Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Clinical Chemistry and Hematology Laboratory, Hospital Gelderse Vallei Ede, Ede, The Netherlands.
Am J Physiol Heart Circ Physiol. 2023 Jan 1;324(1):H47-H56. doi: 10.1152/ajpheart.00335.2022. Epub 2022 Dec 2.
Coronavirus disease 2019 (COVID-19) is reported to have long-term effects on cardiovascular health and physical functioning, even in the nonhospitalized population. The physiological mechanisms underlying these long-term consequences are however less well described. We compared cardiovascular risk factors, arterial stiffness, and physical functioning in nonhospitalized patients with COVID-19, at a median of 6 mo postinfection, versus age- and sex-matched controls. Cardiovascular risk was assessed using blood pressure and biomarker concentrations (amino-terminal pro-B-type-natriuretic-peptide, high-sensitive cardiac troponin I, C-reactive protein), and arterial stiffness was assessed using carotid-femoral pulse wave velocity. Physical functioning was evaluated using accelerometry, handgrip strength, gait speed and questionnaires on fatigue, perceived general health status, and health-related quality of life (hrQoL). We included 101 former patients with COVID-19 (aged 59 [interquartile range, 55-65] yr, 58% male) and 101 controls. At 175 [126-235] days postinfection, 32% of the COVID-19 group reported residual symptoms, notably fatigue, and 7% required post-COVID-19 care. We found no differences in blood pressure, biomarker concentrations, or arterial stiffness between both groups. Former patients with COVID-19 showed a higher handgrip strength (43 [33-52] vs. 38 [30-48] kg, = 0.004) and less sleeping time (8.8 [7.7-9.4] vs. 9.8 [8.9-10.3] h/day, < 0.001) and reported fatigue more often than controls. Accelerometry-based habitual physical activity levels, gait speed, perception of general health status, and hrQoL were not different between groups. In conclusion, one in three nonhospitalized patients with COVID-19 reports residual symptoms at a median of 6 mo postinfection, but we were unable to relate these symptoms to increases in cardiovascular risk factors, arterial stiffness, or physical dysfunction. We examined cardiovascular and physical functioning outcomes in nonhospitalized patients with COVID-19, at a median of 6 mo postinfection. When compared with matched controls, minor differences in physical functioning were found, but objective measures of cardiovascular risk and arterial stiffness did not differ between groups. However, one in three former patients with COVID-19 reported residual symptoms, notably fatigue. Follow-up studies should investigate the origins of residual symptoms and their long-term consequences in former, nonhospitalized patients with COVID-19.
新型冠状病毒病 2019（COVID-19）据报道对心血管健康和身体功能有长期影响，即使在未住院的人群中也是如此。然而，这些长期后果的生理机制描述得还不够充分。我们比较了 COVID-19 非住院患者在感染后中位数为 6 个月时的心血管危险因素、动脉僵硬度和身体功能，与年龄和性别匹配的对照组进行比较。使用血压和生物标志物浓度（氨基末端 B 型利钠肽前体、高敏心肌肌钙蛋白 I、C 反应蛋白）评估心血管风险，使用颈股脉搏波速度评估动脉僵硬度。使用加速度计、握力、步态速度以及疲劳、感知一般健康状况和健康相关生活质量（hrQoL）问卷评估身体功能。我们纳入了 101 名以前的 COVID-19 患者（年龄 59 [四分位间距，55-65]岁，58%为男性）和 101 名对照组。在感染后 175 [126-235] 天，COVID-19 组有 32%报告有残留症状，特别是疲劳，有 7%需要 COVID-19 后护理。我们发现两组之间的血压、生物标志物浓度或动脉僵硬度没有差异。COVID-19 前患者的握力（43 [33-52] vs. 38 [30-48] kg， = 0.004）更高，睡眠时间更少（8.8 [7.7-9.4] vs. 9.8 [8.9-10.3] h/天， < 0.001），且比对照组更常报告疲劳。基于加速度计的习惯性体力活动水平、步态速度、一般健康状况感知和 hrQoL 在两组之间没有差异。总之，三分之一的 COVID-19 非住院患者在感染后中位数为 6 个月时报告有残留症状，但我们无法将这些症状与心血管危险因素、动脉僵硬度或身体功能障碍的增加联系起来。我们在 COVID-19 非住院患者感染后中位数为 6 个月时检查了心血管和身体功能结果。与匹配的对照组相比，身体功能方面存在较小的差异，但两组之间的心血管风险和动脉僵硬度的客观测量没有差异。然而，三分之一的 COVID-19 前患者报告有残留症状，特别是疲劳。后续研究应调查 COVID-19 非住院前患者残留症状的来源及其长期后果。
