Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective
Background: Patients recovering from COVID-19 often present with impaired health and persisting symptoms such as exercise intolerance ⩾3 months post-infection. Uncertainty remains about long-term recovery. We aimed to review studies examining cardiac function, macro- or microvascular function, blood...
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SAGE Publishing
2024-11-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121241296701 |
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| author | Fabian Schwendinger Denis Infanger Debbie J Maurer Thomas Radtke Justin Carrard Julia M Kröpfl Aglaia Emmenegger Henner Hanssen Christoph Hauser Udo Schwehr Hans H Hirsch Julijana Ivanisevic Karoline Leuzinger Aurélien E Martinez Marc Maurer Thomas Sigrist Lukas Streese Roland von Känel Timo Hinrichs Arno Schmidt-Trucksäss |
| author_facet | Fabian Schwendinger Denis Infanger Debbie J Maurer Thomas Radtke Justin Carrard Julia M Kröpfl Aglaia Emmenegger Henner Hanssen Christoph Hauser Udo Schwehr Hans H Hirsch Julijana Ivanisevic Karoline Leuzinger Aurélien E Martinez Marc Maurer Thomas Sigrist Lukas Streese Roland von Känel Timo Hinrichs Arno Schmidt-Trucksäss |
| author_sort | Fabian Schwendinger |
| collection | DOAJ |
| description | Background: Patients recovering from COVID-19 often present with impaired health and persisting symptoms such as exercise intolerance ⩾3 months post-infection. Uncertainty remains about long-term recovery. We aimed to review studies examining cardiac function, macro- or microvascular function, blood biomarkers and physical activity in adult patients post-COVID-19 and highlight current knowledge gaps. Results: Using echocardiography, persistent cardiac involvement of the left ventricle was observed in a fraction of patients both hospitalized and non-hospitalized. Ventricular dysfunction was often subclinical but may partly contribute to exercise intolerance post-COVID-19. Endothelial dysfunction was seen on micro- and macrovascular levels using retinal vessel imaging methods and brachial artery flow-mediated dilation, respectively. Studies reporting blood biomarkers of disease-specific impairment and endothelial dysfunction yielded upregulated inflammation, hypercoagulability, organ and endothelial damage up to several months after infection. Omics’ scale lipid profiling studies provide preliminary evidence of alterations in several lipid subspecies, mostly during acute COVID-19, which might contribute to subsequent endothelial and cardiometabolic dysfunction. Yet, more robust evidence is warranted. Physical activity may be reduced up to 6 months post-COVID-19. However, studies measuring physical activity more precisely using accelerometry are sparse. Overall, there is growing evidence for long-term multiple organ dysfunction. Conclusion: Research combining all the above methods in the search for underlying mechanisms of post-COVID-19 symptoms is mostly missing. Moreover, studies with longer follow-ups (i.e. ⩾18 months) and well-matched control groups are lacking. The findings may aid the development of rehabilitation regimes for post-COVID-19 syndrome. Condensed abstract This review examined cardiac function, vascular function, blood biomarkers and physical activity in patients post-COVID-19. Evidence suggests long-term dysfunction in multiple organ systems and exercise intolerance due to various factors, including endothelial damage and, in some patients, subclinical ventricular dysfunction. We highlight knowledge gaps for further research to aid post-COVID-19 rehabilitation. |
| format | Article |
| id | doaj-art-ebe0e5c5dedc4d7ea5a6b6b2ca9ce9d8 |
| institution | Kabale University |
| issn | 2050-3121 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj-art-ebe0e5c5dedc4d7ea5a6b6b2ca9ce9d82025-02-03T12:03:20ZengSAGE PublishingSAGE Open Medicine2050-31212024-11-011210.1177/20503121241296701Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspectiveFabian Schwendinger0Denis Infanger1Debbie J Maurer2Thomas Radtke3Justin Carrard4Julia M Kröpfl5Aglaia Emmenegger6Henner Hanssen7Christoph Hauser8Udo Schwehr9Hans H Hirsch10Julijana Ivanisevic11Karoline Leuzinger12Aurélien E Martinez13Marc Maurer14Thomas Sigrist15Lukas Streese16Roland von Känel17Timo Hinrichs18Arno Schmidt-Trucksäss19Faculty of Medicine, University of Basel, Basel, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandDivision of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandTransplantation and Clinical Virology, Department Biomedicine, University of Basel, Basel, SwitzerlandMetabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Quartier UNIL-CHUV, Lausanne, SwitzerlandTransplantation and Clinical Virology, Department Biomedicine, University of Basel, Basel, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, SwitzerlandDepartment of Pneumology, Cantonal Hospital Olten, Olten, SwitzerlandDepartment of Pulmonology, Clinic Barmelweid, Barmelweid, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandFaculty of Medicine, University of Basel, Basel, SwitzerlandDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, SwitzerlandBackground: Patients recovering from COVID-19 often present with impaired health and persisting symptoms such as exercise intolerance ⩾3 months post-infection. Uncertainty remains about long-term recovery. We aimed to review studies examining cardiac function, macro- or microvascular function, blood biomarkers and physical activity in adult patients post-COVID-19 and highlight current knowledge gaps. Results: Using echocardiography, persistent cardiac involvement of the left ventricle was observed in a fraction of patients both hospitalized and non-hospitalized. Ventricular dysfunction was often subclinical but may partly contribute to exercise intolerance post-COVID-19. Endothelial dysfunction was seen on micro- and macrovascular levels using retinal vessel imaging methods and brachial artery flow-mediated dilation, respectively. Studies reporting blood biomarkers of disease-specific impairment and endothelial dysfunction yielded upregulated inflammation, hypercoagulability, organ and endothelial damage up to several months after infection. Omics’ scale lipid profiling studies provide preliminary evidence of alterations in several lipid subspecies, mostly during acute COVID-19, which might contribute to subsequent endothelial and cardiometabolic dysfunction. Yet, more robust evidence is warranted. Physical activity may be reduced up to 6 months post-COVID-19. However, studies measuring physical activity more precisely using accelerometry are sparse. Overall, there is growing evidence for long-term multiple organ dysfunction. Conclusion: Research combining all the above methods in the search for underlying mechanisms of post-COVID-19 symptoms is mostly missing. Moreover, studies with longer follow-ups (i.e. ⩾18 months) and well-matched control groups are lacking. The findings may aid the development of rehabilitation regimes for post-COVID-19 syndrome. Condensed abstract This review examined cardiac function, vascular function, blood biomarkers and physical activity in patients post-COVID-19. Evidence suggests long-term dysfunction in multiple organ systems and exercise intolerance due to various factors, including endothelial damage and, in some patients, subclinical ventricular dysfunction. We highlight knowledge gaps for further research to aid post-COVID-19 rehabilitation.https://doi.org/10.1177/20503121241296701 |
| spellingShingle | Fabian Schwendinger Denis Infanger Debbie J Maurer Thomas Radtke Justin Carrard Julia M Kröpfl Aglaia Emmenegger Henner Hanssen Christoph Hauser Udo Schwehr Hans H Hirsch Julijana Ivanisevic Karoline Leuzinger Aurélien E Martinez Marc Maurer Thomas Sigrist Lukas Streese Roland von Känel Timo Hinrichs Arno Schmidt-Trucksäss Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective SAGE Open Medicine |
| title | Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective |
| title_full | Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective |
| title_fullStr | Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective |
| title_full_unstemmed | Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective |
| title_short | Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective |
| title_sort | medium to long term health condition of patients post covid 19 exercise intolerance and potential mechanisms a narrative review and perspective |
| url | https://doi.org/10.1177/20503121241296701 |
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