- The post-acute COVID syndrome is defined by symptoms that last longer than 3–4 weeks following exposure to SARS-CoV-2.
- Women hospitalized with COVID-19 are more likely than males to have chronic cardiovascular and pulmonary dysfunction months after discharge.
- In the post-acute phase of SARS-CoV-2 infection, women with mild-to-moderate COVID-19 infection may have slower resting heart rates following physical exercise.
- Deficiencies in cardiovascular function during exercise are linked to lower capacity for exercise and possibly everyday activities.
- Women with long-lasting COVID symptoms, such as shortness of breath or joint or muscle pains, had difficulty walking compared to those who had only a SARS-CoV-2 infection with no symptoms.
Although the majority of people recover within 3–4 weeks of getting COVID-19, a significant percentage of people continue to have symptoms for weeks or months after the first or acute phase of the disease has passed.
Shortness of breath, loss of smell and taste, brain fog, headaches, and exhaustion are among the symptoms that people refer to as long COVID or post-acute COVID-19.
More than half of those hospitalized with COVID-19 at the early stages of the SARS-CoV-2 infection have chronic deficits in cardiovascular and pulmonary function months after release, according to studies. Furthermore, women with severe COVID-19 are more likely than males to have such long-term cardiovascular and pulmonary function abnormalities following discharge.
Regardless of the intensity of symptoms during the acute phase of COVID-19, individuals may experience chronic symptoms throughout the post-acute phase of the illness. The consequences of mild-to-moderate COVID-19 on pulmonary and cardiovascular function, as well as everyday physical functioning, throughout the post-acute period are unknown.
The effect of mild-to-moderate COVID-19 on exercise ability or tolerance in women during the post-acute phase was recently investigated by researchers at Indiana University Bloomington. The ability of an individual’s cardiovascular system to withstand physical activity is referred to as exercise tolerance or capacity.
The 6-minute walk test was performed by the researchers to investigate the long-term effects of SARS-CoV-2 infection on cardiovascular function in women during the post-acute phase of the virus.
The researchers discovered that women with COVID-19 who had mild-to-moderate sickness during the acute phase had a slower heart rate fall following the 6-minute walk test than the control group. This difference was more obvious among women who had been suffering with COVID symptoms for a long time.
However, they observed no statistically significant variations in pre- and post-test oxygen saturations, pre- and post-test heart rate, ratings of felt effort, and ratings of experienced breathlessness.
“A confusing aspect of post-acute COVID-19 syndrome is the varying presentation of symptoms that appear to be independent of initial sickness severity,” research lead author Dr. Stephen Carter, an Indiana University professor, told Medical News Today. Even individuals with mild-to-moderate initial symptoms can be influenced by underlying cardiac-related abnormalities, which can affect exercise tolerance and/or activities of daily life, according to the current research.”
“It’s also possible that persistent symptoms, such as muscle/joint discomfort and/or shortness of breath, might set off a maladaptive cycle that increases systemic deconditioning.” More research, however, is required.”
MNT also met with Dr. Ziyad Al-Aly, the chief of research and education service at the Veterans Affairs St. Louis Health Care System. “Studies like these are important to help us understand why certain people with lengthy COVID have significant exertional tiredness that may impair their capacity to exercise and carry out activities of daily living,” said Dr. Al-Aly.
The findings have been published in the journal Experimental Physiology.
Exercise tolerance
The research comprised 29 women who had suffered from mild to moderate COVID-19-related sickness. These women had been diagnosed with SARS-CoV-2 at least 4 weeks before to the trial, with an average of 94 days between diagnosis and study. A total of 16 women in the control group had never tested positive for SARS-CoV-2 infection.
At the time of the trial, 17 of the 29 women in the test group reported suffering at least one long COVID symptom. Shortness of breath, exhaustion, cough, muscle or joint discomfort, loss of smell or taste, and skin irritation were among the long COVID symptoms.
To investigate various aspects of lung function, the researchers used pulmonary function tests. They discovered that women who tested positive for SARS-CoV-2 had lower total lung capacity than women in the control group.
After that, the researchers looked at how cardiovascular function changed during and after the 6-minute walk test. Researchers use the test to assess exercise tolerance by measuring how far individuals walk in 6 minutes at their typical speed. To avoid these variables impacting the test findings, the researchers corrected the data for age, sex, and body mass index (BMI).
The distances reached by the two groups throughout the test were not significantly different.
Women with SARS-CoV-2 who had shortness of breath, joint or muscle discomfort, or both had a lower adjusted distance value than women with SARS-CoV-2 who didn’t have these lengthy COVID symptoms.
Heart rate response
Before and after the 6-minute walk test, the researchers measured blood pressure, heart rate, and blood oxygen or oxygen saturation levels. The heart rate response during exercise was measured by subtracting the resting heart rate from the heart rate at the end of the test.
A lower heart rate response during exercise is a predictor of reduced exercise capacity and cardiovascular disease-related mortality, while a higher heart rate response is a prediction of reduced exercise capacity and cardiovascular disease-related mortality.
The SARS-CoV-2 women had a lower heart rate response than the control women.
Furthermore, individuals in the SARS-CoV-2 group who had shortness of breath as a long COVID symptom at the time of the research had a lower heart rate response during the test than those in the SARS-CoV-2 group who didn’t.
Heart rate recovery
Heart rate recovery was also evaluated, which is another indicator of cardiovascular health and all-cause mortality.
Following severe activity, the heart rate tends to decline quickly. The time it takes for your heart rate to return to normal after you stop exercising is called heart rate recovery. Heart rate recovery, in particular, measures the reduction in heart rate after a certain time interval — usually 1 minute — has passed after the conclusion of the physical activity.
During the 5-minute recovery phase following the 6-minute walk test, the researchers assessed the participants’ heart rates at the end of each minute.
Participants in the SARS-CoV-2 group had a less significant reduction in heart rate at 1 minute following the test than those in the control group. This shows that the ladies in the SARS-CoV-2 group experienced a slower decrease in heart rate. Reduced exercise ability is linked to a delay in heart rate recovery.
In addition, women in the SARS-CoV-2 group who had particular long COVID symptoms at the time of the research had a slower heart rate recovery than those in the SARS-CoV-2 group who did not have these symptoms.
Women experiencing SARS-CoV-2 symptoms such as weariness, loss of taste or smell, joint and muscular pains, or shortness of breath experienced a slower heart rate recovery than women who had not been exposed to the virus.
“A large number of long-term COVID-19 patients are sent to rehabilitation programs for non-COVID-19 patients. These programs may not be appropriate for COVID patients who have been sick for a long time. It’s important to recognize that people with long COVID require special programs (pacing, etc.). Dr. Al-Aly stated, “Findings from this and other studies should be taken into account when planning rehabilitation programs for people with lengthy COVID.”
Study strengths and limitations
“SARS-CoV-2 individuals and [people who did not have the illness] were matched for age, BMI, smoking status, and history of cardiopulmonary disease,” Dr. Carter explained. As a result, we can be more confident that the detected differences are due to SARS-CoV-2 rather than another comorbidity.”
“A strength of the study is that comparisons were made during and after a 6-minute walk test among women who appear to be prone to chronic SARS-CoV-2-related symptoms.”
Dr. Carter acknowledged that the study had a few limitations. It’s also possible that some of the controls had an asymptomatic SARS-CoV-2 infection and/or a prior false-negative SARS-CoV-2 diagnostic test.” he said.
