Chronotropic incompetence is associated with reduced aerobic conditioning and sedentary behavior in patients with post-acute COVID-19 syndrome

Authors

  • Milena dos Santos Barros Campos Universidade Tiradentes, Departamento de Medicina, Aracaju, Sergipe, Brazil; Universidade Federal de Sergipe, Hospital Universitário, Divisão de Cardiologia, Aracaju, Sergipe, Brazil; Rede D’Or São Luiz, Clínica e Hospital São Lucas, Aracaju, Sergipe, Brazil https://orcid.org/0000-0003-4254-1609
  • Gabriela Menezes Gonçalves de Brito Universidade Tiradentes, Departamento de Medicina, Aracaju, Sergipe, Brazil https://orcid.org/0000-0002-8055-1480
  • Karinne Simões da Cruz Santos Universidade Tiradentes, Departamento de Medicina, Aracaju, Sergipe, Brazil https://orcid.org/0000-0003-3379-2406
  • Marcos Antonio Almeida Santos Universidade Tiradentes, Departamento de Medicina, Aracaju, Sergipe, Brazil; Universidade Tiradentes, Programa de Pós-Graduação em Saúde e Meio Ambiente, Aracaju, Sergipe, Brazil https://orcid.org/0000-0003-0622-6257
  • Paulo Ricardo Martins-Filho Universidade Federal de Sergipe, Programa de Pós-Graduação em Ciências da Saúde, Aracaju, Sergipe, Brazil; Universidade Federal de Sergipe, Laboratório de Patologia Investigativa, Aracaju, Sergipe, Brazil https://orcid.org/0000-0001-8779-0727
  • Antônio Carlos Sobral Sousa Universidade Federal de Sergipe, Programa de Pós-Graduação em Ciências da Saúde, Aracaju, Sergipe, Brazil; Universidade Federal de Sergipe, Hospital Universitário, Divisão de Cardiologia, Aracaju, Sergipe, Brazil; Rede D’Or São Luiz, Clínica e Hospital São Lucas, Aracaju, Sergipe, Brazil https://orcid.org/0000-0003-0439-9808

DOI:

https://doi.org/10.1590/

Keywords:

COVID-19, Post-acute COVID-19 syndrome, Long COVID-19, Exercise test, Cardiovascular system, Sedentary behavior

Abstract

Post-acute COVID-19 syndrome, or long COVID, presents with persistent symptoms, including cough, dyspnea, and fatigue, extending beyond one month after SARS-CoV-2 infection. Cardiac complications such as chest pain and arrhythmias have raised concerns, with chronotropic incompetence (CI), an inadequate heart rate increase during exercise, emerging as a significant condition contributing to diminished exercise tolerance and quality of life. This study estimated the prevalence of CI and explored its association with aerobic capacity and physical activity levels in long COVID patients. A cross-sectional study was conducted at a private hospital in Sergipe, Brazil, involving 93 patients over 18 years old with persistent post-COVID-19 symptoms after confirmed SARS-CoV-2 infections. Exclusion criteria included beta-blocker use, inadequate respiratory exchange ratio, and inability to complete cardiopulmonary exercise testing (CPET). Clinical histories, CPET results, and chronotropic index calculation were used to identify CI, with logistic regression analyzing associated factors. Of the participants (mean age 45 years; average duration since COVID-19 diagnosis 120 days), 20.4% were diagnosed with CI. Logistic regression identified a strong association between CI and sedentary behavior (OR 11.80; 95% CI 2.54 to 54.78; p=0.001). Patients with CI showed lower predicted peak heart rates and maximal oxygen uptake. The prevalence of CI among long COVID patients in this study was approximately 20%, associated with decreased aerobic capacity and increased sedentary behavior. These findings highlight the need for timely diagnosis and therapeutic interventions, including cardiopulmonary rehabilitation, to enhance the quality of life in post-COVID patients with CI. The study’s cross-sectional design and its specific context have limited causality inference and generalizability, underscoring the importance of further research in diverse settings.

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Published

2024-05-14

Issue

Section

Brief Communication

How to Cite

Campos, M. dos S. B., Brito, G. M. G. de, Santos, K. S. da C., Santos, M. A. A., Martins-Filho, P. R., & Sousa, A. C. S. (2024). Chronotropic incompetence is associated with reduced aerobic conditioning and sedentary behavior in patients with post-acute COVID-19 syndrome. Revista Do Instituto De Medicina Tropical De São Paulo, 66, e32. https://doi.org/10.1590/