Abstract P124: Associations of SARS-CoV-2 Infection and Cardiorespiratory Fitness: Findings From the Cooper Center Longitudinal Study

Abstract

Introduction: Prior studies suggest that SARS-CoV-2 infection may be associated with declines in cardiorespiratory fitness (CRF), especially with Long COVID. Few studies have pre-pandemic CRF measures and appropriate comparison groups to evaluate differences in CRF by infection status. Thus, we aim to address these gaps using the well-characterized Cooper Center Longitudinal Study (CCLS) cohort. We hypothesize that SARS-CoV-2 infection will result in greater CRF decline compared to no infection and that CRF declines will be greatest among those with Long COVID. Methods: Data are from 3532 CCLS participants (26.6% women [938 of 3532]; mean age: 51.9 years) who presented for a Cooper Clinic preventive exam during 01/17-12/22 and had CRF assessed twice, i.e., pre-infection and after the COVID questionnaire was available (01/21). Reported SARS-CoV-2 infection status was defined as never diagnosed, diagnosed with symptoms ≤3 or >3 months (Long COVID). CRF was estimated as final workload in METs via a modified Balke treadmill protocol. Linear mixed effects regression models were used to compare pre-post fitness changes among COVID groups after adjustment for age, sex, smoking, BMI and face mask use during the test. Results: A total of 35.4% (1250 of 3532) of the sample reported SARS-CoV-2 infection and 1.7% (61 of 3532) reported symptoms ≥3 months. All 3 groups exhibited significant but minor decreases in mean CRF (0.2 METs). When compared to those without SARS-CoV-2, there were no differences in CRF changes among those with SARS-CoV-2 related symptoms ≤3 or >3 months after full covariate adjustment. Conclusions: Over an average of 2.8 years follow-up, CRF did not significantly vary by SARS-CoV-2 infection status or persistence of symptoms. While potential acute changes to CRF were not captured, these findings suggest that COVID infection does not accelerate age-related declines in CRF regardless of symptom length. Future longitudinal research will clarify if differences in CRF by infection status emerge over longer follow-up.