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Published on: April 19, 2019
Long-term cardiovascular health status and physical functioning of nonhospitalized patients with COVID-19 compared
Koen M van der Sluijs1, Esmée A Bakker1, Tim J Schuijt2
1Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Insights
Long COVID may cause lasting fatigue in non-hospitalized individuals, but objective cardiovascular risks and physical function do not significantly differ from controls six months post-infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Coronavirus disease 2019 (COVID-19) can lead to long-term cardiovascular and physical health issues, even in non-hospitalized individuals.
- The underlying physiological mechanisms for these persistent consequences remain unclear.
Purpose of the Study:
- To compare cardiovascular risk factors, arterial stiffness, and physical functioning in non-hospitalized COVID-19 survivors versus matched controls at approximately 6 months post-infection.
Main Methods:
- Assessed cardiovascular risk via blood pressure and biomarkers (NT-proBNP, hs-cTnI, CRP).
- Measured arterial stiffness using carotid-femoral pulse wave velocity.
- Evaluated physical functioning through accelerometry, handgrip strength, gait speed, and validated questionnaires for fatigue, general health, and health-related quality of life (hrQoL).
Main Results:
- No significant differences were observed in blood pressure, cardiovascular biomarkers, or arterial stiffness between the COVID-19 group and controls.
- Former COVID-19 patients reported fatigue more frequently and exhibited higher handgrip strength but less sleeping time compared to controls.
- Habitual physical activity, gait speed, general health perception, and hrQoL did not differ between the groups.
Conclusions:
- One-third of non-hospitalized COVID-19 survivors experience residual symptoms, primarily fatigue, at 6 months post-infection.
- These residual symptoms could not be attributed to objective increases in cardiovascular risk factors, arterial stiffness, or physical dysfunction.
- Further research is needed to explore the origins and long-term implications of persistent symptoms in non-hospitalized COVID-19 patients.
Abstract:
Coronavirus disease 2019 (COVID-19) is reported to have long-term effects on cardiovascular health and physical functioning, even in the nonhospitalized population. The physiological mechanisms underlying these long-term consequences are however less well described. We compared cardiovascular risk factors, arterial stiffness, and physical functioning in nonhospitalized patients with COVID-19, at a median of 6 mo postinfection, versus age- and sex-matched controls. Cardiovascular risk was assessed using blood pressure and biomarker concentrations (amino-terminal pro-B-type-natriuretic-peptide, high-sensitive cardiac troponin I, C-reactive protein), and arterial stiffness was assessed using carotid-femoral pulse wave velocity. Physical functioning was evaluated using accelerometry, handgrip strength, gait speed and questionnaires on fatigue, perceived general health status, and health-related quality of life (hrQoL). We included 101 former patients with COVID-19 (aged 59 [interquartile range, 55-65] yr, 58% male) and 101 controls. At 175 [126-235] days postinfection, 32% of the COVID-19 group reported residual symptoms, notably fatigue, and 7% required post-COVID-19 care. We found no differences in blood pressure, biomarker concentrations, or arterial stiffness between both groups. Former patients with COVID-19 showed a higher handgrip strength (43 [33-52] vs. 38 [30-48] kg, P = 0.004) and less sleeping time (8.8 [7.7-9.4] vs. 9.8 [8.9-10.3] h/day, P < 0.001) and reported fatigue more often than controls. Accelerometry-based habitual physical activity levels, gait speed, perception of general health status, and hrQoL were not different between groups. In conclusion, one in three nonhospitalized patients with COVID-19 reports residual symptoms at a median of 6 mo postinfection, but we were unable to relate these symptoms to increases in cardiovascular risk factors, arterial stiffness, or physical dysfunction.NEW & NOTEWORTHY We examined cardiovascular and physical functioning outcomes in nonhospitalized patients with COVID-19, at a median of 6 mo postinfection. When compared with matched controls, minor differences in physical functioning were found, but objective measures of cardiovascular risk and arterial stiffness did not differ between groups. However, one in three former patients with COVID-19 reported residual symptoms, notably fatigue. Follow-up studies should investigate the origins of residual symptoms and their long-term consequences in former, nonhospitalized patients with COVID-19.
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