Avaliação da idade vascular em adultos pós-COVID-19 submetidos a um teste cardiopulmonar de exercício

Abstract

SARS-CoV-2 infection caused a global crisis in 2019 and, beyond the acute phase, can generate persistent vascular impacts, characterizing the so-called long COVID (LC), whose pathophysiology includes chronic inflammation, arterial stiffness, and possible acceleration of vascular age (VI). This was an observational, controlled, and stratified study, approved by the Ethics Committee (CAAE: 65086622.5.0000.5504), aimed to evaluate the VI response to physiological stress induced by a cardiopulmonary exercise test (CPET), comparing young adults with a history of LC to controls (CON) who had COVID. Thirty-eight participants with prior SARS-CoV-2 infection and complete vaccination schedule (18 CL; 20 CON) were analyzed. They were subdivided by sex and underwent VI measurements at different time points (baseline, pre-test, 10, 30, 60 minutes, and 24 hours post-CPET) using the Arteris AOP® device. Statistical analyses were performed in R software (v. 4.1.2) with the Friedman, Mann-Whitney U, and quantile regression tests. Analysis of variance indicated a significant effect of time on VI in the CON group (p = 0.017), with a trend toward a reduction at 30 and 60 minutes and a return to pre-test values at 24 hours.However, post hoc comparisons revealed no significant differences between the time points evaluated (p > 0.05). In the CL group, there were no significant variations in VI (p = 0.960). Men presented consistently higher VI at all time points analyzed, both in the CON and CL groups (p < 0.05), which may reflect physiological differences related to biological sex. Chronological age was the main predictor of VI in both groups (p < 0.001). Abdominal fat showed a negative correlation with VI only in the control group (p = 0.021). No significant correlations with VO₂max (p > 0.05) were observed in either group. It is concluded that VI did not modulate significantly in response to physiological stress, either in CON individuals or in those with a history of CL, reinforcing the need for longitudinal investigations and specific cardiovascular rehabilitation strategies.