Long-term COVID-19 could wipe out a decade of gains in fitness and exercise capacity

A prolonged virus can rob people of health, energy, employment and joy. It may also shed decades’ worth of aerobic fitness, according to a large-scale new scientific review of COVID-19 patients and exercise.

The studypublished in JAMA Network Open, compiled results from dozens of previous trials to show that people with COVID-19 typically have lower endurance and find exercise more challenging than other people of the same ages who have contracted the virus but recovered.

Matthew Dorstenfeld, a cardiologist at Zuckerberg San Francisco General Hospital, said the findings add to mounting evidence, both from experience and people’s experiences, that “something is happening” in many people who contract COVID-19 that makes exercise difficult, If not impossible. Professor at the University of California, San Francisco Department of Medicine, who led the new study.

This possibility has implications for how long COVID-19 is defined and for the health and well-being of COVID-19 patients, months or years from now.

Long Covid, the name given to the chronic, intense symptoms of illness that persist for months after infection with the COVID-19 virus, infect millions of Americans and others globally. a The study was published Earlier this week, it was reported that at least one in 20 people who contract the coronavirus will be infected with the coronavirus for a long time.

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COVID-19 is usually diagnosed on the basis of a combination of symptoms that include headache, fatigue, brain fog, joint pain, and more. Many people with the long virus also reported that they could not exercise or even walk around the building without feeling windy and tired.

But Durstenfeld said the inability to be active, known as exercise intolerance, has not generally been taken as an official symptom of COVID-19, in part because doctors and researchers thought it was likely due to a lack of conditioning. That is, they believed that people’s stamina decreased when they were bedridden with the Covid virus, and they would regain it once they got up and started moving again.

But, anecdotally, many people with COVID-19 have never regained fitness, and in the past year or so, published science has begun to suggest that their bodies have responded uniquely — and poorly — to exercise. During the exercise test, their hearts, breathing, muscles, and other biological systems struggled much more than healthy people.

But most of these studies were small-scale, sometimes involving a single patient, and typically focused on those who were hospitalized, often for weeks or longer, making it difficult for researchers to separate the effects of bedridden and inactivity from the prolonged effects. Corona virus disease.

Therefore, for the new study, Durstenfeld and colleagues decided to aggregate and reanalyze data from all relevant recent studies, to provide more weight to any findings by including as many patients as possible.

To achieve this, they identified nine trials comparing tolerance to prolonged exercise in people infected with the virus with those who were infected but recovered. Combining the studies’ data, they ended up with results for 464 people with the long virus and 359 without it. These groups were similar in age, ranging from 39 to 56 years old, and all completed a clinical test of their aerobic capacity and heart rate on a treadmill or stationary bike, along with some additional medical tests.

However, their results were completely different. In general, those who outlived Covid showed normal exercise capacity for their age. But those with Covid-19 disease had the stamina of someone 10 years older than him. Dorstenfeld said the children in their forties ran or ran like “a person in their fifties.”

Unusual response to exercise

Previous studies showed that it also had a range of unusual internal responses to exercise. Muscles draw less oxygen from the bloodstream than normal, which hinders the muscles’ ability to contract. People’s heart rates often failed to rise as expected during exercise, slowing blood flow throughout the body, and some people also experienced hyperventilation.

These are not common physiological reactions after someone falls out of shape due to illness and bed rest, Dorstenfeld said. “This is more than just de-conditioning.”

Other scholars agree. “I think the main and valid point of this review is that lack of conditioning alone” isn’t what makes exercise so difficult for many people with Covid disease, said David Systrom, MD, a pulmonologist at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard University. -19. Faculty of medicine. He was not involved in the new study but did study and treat patients with COVID-19.

He said that people with the long-term coronavirus may develop molecular changes within their muscles and some nerves and blood vessels, which could affect how their bodies handle the physical demands of exercise. These changes and challenges occur even though most people with COVID-19 do not show any visible abnormalities in their lungs or hearts.

new symptoms of covid-19 virus

And compounding the complications, few of the people with the long virus showed the same patterns of physiological changes, and some seemed less affected by the stress than others.

However, Dorstenfeld said one of the findings of the new study is that exercise intolerance “should be considered a symptom of COVID-19.”

Another reason, said Stephen J. Carter, a cardiovascular physiologist at Indiana University’s Bloomington School of Public Health, is that people with COVID-19 might want to consider exercise testing, which has been studying people with the virus for a long time but haven’t Participate in the new review.

“If individuals are having difficulty exercising, consulting with their physician about a cardiopulmonary exercise test would be an important starting point,” he said. “These tests provide a non-invasive way to determine the source of exercise limitations.”

Dorstenfeld said that visiting a clinic specializing in COVID-19 and being aware of an exercise intolerance might also be helpful.

He continued, “We don’t yet know the ‘trajectory’ of prolonged hunger and exercise intolerance, or how long the condition will last, and whether it can be treated or if it will slowly resolve on its own.” But the long-term goal of his and other research, he said, is to eventually help people with COVID-19 find ways to become active again.

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