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Garg S, Saini P, Rizvi MR, Ahmad F, AlTaweel M, Sabah ZU, Durrani HK, Almasswary SA, Seyam MK, Sharma A, Ahmad I, Marzoogi SA, Shaphe MA, Uddin S, Ahmad I. The Cardiac Comeback-Beating Stronger: Exploring the Remarkable Resilience of the Heart in COVID-19 Recovery through Cardiac Autonomic Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1397. [PMID: 37629687 PMCID: PMC10456477 DOI: 10.3390/medicina59081397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/15/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Analyzing the cardiac autonomic function in COVID-19 patients can provide insights into the impact of the virus on the heart's regulatory mechanisms and its recovery. The autonomic nervous system plays a crucial role in regulating the heart's functions, such as heart rate, blood pressure, and cardiac output. This study aimed to investigate the impact of COVID-19 on heart rate variability (HRV) during a 6-min walk test (6MWT). Materials and Methods: The study included 74 participants, consisting of 37 individuals who had recovered from mild to moderate COVID-19 and 37 healthy controls. The study assessed heart rate variability (HRV) and blood pressure both before and after a 6-min walk test (6MWT). Results: The study found significant differences in a few time domains (SDNN and pNN50) and all frequency domain measures, whereas there were no significant differences in demographic characteristics or blood pressure between COVID-19-recovered individuals and healthy controls at rest. There were significant 6MWT effects on average HR, time-domain (SDNN and pNN50) measures of HRV, and all frequency domain measures of HRV. A significant group × 6MWT interaction was found for SDNN, pNN50, total power, Ln total power, LF, HF, Ln LF, Ln HF, and LF nu. Conclusions: Cardiac Autonomic analysis through HRV is essential to ensure the continued health and well-being of COVID-19 survivors and to minimize the potential long-term impacts of the disease on their cardiovascular system. This suggests that HRV analysis during the recovery phase following exercise could serve as a valuable tool for evaluating the physiological effects of COVID-19 and monitoring the recovery process.
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Affiliation(s)
- Sakshi Garg
- Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India; (S.G.); (P.S.); (A.S.); (I.A.)
- Department of Physiotherapy, School of Allied Health Sciences, MVN University, Palwal 121102, Haryana, India
| | - Preeti Saini
- Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India; (S.G.); (P.S.); (A.S.); (I.A.)
| | - Moattar Raza Rizvi
- School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India;
| | - Fuzail Ahmad
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Diriya 13713, Riyadh, Saudi Arabia;
| | - Mohammed AlTaweel
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Diriya 13713, Riyadh, Saudi Arabia;
| | - Zia Ul Sabah
- Department of Medicine, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia; (Z.U.S.); (H.K.D.)
| | - Humayoun K. Durrani
- Department of Medicine, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia; (Z.U.S.); (H.K.D.)
| | | | - Mohamed K. Seyam
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Almajmaah 15431, Saudi Arabia;
| | - Ankita Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India; (S.G.); (P.S.); (A.S.); (I.A.)
| | - Irshad Ahmad
- Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India; (S.G.); (P.S.); (A.S.); (I.A.)
| | - Sara Al Marzoogi
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Diriya 13713, Riyadh, Saudi Arabia;
| | - Mohammad A. Shaphe
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (S.U.)
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (S.U.)
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia;
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Gochicoa-Rangel L, Arce SC, Aguirre-Franco C, Madrid-Mejía W, Gutiérrez-Clavería M, Noriega-Aguirre L, Schonffeldt-Guerrero P, Acuña-Izcaray A, Cortés-Telles A, Martínez-Valdeavellano L, Hernández-Rocha FI, Ceballos-Zúñiga O, Del Rio Hidalgo R, Sánchez S, Meneses-Tamayo E, Chérrez-Ojeda I. Effect of Altitude on Respiratory Functional Status in COVID-19 Survivors: Results from a Latin American Cohort-FIRCOV. High Alt Med Biol 2023; 24:37-48. [PMID: 36757307 DOI: 10.1089/ham.2022.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Laura Gochicoa-Rangel, Santiago C. Arce, Carlos Aguirre-Franco, Wilmer Madrid-Mejía, Mónica Gutiérrez-Clavería, Lorena Noriega-Aguirre, Patricia Schonffeldt-Guerrero, Agustín Acuña-Izcaray, Arturo Cortés-Telles, Luisa Martínez-Valdeavellano, Federico Isaac Hernández-Rocha, Omar Ceballos-Zúñiga, Rodrigo Del Rio Hidalgo, Sonia Sánchez, Erika Meneses-Tamayo, and Iván Chérrez-Ojeda; and on Behalf of the Respiratory Physiology Project in COVID-19 (FIRCOV). Effect of altitude on respiratory functional status in COVID-19 survivors: results from a Latin American Cohort-FIRCOV. High Alt Med Biol 24:37-48, 2023. Persistent symptoms and lung function abnormalities are common in COVID-19 survivors. Objectives: To determine the effect of altitude and other independent variables on respiratory function in COVID-19 survivors. Methods: Analytical, observational, cross-sectional cohort study done at 13 medical centers in Latin America located at different altitudes above sea level. COVID-19 survivors were invited to perform pulmonary function tests at least 3 weeks after diagnosis. Results: 1,368 participants (59% male) had mild (20%), moderate (59%), and severe (21%) disease. Restriction by spirometry was noted in 32%; diffusing capacity of the lung for carbon monoxide (DLCO) was low in 43.7%; and 22.2% walked less meters during the 6-minute walk test (6-MWT). In multiple linear regression models, higher altitude was associated with better spirometry, DLCO and 6-MWT, but lower oxygen saturation at rest and during exercise. Men were 3 times more likely to have restriction and 5.7 times more likely to have a low DLCO. Those who had required mechanical ventilation had lower DLCO and walked less during the 6-MWT. Conclusions: Men were more likely to have lower lung function than women, even after correcting for disease severity and other factors. Patients living at a higher altitude were more likely to have better spirometric patterns and walked farther but had lower DLCO and oxygen saturation.
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Affiliation(s)
- Laura Gochicoa-Rangel
- Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Ciudad de México, México
| | - Santiago C Arce
- Pulmonary Function Laboratory, Instituto de Investigaciones Médicas A. Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Aguirre-Franco
- Servicio de Pruebas de Función Pulmonar, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Wilmer Madrid-Mejía
- Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Ciudad de México, México
| | | | - Lorena Noriega-Aguirre
- Centro de Diagnóstico y Tratamiento de Enfermedades Respiratorias CEDITER, Cd. De Panamá, Panamá
| | | | - Agustín Acuña-Izcaray
- Servicio de Neumonología, Centro Médico Docente La Trinidad y Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Arturo Cortés-Telles
- Clínica de Enfermedades Respiratorias, HRAE de la Península de Yucatán, Mérida, México
| | | | | | | | | | - Sonia Sánchez
- Centro de Estudios Respiratorios, Asunción, Paraguay
| | - Erika Meneses-Tamayo
- Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Ciudad de México, México
| | - Iván Chérrez-Ojeda
- Universidad de Especialidades Espíritu Santo, Samborondón, Ecuador
- Respiralab Research Center, Guayaquil, Ecuador
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Campos MC, Nery T, Starke AC, de Bem Alves AC, Speck AE, S Aguiar A. Post-viral fatigue in COVID-19: A review of symptom assessment methods, mental, cognitive, and physical impairment. Neurosci Biobehav Rev 2022; 142:104902. [PMID: 36202253 PMCID: PMC9528075 DOI: 10.1016/j.neubiorev.2022.104902] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 12/14/2022]
Abstract
Coronavirus 2 is responsible for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), and the main sequela is persistent fatigue. Post-viral fatigue is common and affects patients with mild, asymptomatic coronavirus disease-2019 (COVID-19). However, the exact mechanisms involved in developing post-COVID-19 fatigue remain unclear. Furthermore, physical and cognitive impairments in these individuals have been widely described. Therefore, this review aims to summarize and propose tools from a multifaceted perspective to assess COVID-19 infection. Herein, we point out the instruments that can be used to assess fatigue in long-term COVID-19: fatigue in a subjective manner or fatigability in an objective manner. For physical and mental fatigue, structured questionnaires were used to assess perceived symptoms, and physical and cognitive performance assessment tests were used to measure fatigability using reduced performance.
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Affiliation(s)
| | | | | | | | | | - Aderbal S Aguiar
- Correspondence to: Labioex, Federal University of Santa Catarina, Pedro João Pereira, nº 150, Mato Alto, Araranguá, Santa Catarina, Brazil
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COVID-19, cardiac involvement and cardiac rehabilitation: Insights from a rehabilitation perspective - State of the Art. Turk J Phys Med Rehabil 2022; 68:317-335. [DOI: 10.5606/tftrd.2022.11435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Since the beginning of the pandemic, many novel coronavirus disease 2019 (COVID-19) patients have experienced multisystem involvement or become critically ill and treated in intensive care units, and even died. Among these systemic effects, cardiac involvement may have very important consequences for the patient’s prognosis and later life. Patients with COVID-19 may develop cardiac complications such as heart failure, myocarditis, pericarditis, vasculitis, acute coronary syndrome, and cardiac arrhythmias or trigger an accompanying cardiac disease. The ratio of COVID-19 cardiac involvement ranges between 7 and 28% in hospitalized patients with worse outcomes, longer stay in the intensive care unit, and a higher risk of death. Furthermore, deconditioning due to immobility and muscle involvement can be seen in post-COVID-19 patients and significant physical, cognitive and psychosocial impairments may be observed in some cases. Considering that the definition of health is “a state of complete physical, mental and social well-being”, individuals with heart involvement due to COVID-19 should be rehabilitated by evaluating all these aspects of the disease effect. In the light of the rehabilitation perspective and given the increasing number of patients with cardiac manifestations of COVID-19, in this review, we discuss the rehabilitation principles in this group of patients.
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