The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals, 2025, Russell+

The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals
Sophie L. Russell; Nduka C. Okwose; Mushidur Rahman; Ben J Lee; Gordon McGregor; Stuart M. Raleigh; Hardip Sandhu; Laura C. Roden; Prithwish Banerjee; Djordje G. Jakovljevic

AIMS
Coronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.

METHODS
This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.

RESULTS
There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12%, non-COVID-19: 29.2 ± 8.44%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m2, non-COVID-19: 2.79 ± 0.37 L/min/m2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m2, non-COVID-19: 47.0 ± 7.59 mL/m2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m2, p = 0.028).

CONCLUSION
Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise.

Link | PDF (Scandinavian Cardiovascular Journal) [Open Access]

 

Is there any reason to think this isn't just people who are less fit are more likely to get COVID?

Edit: Yeah, unless I'm missing something, I think they imply they are showing that COVID caused these changes without evidence to support this:

It's worded strangely, but I think the most obvious way to interpret this is they say there are no long term effects from COVID at rest, but COVID does cause effects in the response to CPET.

 

Are these differences clinically significant?

The p-values are quite high and they tested many things, could the results be due to variance?
https://xkcd.com/882/