Association of SARS-CoV-2 Infection and Cardiopulmonary Long COVID With Exercise Capacity and Chronotropic Incompetence Among People With HIV.
Association of SARS-CoV-2 Infection and Cardiopulmonary Long COVID With Exercise Capacity and Chronotropic Incompetence Among People With HIV.
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DOI：
10.1161/jaha.123.030896
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发表时间：
2023-10-17
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
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作者：
新冠肺炎的急性后遗症(PASC)和艾滋病毒都与运动能力降低有关，但在艾滋病毒携带者中，SARS-CoV-2或PASC是否与运动能力有关尚不清楚。我们假设PASC合并PWH会因变时性功能不全而降低运动能力。我们在COVID恢复队列中进行了横断面心肺运动试验，包括既往有和没有SARS-CoV-2感染的PWH和既往有SARS-CoV-2感染的未感染HIV的人(对照组)。我们评估了HIV、SARS-CoV-2和PASC与运动能力(峰值耗氧量)和变时性(调整后的心率储备)之间的关系。我们纳入了83名参与者(中位年龄54岁，女性35%，威斯康星37名)：37名威斯康星患者和所有46名对照中有23名(62%)有过 -CoV2感染史，23名威斯康星患者中有11名(48%)有PASC，46名未感染艾滋病毒的患者中有28名(61%)有PASC。与对照组相比，预见组的峰值氧耗量降低了80%和99%，P=0.005，相差5.5 毫升/公斤每分钟(95%可信区间为2.78.2；P<；0.001)。变时性功能不全在PWH患者中更为普遍(38%比11%，P=0.002)，与对照组相比，调整后的心率储备更低(60%比83%，P<；0.0001)。在PWH中，SARS-CoV-2合并感染和PASC与运动耐量无关。伴PASC的PWH患者中变时性功能不全更为常见：PASC组11例中7例(%)，而无PASC组26例中7例(27%)(P=0.04)。与未感染HIV的SARS-CoV-2感染者相比，PWH患者的运动能力和变时性较低。在PWH中，SARS-CoV-2感染和PASC与运动能力下降没有很强的相关性。变时性功能不全可能是PWH，尤其是心肺PASC患者运动不耐受的常见机制。
Postacute sequelae of COVID‐19 (PASC) and HIV are both associated with reduced exercise capacity, but whether SARS‐CoV‐2 or PASC are associated with exercise capacity among people with HIV (PWH) is unknown. We hypothesized that PWH with PASC would have reduced exercise capacity from chronotropic incompetence. We conducted cross‐sectional cardiopulmonary exercise testing within a COVID recovery cohort that included PWH with and without prior SARS‐CoV‐2 infection and people without HIV with prior SARS‐CoV‐2 infection (controls). We evaluated associations of HIV, SARS‐CoV‐2, and PASC with exercise capacity (peak oxygen consumption) and chronotropy (adjusted heart rate reserve). We included 83 participants (median age, 54 years; 35% women; 37 PWH): 23 out of 37 (62%) PWH and all 46 controls had prior SARS‐CoV‐2 infection, and 11 out of 23 (48%) PWH and 28 out of 46 (61%) without HIV had PASC. Peak oxygen consumption was reduced among PWH versus controls (80% predicted versus 99%, P=0.005), a difference of 5.5 mL/kg per minute (95% CI, 2.7–8.2; P<0.001). Chronotropic incompetence was more prevalent among PWH (38% versus 11%, P=0.002), with lower adjusted heart rate reserve (60% versus 83%, P<0.0001) versus controls. Among PWH, SARS‐CoV‐2 coinfection and PASC were not associated with exercise capacity. Chronotropic incompetence was more common among PWH with PASC: 7 out of 11 (64%) with PASC versus 7 out of 26 (27%) without PASC (P=0.04). Exercise capacity and chronotropy are lower among PWH compared with individuals with SARS‐CoV‐2 infection without HIV. Among PWH, SARS‐CoV‐2 infection and PASC were not strongly associated with reduced exercise capacity. Chronotropic incompetence may be a common underrecognized mechanism of exercise intolerance among PWH, especially those with cardiopulmonary PASC.
DOI：
10.1186/s12968-020-00664-6
发表时间：
2020-10-12
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
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作者：
Patterson AJ;Sarode A;Al-Kindi S;Shaver L;Thomas R;Watson E;Alaiti MA;Liu Y;Hamilton J;Seiberlich N;Rashid I;Gilkeson R;Schilz R;Hoit B;Jenkins T;Zullo M;Bossone E;Longenecker C;Simonetti O;Rajagopalan S
通讯作者：
Rajagopalan S