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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Cardiovascular implications and physical activity in middle-aged and older adults with a history of COVID-19 (CV
Mushidur Rahman1,2, Sophie L Russell1,2, Nduka C Okwose1,2
1Research Centre for Health and Life Sciences, Institute for Health and Wellbeing, Faculty of Health and Life Sciences, Coventry University, Alison Gingell Building, 20 White Friars Street, Coventry, CV1 2DS, UK.
Insights
This study investigates the cardiovascular effects of COVID-19 in adults, finding that a home-based physical activity intervention can improve cardiac function. It highlights the importance of exercise for recovery after COVID-19 infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Exercise Physiology
Background:
- COVID-19 infection can impact cardiovascular system structure and function.
- The long-term cardiovascular consequences of COVID-19 are not fully understood.
- Research is needed to define COVID-19's effects on cardiovascular health.
Purpose of the Study:
- To assess the impact of COVID-19 on arterial stiffness and cardiac function in healthy adults.
- To evaluate the effectiveness of a home-based physical activity intervention on cardiovascular function in individuals with a history of COVID-19.
Main Methods:
- 120 vaccinated adults (80 with COVID-19 history, 40 controls) aged 50-85 years.
- Comprehensive baseline assessments including ECG, echocardiography, exercise testing, and biomarker analysis.
- Randomized controlled trial of a 12-week home-based physical activity intervention for COVID-19 survivors.
Main Results:
- Primary outcome: change in left ventricular global longitudinal strain.
- Secondary outcomes: arterial stiffness, cardiac systolic/diastolic function, functional capacity, lung function, sleep, and quality of life.
- Biomarker analysis including cardiac troponin T, NT-proBNP, and inflammatory markers.
Conclusions:
- The study will elucidate the cardiovascular sequelae of COVID-19.
- Findings will demonstrate the potential for physical activity interventions to improve cardiovascular outcomes post-COVID-19.
Background:
The clinical manifestation of COVID-19 is associated with infection and inflammation of the lungs, but there is evidence to suggest that COVID-19 may also affect the structure and function of the cardiovascular system. At present, it is not fully understood to what extent COVID-19 impacts cardiovascular function in the short- and long-term following infection. The aim of the present study is twofold: (i) to define the effect of COVID-19 on cardiovascular function (i.e. arterial stiffness, cardiac systolic and diastolic function) in otherwise healthy individuals and (ii) to evaluate the effect of a home-based physical activity intervention on cardiovascular function in people with a history of COVID-19.
Methods:
This prospective, single-centre, observational study will recruit 120 COVID-19-vaccinated adult participants aged between 50 and 85 years, i.e. 80 with a history of COVID-19 and 40 healthy controls without a history of COVID-19. All participants will undergo baseline assessments including 12-lead electrocardiography, heart rate variability, arterial stiffness, rest and stress echocardiography with speckle tracking imaging, spirometry, maximal cardiopulmonary exercise testing, 7-day physical activity and sleep measures and quality of life questionnaires. Blood samples will be collected to assess the microRNA expression profiles, cardiac and inflammatory biomarkers, i.e. cardiac troponin T; N-terminal pro B-type natriuretic peptide; tumour necrosis factor alpha; interleukins 1, 6 and 10; C-reactive protein; D-dimer; and vascular endothelial growth factors. Following baseline assessments, COVID-19 participants will be randomised 1:1 into a 12-week home-based physical activity intervention aiming to increase their daily number of steps by 2000 from baseline. The primary outcome is change in left ventricular global longitudinal strain. Secondary outcomes are arterial stiffness, systolic and diastolic function of the heart, functional capacity, lung function, sleep measures, quality of life and well-being (depression, anxiety, stress and sleep efficiency).
Discussion:
The study will provide insights into the cardiovascular implications of COVID-19 and their malleability with a home-based physical activity intervention.
Trial Registration:
ClinicalTrials.gov NCT05492552. Registered on 7 April 2022.
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