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Even mild or moderate COVID-19 disease affects the cardiovascular system in young adults (72 notícias)

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Researchers followed young men and women aged 20-40 years without pre-existing disease. The results show that overweight and physical inactivity increase the impact of the disease on the autonomic nervous system.

A study conducted at São Paulo State University (UNESP) in Brazil shows that even mild to moderate infection with SARS-CoV-2 can cause imbalance in the cardiovascular system in young adults without pre-existing diseases. The researchers also concluded that both obesity and a low level of physical activity are key factors in post-COVID that help alter the autonomic nervous system, which regulates such vital functions as blood pressure, heart rate and breathing.

The study, which was supported by FAPESPinvolved male and female patients aged 20-40 years before being vaccinated.

“The results offer elements that should encourage people even with mild symptoms of COVID-19 to seek a more detailed diagnosis. The processes triggered by the virus may have consequences that the patient is not aware of,” he said. Fábio Santos de Lira, principal investigator for the project. Lira is a professor at the Department of Physical Education at UNESP’s School of Sciences and Technology in Presidente Prudente, and one of the authors of an article on the study published in a special issue of International Journal of Environmental Research and Public Health justified “Impact of lifestyle interventions on immune response, inflammation and vascular health”.

The study was part of a broader project called Fit-COVIDwhich aims to explain some of the gaps in the scientific knowledge of the natural history of the disease with a specific focus on immune, inflammatory and metabolic markers, alongside an assessment of the time-related modulating effects of physical activity and body composition.

The researchers recruited COVID patients in Presidente Prudente, a city in the interior of the state of São Paulo with about 232,000 inhabitants. By the end of February 2022, it had 39,049 confirmed cases and 982 deaths due to the disease.

Participants had been diagnosed with RT-PCR no more than six months earlier and had mild to moderate symptoms of COVID. A control group included age-matched healthy subjects. A total of 57 people were evaluated, with 38 left as a study sample after exclusions due to, among other things, chronic illness, drug use and vaccination.

They underwent an initial assessment that included body mass index (BMI, the ratio of weight to height in the second square, used to determine overweight and obesity) and measurement of physical activity with a three-axis accelerometer. The function of the autonomic nervous system (ANS) was assessed by measuring heart rate variability.

The main finding was that post-COVID patients, even after having mild to moderate symptoms, showed increased activity of the sympathetic nervous system (a division of ANS that regulates the response to danger, intense exertion and stress), decreased activity of the sympathetic nervous system. parasympathetic nervous system (the second division of the ANS, responsible for resting functions, digestion and energy conservation) and lower overall variability than the control group. In other words, the heart rate was higher and the organism did less to alleviate this in the post-COVID patients.

In subjects who were overweight or obese and / or physically inactive, autonomic heart rate modulation was less effective. According to the authors, the study provides new insights regarding the role of BMI and physical activity on post-COVID autonomic deregulation, which may contribute to a better understanding of the pathophysiology and treatment of post-acute COVID symptoms.

“We did not expect such a changed cardiovascular system because they were young and had no other diseases. Our study shows that significant functional changes are possible in individuals who have had COVID, even without severe symptoms. This pulse variation can, for example, turn into an arrhythmia in the future, ”he said Luciele Guerra Minuzzia postdoc at UNESP and co-author of the article, next to Ana Paula Coelho Figueira Freirefirst author and researcher at the University of Western São Paulo (UNOESTE), and Bruna Spolador de Alencar Silva, last author and also postdoc at UNESP.

The variations were reflected in the subjects’ daily activities, such as the ability to perform physical exercises, go up stairs and even walk. They reported fatigue and weakness. A simple test such as a six-minute walk is sufficient to detect the problem.

According to Minuzzi, the group previously found evidence of metabolic dysregulation in hospitalized severe COVID patients, including high levels of lipids in the bloodstream and altered glycemia.

A study published in August 2021 of researchers at Appalachian State University in North Carolina (USA) discovered autonomic dysregulation in young adults who recovered from COVID but used an invasive method, whereas Brazilian researchers chose a simpler, cheaper and non-invasive method.

At that time, the conclusion was that the physiological effect of COVID on the resting heart rate can last as long as two to three months, possibly due to autonomic dysfunction. The results were attributed to exacerbated inflammation during COVID, not least due to the release of inflammatory cytokines.

NEXT STEP

According to Lira, the researchers are now analyzing other results of the same tests and will soon publish further results. The project involves a multicenter study involving researchers at the University of Coimbra and the Coimbra Polytechnic Institute (Portugal).

In addition, the same patients continue to be tracked after being vaccinated. They were assessed six weeks after taking the vaccine. The next assessment will be performed in the 18th month after vaccination.

Role of body mass and physical activity in autonomous function modulation on post-COVID-19 condition: An observational sub-analysis of Fit-COVID study. International Journal of Environmental Research and Public HealthFebruary 21, 2022