it will be necessary to continue with the data analysis in order to modulate and optimize the protocols especially in the pediatric field.


Subject(s)
COVID-19/complications , Return to Sport , Adolescent , Age Factors , COVID-19/physiopathology , COVID-19/therapy , Cardiorespiratory Fitness , Child , Clinical Protocols , Female , Humans , Italy , Male , Recovery of Function , Respiratory Function Tests , Time Factors
13.
Int J Environ Res Public Health ; 18(20)2021 10 13.
Article in English | MEDLINE | ID: covidwho-1480722

ABSTRACT

The purpose of this research was to develop the 3 min incremental step-in-place (3MISP) test for predicting maximal oxygen uptake (V.O2max). A total of 205 adults (20-64 years) completed the 3MISP and V.O2max tests. Using age, gender, body composition (BC) including percent body fat (PBF) or body mass index (BMI), and with or without heart rate (HR) at the beginning of exercise (HR0) or difference between HR at the third minute during the exercise and the first minute post exercise (ΔHR3 - HR4) in the 3MISP test, six V.O2max prediction models were derived from multiple linear regression. Age (r = -0.239), gender (r = 0.430), BMI (r = -0.191), PBF (r = -0.706), HR0 (r = -0.516), and ΔHR3 - HR4 (r = 0.563) were significantly correlated to V.O2max. Among the six V.O2max prediction models, the PBF model∆HR3 - HR4 has the highest accuracy. The simplest models with age, gender, and PBF/BMI explained 54.5% of the V.O2max in the PBF modelBC and 39.8% of that in the BMI modelBC. The addition of HR0 and ∆HR3 - HR4 increases the variance of V.O2max explained by the PBF and BMI models∆HR3 - HR4 by 17.98% and 45.23%, respectively, while standard errors of estimate decrease by 10.73% and 15.61%. These data demonstrate that the models established using 3MISP-HR data can enhance the accuracy of V.O2max prediction.


Subject(s)
Cardiorespiratory Fitness , Exercise , Exercise Test , Oxygen , Oxygen Consumption
14.
Int J Behav Nutr Phys Act ; 18(1): 135, 2021 10 19.
Article in English | MEDLINE | ID: covidwho-1477431

ABSTRACT

BACKGROUND: The impact of cardiorespiratory fitness (CRF) and other lifestyle-related factors on severe COVID-19 risk is understudied. The present study aims to investigate lifestyle-related and socioeconomic factors as possible predictors of COVID-19, with special focus on CRF, and to further study whether these factors may attenuate obesity- and hypertension-related risks, as well as mediate associations between socioeconomic factors and severe COVID-19 risk. METHODS: Out of initially 407,131 participants who participated in nationwide occupational health service screening between 1992 and 2020, n = 857 cases (70% men, mean age 49.9 years) of severe COVID-19 were identified. CRF was estimated using a sub-maximum cycle test, and other lifestyle variables were self-reported. Analyses were performed including both unmatched, n = 278,598, and sex-and age-matched, n = 3426, controls. Severe COVID-19 included hospitalization, intensive care or death due to COVID-19. RESULTS: Patients with more severe COVID-19 had significantly lower CRF, higher BMI, a greater presence of comorbidities and were more often daily smokers. In matched analyses, there was a graded decrease in odds for severe COVID-19 with each ml in CRF (OR = 0.98, 95% CI 0.970 to 0.998), and a two-fold increase in odds between the lowest and highest (< 32 vs. ≥ 46 ml·min-1·kg-1) CRF group. Higher BMI (per unit increase, OR = 1.09, 1.06 to 1.12), larger waist circumference (per cm, OR = 1.04, 1.02 to 1.06), daily smoking (OR = 0.60, 0.41 to 0.89) and high overall stress (OR = 1.36, 1.001 to 1.84) also remained significantly associated with severe COVID-19 risk. Obesity- and blood pressure-related risks were attenuated by adjustment for CRF and lifestyle variables. Mediation through CRF, BMI and smoking accounted for 9% to 54% of the associations between low education, low income and blue collar/low skilled occupations and severe COVID-19 risk. The results were consistent using either matched or unmatched controls. CONCLUSIONS: Both lifestyle-related and socioeconomic factors were associated with risk of severe COVID-19. However, higher CRF attenuated the risk associated with obesity and high blood pressure, and mediated the risk associated with various socioeconomic factors. This emphasises the importance of interventions to maintain or increase CRF in the general population to strengthen the resilience to severe COVID-19, especially in high-risk individuals.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Adult , Case-Control Studies , Female , Humans , Life Style , Male , Middle Aged , Risk Factors , SARS-CoV-2
15.
Scand J Med Sci Sports ; 31(12): 2249-2258, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1434834

ABSTRACT

The study aimed to determine the levels of skeletal muscle angiotensin-converting enzyme 2 (ACE2, the SARS-CoV-2 receptor) protein expression in men and women and assess whether ACE2 expression in skeletal muscle is associated with cardiorespiratory fitness and adiposity. The level of ACE2 in vastus lateralis muscle biopsies collected in previous studies from 170 men (age: 19-65 years, weight: 56-137 kg, BMI: 23-44) and 69 women (age: 18-55 years, weight: 41-126 kg, BMI: 22-39) was analyzed in duplicate by western blot. VO2 max was determined by ergospirometry and body composition by DXA. ACE2 protein expression was 1.8-fold higher in women than men (p = 0.001, n = 239). This sex difference disappeared after accounting for the percentage of body fat (fat %), VO2 max per kg of legs lean mass (VO2 max-LLM) and age (p = 0.47). Multiple regression analysis showed that the fat % (ß = 0.47) is the main predictor of the variability in ACE2 protein expression in skeletal muscle, explaining 5.2% of the variance. VO2 max-LLM had also predictive value (ß = 0.09). There was a significant fat % by VO2 max-LLM interaction, such that for subjects with low fat %, VO2 max-LLM was positively associated with ACE2 expression while as fat % increased the slope of the positive association between VO2 max-LLM and ACE2 was reduced. In conclusion, women express higher amounts of ACE2 in their skeletal muscles than men. This sexual dimorphism is mainly explained by sex differences in fat % and cardiorespiratory fitness. The percentage of body fat is the main predictor of the variability in ACE2 protein expression in human skeletal muscle.


Subject(s)
Adiposity , Angiotensin-Converting Enzyme 2/metabolism , COVID-19 , Cardiorespiratory Fitness , Exercise , Muscle, Skeletal/metabolism , Adolescent , Adult , Angiotensin-Converting Enzyme 2/genetics , Biopsy , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Energy Metabolism , Female , Humans , Male , Middle Aged , SARS-CoV-2 , Sex Factors , Young Adult
17.
JAMA Netw Open ; 4(8): e2121675, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1372682

ABSTRACT

Importance: Previous studies have shown reductions in self-reported physical activity levels in children associated with implementation of COVID-19 mitigation measures, and data on objectively assessed health parameters are limited. Objective: To examine the association of COVID-19 mitigation measures with changes in cardiorespiratory fitness (CRF) measures and body mass index (BMI) among primary schoolchildren. Design, Setting, and Participants: This cohort study included children aged 7 to 10 years from 12 randomly selected primary schools in urban and rural districts of Klagenfurt, Austria. Baseline CRF and BMI measurements were obtained in September 2019 before COVID-19 mitigation measures were implemented, and follow-up measurements were obtained in June and September 2020. Exposures: COVID-19 mitigation measures. Main Outcomes and Measures: Cardiorespiratory fitness was measured with a 6-minute endurance run test. Height and weight were objectively measured. Standard deviation scores were calculated for CRF and BMI. Changes over time were analyzed using analyses of variance. Secondary analyses were performed for subgroups stratified by sex. Results: A total of 764 children (383 girls [50.1%]) aged 7 to 10 years had all measurements completed. From September 2019 to September 2020, CRF SD scores changed by -1.06 (95% CI, -1.13 to -1.00), with a similar decrease in both boys and girls. Body mass index SD scores had increased by 0.12 (95% CI, 0.06-0.16) in June 2020 and by 0.16 (95% CI, 0.12-0.20) in September 2020 compared with September 2019. The increase in BMI SD scores (from September 2019 to September 2020) was greater among boys (0.23; 95% CI, 0.18-0.29) than among girls (0.09; 95% CI, 0.04-0.15). During the 1-year period, the percentage of children with overweight or obesity increased from 20.3% (155 children) to 24.1% (184 children) (difference, 3.8% [29 children]). Conclusions and Relevance: In this cohort study of children in Austria, COVID-19 mitigation measures were associated with decreases in CRF measures and increases in BMI. The findings suggest that collaborative efforts are needed to reverse these changes in children's health to prevent long-term negative health outcomes.


Subject(s)
Body Mass Index , COVID-19 , Cardiorespiratory Fitness , Exercise , Obesity/etiology , Pandemics , Physical Distancing , Austria , COVID-19/prevention & control , Child , Child Health , Cohort Studies , Female , Humans , Male , Overweight , SARS-CoV-2 , Schools , Sports
18.
BMJ Support Palliat Care ; 12(1): 33-37, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1356955

ABSTRACT

BACKGROUND: A strategy for maintaining and/or improving cardiorespiratory fitness (CRF) in the growing population of cancer survivors is of major clinical importance, especially in the COVID-19 era. The effect of unsupervised high-intensity interval training (HIIT) on increasing CRF in breast cancer survivors is unknown. PURPOSE: The purpose of this study was to determine whether the newly developed habit-B programme, which involves home-based smartphone-supported HIIT using body weight exercises, improves CRF in early-stage breast cancer survivors. METHODS: This single-centre, 12-week, parallel-group, single-blind, randomised controlled trial involved 50 women with stage I-IIa breast cancer, aged 20-59 years, who had completed initial treatment except for hormone therapy. Participants were randomised to either the exercise or control group. The primary outcome was the 12-week change in peak oxygen uptake [Formula: see text]. Other outcomes included muscle strength, 6 min walk test, resting heart rate, physical activity, fatigue, safety and quality of life. RESULTS: The change in [Formula: see text] and leg strength increased significantly in the exercise group compared with the control group (p<0.01). Changes in other outcomes were not significantly different between the groups. CONCLUSION: A home-based HIIT intervention can lead to improve CRF and muscle strength in early-stage breast cancer survivors.


Subject(s)
Breast Neoplasms , COVID-19 , Cancer Survivors , Cardiorespiratory Fitness , High-Intensity Interval Training , Adult , Breast Neoplasms/drug therapy , Female , Humans , Middle Aged , Quality of Life , SARS-CoV-2 , Single-Blind Method , Smartphone , Young Adult
19.
Aging Ment Health ; 26(8): 1678-1685, 2022 08.
Article in English | MEDLINE | ID: covidwho-1294607

ABSTRACT

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Hypertension , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Hypertension/epidemiology , Mental Health , Pandemics , Quality of Life
20.
BMJ Open Respir Res ; 8(1)2021 05.
Article in English | MEDLINE | ID: covidwho-1247381

ABSTRACT

INTRODUCTION: Participating in singing is considered to have a range of social and psychological benefits. However, the physiological demands of singing and its intensity as a physical activity are not well understood. METHODS: We compared cardiorespiratory parameters while completing components of Singing for Lung Health sessions, with treadmill walking at differing speeds (2, 4 and 6 km/hour). RESULTS: Eight healthy adults were included, none of whom reported regular participation in formal singing activities. Singing induced acute physiological responses that were consistent with moderate intensity activity (metabolic equivalents: median 4.12, IQR 2.72-4.78), with oxygen consumption, heart rate and volume per breath above those seen walking at 4 km/hour. Minute ventilation was higher during singing (median 22.42 L/min, IQR 16.83-30.54) than at rest (11 L/min, 9-13), lower than 6 km/hour walking (30.35 L/min, 26.94-41.11), but not statistically different from 2 km/hour (18.77 L/min, 16.89-21.35) or 4 km/hour (23.27 L/min, 20.09-26.37) walking. CONCLUSIONS: Our findings suggest the acute metabolic demands of singing are comparable with walking at a moderately brisk pace, hence, physical effects may contribute to the health and well-being benefits attributed to singing participation. However, if physical training benefits result remains uncertain. Further research including different singing styles, singers and physical performance impacts when used as a training modality is encouraged. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registry (NCT04121351).


Subject(s)
Cardiorespiratory Fitness/physiology , Heart Rate/physiology , Lung/physiology , Oxygen Consumption/physiology , Singing/physiology , Walking/physiology , Adult , Exercise Test , Female , Healthy Volunteers , Humans , Male , Metabolic Flux Analysis/methods , Music , Physical Exertion/physiology , Respiratory Function Tests/methods , Warm-Up Exercise
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