BODY MASS AND PHYSICAL ACTIVITY IN AUTONOMIC FUNCTION MODULATION ON POST-COVID-19 CONDITION: AN OBSERVATIONAL SUBANALYSIS OF FIT-COVID STUDY

Abstract

The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with COVID-19 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with COVID-19 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in post-COVID-19 group was increased (stress index; p=0.0273). They also presented lower values of parasympathetic activity (p<0.05). Overweight/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p<0.05). Physically inactive subjects in post-COVID-19 group presented significantly higher sympathetic activity than active subjects in control group. Parasympathetic activity was significantly increased in physically active subjects in control group compared to the physically inactive post-COVID-19 group (p<0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by Overweight/obesity and physical activity levels. Key Points- Our main finding is that even in mild and moderate infections, young adults who had COVID-19 had greater sympathetic activity, less parasympathetic activity, and global variability when compared to uninfected individuals. - In participants who were overweight and obese and/or physically inactive, cardiac autonomic modulation showed worse indices. - Our study provides new insights regarding the role of body mass index and physical activity status on post-COVID-19 infection autonomic deregulation that may contribute to the understand of pathophysiology and treatment of of post-acute sequelae SARS-CoV-2 infection.