JACC. Advances

Long COVID is linked to lasting lower heart and lung fitness

Updated

Abstract

Among 1,475 participants, 34% had high symptom burden related to Long COVID, assessed 21 months post-infection.

  • High symptom burden was linked to significantly lower heart rate variability, indicating impaired autonomic function.
  • Participants with high symptom burden had a higher resting heart rate, suggesting increased cardiovascular stress.
  • A lower number of metabolic equivalent of task minutes was observed in those with high symptom burden, reflecting reduced physical activity.
  • Step counts were lower by 1,624 steps per day in individuals with high symptom burden, indicating decreased mobility.
  • Activity levels were reduced by 7.9 minutes per day of being very or fairly active among those with high symptoms.
  • Two subphenotypes with abnormal cardiovascular measures were identified, associated with lower quality of life scores.

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Funding

Competing interests

Funding support and author disclosures This research was funded by the NIHOT2HL161847 as part of the Researching COVID to Enhance Recovery (RECOVER) Initiative. This content is solely the responsibility of the authors and does not necessarily represent the official views of the RECOVER. Initiative, the NIH, or other funders. Dr Vogel has received unrelated grant funding from the National Institutes of Health. Dr Goldman has received contracted research from Gilead, BioVie, Pfizer, and Helix; grants from Gilead; and serving as a speaker and or advisory board member for Gilead, Merck, and Invivyd. J.D.G. reports a grant from Gilead; contracted research from Gilead, BioVie andPfizer, and serving as a speaker, consultant or advisory board member for Gilead, Merck and Invivyd related to Long COVID, outside the submitted work. Dr Brown has received consulting fees from Baxter and Breas Medical outside of the submitted work. Dr Castro has received grants from American Lung Association, AstraZeneca, Gala Therapeutics, Genentech, GSK, NIH, Novartis, PCORI, Pulmatrix, Sanofi, Shionogi, and Theravance Biopharma during the conduct of the study; consulting fees from Allakos, Amgen, Arrowhead Pharmaceuticals, Genentech, GSK, Merck & Co., Novartis, OM Pharma, Pfizer, Pioneering Medicines, Sanofi, and Teva; speaker fees from Amgen, AstraZeneca, Genentech, Regeneron Pharmaceuticals Inc, Sanofi, and Teva; and royalties from Aer Therapeutics. Dr Durstenfeld has received grants from the National Institutes of Health during the conduct of the study; and consulting fees from Merck outside the submitted work. Dr Erlandson has received grants from the National Institutes of Health during the conduct of the study; and consulting fees from Gilead, Merck, and ViiV outside of the submitted work (paid to the University of Colorado). Dr Flaherman has received grants from the National Institutes of Health during the conduct of the study. Dr Foulkes has received grants from NIH during the conduct of the study. Dr Heath has received grants from the National Institutes of Health and consulting fees from Regeneron during the conduct of this study. Dr Kellogg has received grants from the National Institute on Aging, National Institutes of Health, and Veterans Administration during the conduct of the study. Dr Levitan has received grants from the NIH during the conduct of this study; grants from Amgen unrelated to the current work; and personal fees from University of Pittsburgh. Dr McComsey has received grants from NIH and Pfizer during the conduct of the study; and consultant fees from Merck, Gilead, and GlaxoSmithkline unrelated to the current work. Dr Metz has received grants from Pfizer during the conduct of the study; and royalties from UpToDate unrelated to the current work. Dr Motl reports grants from National Institutes of Health, Department of Defense, PCORI, National MS Society, and Brystol Myers Squibb Foundation during the conduct of the study. Dr Mullington has received grants from the National Institutes of Health during the conduct of the study; and foundation research grants from the Open Medicine Foundation and Patient Led Collaborative. Dr Reeves has received grants from the National Institutes of Health during the conduct of this study. Dr Rischard reports grant support from NIH/NHLBI, United Therapeutics, Merck, OrphAI, Tenax, and Bayer. Dr Thaweethai has received grants from NIH during the conduct of the study. Dr Trinity reports grants from the National Institutes of Health and VA during the conduct of the study. Dr Urdaneta has received grants from the NIH during the conduct of this study. Dr Villanueva has received grants from NIH during the conduct of this study. Dr Walker has received grants from NIH, AHRQ, Alzheimer’s Association during the conduct of this study. Dr Wiley reports grants from the National Institutes of Health during conduct of the study. She also reports research grants from Health Resources and Service Administration (HRSA), Agency for Healthcare Research and Quality (AHRQ), and Administration for Strategic Preparedness and Response (ASPR) within the U.S. Department of Health and Human Services outside of the submitted work. Dr Sieberts has received grants from the NIH during the conduct of the study. Dr Krishnan has received grants from National Institutes of Health during the conduct of the study; research grants from the American Lung Association, BioVie Pharma, COPD Foundation, and Patient Centered Outcomes Research Institute outside the submitted work; and personal fees from AstraZeneca, Inogen, MedImmune, RespirAI, and Verona Pharma. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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