Impaired Endothelial Function in Individuals With Post-Acute Sequelae of COVID-19: Effects of Combined Exercise
Tae Gu Choi1, Jae Yeop Kim, Joon Youp Seong
1Author Affiliations: Department of Sport Science, University of Seoul, Seoul, Republic of Korea (Mrs Choi, J.Y. Kim, Seong, Jung and Y.W. Kim, Ms Min, and Drs Cho, H.J. Kim, and Jae); Diabetes Research Centre, Real World Evidence Unit, Leicester General Hospital, University of Leicester, Leicester, UK (Dr Kunutsor); Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Saint Boniface Hospital, Winnipeg, Canada (Dr Kunutsor); Graduate Program of Movement Science and Education, Columbia University, New York, NY, USA (Dr Heffernan); and Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea (Dr Jae).
Insights
Post-acute sequelae of coronavirus disease-2019 (PASC) is linked to impaired endothelial function. Combined exercise training effectively restores vascular function in PASC patients, offering a promising intervention.
Area of Science:
- Cardiovascular Physiology
- Pulmonary Rehabilitation
- Infectious Disease Research
Background:
- Post-acute sequelae of coronavirus disease-2019 (PASC) can manifest with various long-term health issues.
- Endothelial dysfunction is increasingly recognized as a potential contributor to PASC symptoms.
- Understanding the impact of PASC on vascular health is crucial for developing effective treatments.
Purpose of the Study:
- To compare endothelial function in individuals with PASC versus healthy controls.
- To evaluate the efficacy of a combined exercise training program in improving endothelial function in individuals with PASC.
Main Methods:
- A cross-sectional study compared endothelial function (flow-mediated dilation) in PASC patients and healthy individuals.
- An 8-week intervention study assessed the effects of combined aerobic, resistance, and inspiratory muscle training on endothelial function, VO2peak, dyspnea, and fatigue in PASC patients.
- Control groups were used in both study designs for comparison.
Main Results:
- Individuals with PASC demonstrated significantly impaired endothelial function compared to healthy controls.
- The 8-week combined exercise training program significantly improved endothelial function in PASC patients, restoring it to levels comparable to healthy individuals.
- Exercise intervention also led to significant improvements in peak oxygen uptake (VO2peak) and reductions in dyspnea and fatigue.
Conclusions:
- PASC is associated with significant endothelial dysfunction.
- Combined exercise training represents a viable and effective intervention for restoring vascular function in individuals suffering from PASC.
- This multimodal exercise approach holds promise for improving overall cardiovascular health and quality of life in PASC patients.
Purpose:
We investigated the presence of impaired endothelial function in individuals with post-acute sequelae of coronavirus disease-2019 (PASC) compared to healthy individuals and explored the efficacy of combined exercise training in restoring or improving endothelial function in those with PASC.
Methods:
Study I was a cross-sectional study which compared endothelial function between individuals with PASC (n = 29, mean age 22.9 ± 3.9 year) and healthy individuals (n = 42, mean age 21.7 ± 2.0 year). Study II, an intervention design, explored if combined exercise training (n = 14) could reverse the decline in endothelial function associated with PASC compared to controls (n = 14). The combined exercise program included aerobic, resistance, and inspiratory muscle training administered for 8 weeks. We measured endothelial function using flow-mediated dilation of the brachial artery and assessed peak oxygen uptake (VO2peak), dyspnea, and fatigue before and after the intervention.
Results:
Individuals with PASC exhibited significantly lower endothelial function compared to healthy controls (4.95 ± 2.0% vs 8.00 ± 2.4%, P < .001). The exercise group showed a significant increase in endothelial function (4.73 ± 1.5% to 7.98 ± 2.4%) as opposed to the control group (5.31 ± 2.5% to 6.30 ± 2.5%) (interaction effect: P = .008), reaching levels similar to those in healthy individuals. Additionally, the exercise group demonstrated improvement in VO2peak (38.3 ± 6.4 ml/min/kg to 42.8 ± 7.3 ml/min/kg, P < .001) and a reduction in dyspnea and fatigue compared to the control group (P < .001).
Conclusions:
Having PASC is associated with impaired endothelial function, but combined exercise training effectively restores it, making it a promising lifestyle intervention for vascular function in PASC.
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