A study conducted at the Universidade Estadual Paulista (Unesp) indicates that even a mild to moderate infection with SARS-CoV-2 can cause an imbalance in the cardiovascular system of young adults without pre-existing diseases. Research has also concluded that obesity and low levels of physical activity are key post-COVID-19 factors that help alter the autonomic nervous system, which is responsible for vital body functions, such as blood pressure, heart rate and respiratory rate. .
The work, which included the Support from FAPESP (Fundação de Amparo in Pesquisa do Estado de São Paulo), followed individuals between 20 and 40 years of age before being vaccinated.
“These results give us elements to encourage people, even with mild symptoms of COVID, to seek further diagnosis after contamination. The baggage triggered by the virus can have consequences and the patient does not know it”, assesses the project coordinator, professor Fabio Santos de Lira, from the Department of Physical Education, Faculty of Science and Technology, Unesp, Presidente Prudente campus. He is one of the authors of article published on International Journal of Environmental Research and Public Healthat special edition Impact of lifestyle interventions on immune response, inflammation and vascular health.
The research is part of a larger project, the FIT-COVIDwhich aims to investigate the gaps in scientific knowledge of the disease with a particular focus on immunological, inflammatory and metabolic markers, exploring the temporal modulating effects of physical activity and body composition.
For the study, the researchers recruited patients infected with SARS-CoV-2 in Presidente Prudente, a municipality in the interior of São Paulo of about 231,000 inhabitants and which, at the end of February, had registered 39,049 confirmed cases. of COVID-19. and 982 deaths.
Subjects had a diagnosis confirmed by RT-PCR test and infection with mild to moderate symptoms. A healthy control group was age-matched. A total of 57 people were assessed, but after exclusions, 38 made it into the final result.
Body mass index (BMI, a parameter used to assess overweight and obesity and which corresponds to the ratio between weight and height squared) and physical activity levels (using a triaxial accelerometer ) were measured, in addition to assessment of the autonomic nervous system. by heart rate variability.
The key finding was that even in mild and moderate infections, young adults infected with SARS-CoV-2 exhibited: greater sympathetic activity (a system that adjusts the body to resist situations of danger, intense exertion and stress); less parasympathetic activity (responsible for calming the body after a stressful situation); and overall variability compared to uninfected individuals. That is, in the post-COVID group, there was an increase in heart rate and less body activity to “stop” that rate.
When comparing overweight and obese and/or physically inactive individuals, cardiac autonomic modulation showed worse indices. Thus, the results provide new knowledge on the role of BMI and physical activity in the dysregulation of post-COVID-19 infection that may contribute to the understanding of pathophysiology and the treatment of later acute symptoms.
“We did not expect such an impaired cardiovascular system because they are young and without other diseases. Our work shows that people infected with COVID, even without severe symptoms, can show significant functional changes. For example, this variation in the heart rhythm can, in the future, become an arrhythmia”, explains the post-doctoral fellow at Unesp. Lucielle Guerra Minuzzione of the researchers who participated in the article with the first author, Ana Paula Coelho Figueira Freirefrom the Universidade do Oeste Paulista (Unoeste), and with Bruna Spolador de Alencar Silva, also a postdoctoral fellow at Unesp and one of the project coordinators.
The reflection of these variations was recorded in the patients’ daily activities, such as the ability to exercise, climb stairs and even walk. They reported tiredness and fatigue. To detect the problem, you can perform a simple test called a six-minute walk test.
According to Minuzzi, the group had previously shown metabolic dysregulations — such as a higher concentration of blood lipids and altered blood sugar — in patients with SARS-CoV-2 who had more severe conditions and who were hospitalized.
Other study published last August by scientists at Appalachian State University in North Carolina (USA), highlighted that young adults recovering from COVID-19 exhibit autonomic dysregulation. However, the work used an invasive method, while the Brazilian research adopted a simpler, cheaper and non-invasive form of assessment.
At the time, the conclusion was that there was a prolonged physiological impact of SARS-CoV-2 infection, lasting two to three months, on resting heart rate, which may reflect autonomic dysfunction. The findings were attributed to the heightened state of inflammation generated during COVID-19 infection and the direct infusion of inflammatory cytokines.
According to Lira, the researchers are currently evaluating other results obtained in the analyses, which should be published soon. The project is multicentric and has the participation of scientists from the University of Coimbra and the Polytechnic Institute of Coimbra (both from Portugal).
Moreover, the same patients continue to be followed after having been vaccinated. There has already been an evaluation six weeks after the vaccine and the next one will be at the 18th month post-vaccination.
The article Role of body mass and physical activity in modulating autonomic function on post-COVID-19 status: an observational sub-analysis of the Fit-COVID study can be read at: www.mdpi.com/1660-4601/19/4/2457/htm.
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