Impaired Cardiorespiratory Fitness and Endothelial Function After SARS-CoV-2 Infection in a Sample of Mainly Immunocompromised Youth.

Astley C; Children and Adolescent Institute: University of Sao Paulo, Sao Paulo, Brazil.
Prado DMLD; Sieczkowska SM; Esteves GP; Suguita P; Fink T; Lindoso L; Matsuo O; Martins F; Bain V; Badue MF; Marques HH; Malluf A; Leal G; Silva CA; Roschel H; Gualano B;

Journal of applied physiology (Bethesda, Md. : 1985) [J Appl Physiol (1985)] 2023 Nov 02.
Date of Electronic Publication: 2023 Nov 02.

Purpose: This study aimed to describe cardiopulmonary fitness and endothelial function 6 months after hospital diagnosis in a sample mainly comprising immunocompromised patients with confirmed SARS-Cov-2 infection vs. controls.
Methods: Youth (n=30; 14; 60% females) with confirmed SARS-CoV-2 seen in a tertiary hospital of Sao Paulo, Brazil, were matched by propensity score based on BMI, age, sex and pre-existing diseases with a control group who had not been tested positive for SARS-CoV-2 (n=30; age: 15; 50% females). Cardiopulmonary fitness (by means of a cardiopulmonary exercise test: CPET) and brachial flow-mediated dilation (%b-FMD) were assessed 6 months after diagnosis.
Results: Patients were similar for pre-existing diseases, sex, age and body mass index (all p>.05). Compared with controls, COVID-19 patients showed reduced VAT and peak exercise time (all p>.01), and VE/MVV (p<0.1). Brachial endothelial function variables were all adjust for body surface area (BSA). COVID-19 patients had decreased %b-FMD (3.6 vs. 5.4; p=.03) mean and positive flow (p=.02 and p=.03, respectively) vs. controls. Adjusted linear regression models exploring associations between CPET variables, %b-FMD and the potential predictors post-COVID-19 syndrome, number of symptoms, hospitalization and COVID severity did not detect significant associations, except for total shear rate in hospitalization (Coefficient: -65.07 [95%CI -119.5;-10.5], p=0.02).
Conclusion: In a sample of mainly immunocompromised youth with COVID-19, we found impaired exercise performance and endothelial function. These findings reinforce the need for preventive measures against infection in this vulnerable population and suggest that proper monitoring and treatment for these patients are warranted.