背景:长COVID-19综合征(LCS)表现出神经系统问题,例如周围神经病变和自主神经系统(ANS)功能障碍。锻炼不容忍和,因此,低心肺功能(CRF)是LCS最常见的症状.我们描述了与对照组相比表现出LCS症状的一系列个体,并认为这种情况可能与运动能力介导的ANS破坏有关,特别是导致运动不耐受。
方法:本研究包括87名LCS患者和71名未诊断为COVID-19的对照参与者。仰卧位的心率变异性(HRV)通常用于诊断自主神经失调,随后使用Kubios软件进行分析(Kuopio,芬兰)。CRF(峰值VO2),COVID-19后患者报告的症状,最大肌肉力量(握力,双侧腿部按压,腿延长,胸压,和背部新闻练习),还测量了身体成分。协方差分析(ANCOVA)和中介分析用于评估LCS之间的关联,峰值VO2和HRV指标。双侧p<0.05被认为是显著的。
结果:HRV参数-RR间期,RMSSD,SDNN,PNS指数,LF,HF,总功率,与LCS患者相比,对照组的SD1和SD2-显着升高(p<0.05)。相比之下,HR,压力指数,而SNS指数参数在LCS组明显高于LCS组(p<0.05)。当针对RR间隔进行调整时,这些参数仍具有统计学意义(p<0.05).在LCS患者中,峰值VO2和RMSSD(调解效果=24.4%)以及峰值VO2和SDNN(调解效果=25.1%)之间存在调解效果。
结论:这些发现为CRF和HRV指标之间的相互作用提供了新的见解,并认可自主神经失调可能与在长COVID-19患者中观察到的低峰值VO2有关。
BACKGROUND: Long-COVID-19 syndrome (LCS) exhibits neurological problems such as peripheral neuropathy and autonomic nervous system (ANS) dysfunction. Exercise intolerance and, consequently, low cardiorespiratory fitness (CRF) are some of the most common symptoms of LCS. We describe a series of individuals exhibiting LCS symptoms compared to a control group and posit that this condition may be related to the exercise capacity-mediated disruption of the ANS resulting particularly in exercise intolerance.
METHODS: This study included 87 individuals with LCS and 71 control participants without COVID-19 diagnoses. Heart rate variability (HRV) in supine position is commonly measured to diagnose autonomic dysregulation and subsequently analyzed using the Kubios software (Kuopio, Finland). CRF (peak VO2), post-COVID-19 patient-reported symptoms, maximal muscle strength (grip strength, bilateral leg press, leg extension, pectoral press, and back press exercises), and body composition were also measured. Analysis of covariance (ANCOVA) and mediation analysis were employed to assess the associations among LCS, peak VO2, and HRV indicators. Two-sided p < 0.05 was considered as significant.
RESULTS: The HRV parameters-RR interval, RMSSD, SDNN, PNS index, LF, HF, total power, SD1, and SD2-were significantly elevated (p < 0.05) in the control group when compared to the LCS patients. In contrast, the HR, stress index, and SNS index parameters were significantly higher (p < 0.05) in the LCS group. When adjusted for RR intervals, these parameters remained statistically significant (p < 0.05). A partially mediated effect was found between peak VO2 and RMSSD (mediation effect = 24.4%) as well as peak VO2 and SDNN (mediation effect = 25.1%) in the LCS patients.
CONCLUSIONS: These findings contribute new insights on the interplay between CRF and HRV indicators as well as endorse that dysautonomia may be related to the low peak VO2 observed in long COVID-19 patients.