Ongoing blood vessel problems linked to reduced exercise ability in adults 3 years after COVID-19 despite normal heart function

Long COVID participants exhibited a lower peak Vₒ₂ of 19.6 ± 2.5 mL·kg⁻¹·min⁻¹ compared to 24.3 ± 6.5 mL·kg⁻¹·min⁻¹ in controls (p = 0.04).

• Exercise capacity, measured as percent-predicted peak Vₒ₂, was significantly reduced in Long COVID individuals (61.1 ± 8.3%) compared to controls (77.0 ± 14.2%, p = 0.006).
• Long COVID participants had lower Vₒ₂ at first ventilatory threshold (11.0 ± 1.4 mL·kg⁻¹·min⁻¹) than controls (13.7 ± 3.8 mL·kg⁻¹·min⁻¹, p = 0.04).
• No significant differences were found in conventional echocardiographic parameters or myocardial work indices between Long COVID and control groups (all p > 0.05).
• Endothelial function was significantly impaired in the Long COVID group, evidenced by lower flow-mediated dilation (FMD) values (p < 0.001) and other shear rate metrics.
• FMD showed a positive correlation with exercise capacity in the Long COVID group, with peak Vₒ₂ (r = 0.68, p = 0.03) and percent-predicted peak Vₒ₂ (r = 0.64, p = 0.04).

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