Effects of COVID-19 infection on physical performance

Poster

Abstract

^{Background: COVID-19 infection, besides many other consequences, might have an impact on physical performance and strength even in healthy sportsmen. Cardiotoxic complication can be a threat long after the infection therefore time of returning to training is an important question. It is widely known that returning to training after COVID-19 infection must be careful and gradual, but sport medicine specialists need practical tools to make a medically safe decision regarding the timing of going back to physical activity and work. The aim of the present study was to determine the effects of COVID-19 symptoms on post infection physical performance.}

^{Methods: In our research we have analyzed the data of 47 divers and parachuters (age: 36,43 ± 9,52 years, with average BMI of 26,59 ± 2,44 kg/m²) physical performance with a modified Bruce treadmill protocol after an average of 66,91 days following COVID-19 diagnosis. The ‘Bruce protocol’ is performed on treadmill with standard workload by stages, setting the speed and the elevation starting with 2,7 km/h and 10% inclination in the 1st stage. For non-athletes each stage is 3 minutes, for athletes each load stage is usually 1 minute. For patients after COVID-19 infection we focused on moderate and more gradual increase of workload to ensure a longer warm up and medically well-monitored reaction to work load. Therefore in our modified Bruce protocol we used 2 minutes stages and the 1st stage was divided into 3 stages, 2,7 km/h with 0% inclination in stage 0, than 2,7 km/h with 5% inclination in stage ½ and then reach the 2,7 km/h speed with 10% inclination of the standard Bruce protocol stage 1. After this, the workload in the following stages were according to the standard Bruce protocol. The test included the continuous monitoring of pulse, blood pressure, ECG, blood oxygen level with a peripheral pulse oximeter and physical performance in term of metabolic equivalent (MET). Self-reported data on symptoms (fatigue, fever, loss of smell or taste perception, and cough) during COVID-19 infection were collected also.}

^{Results: Maximum level of physical performance (MET) was negatively associated with pulse reaction in each stage of workload (r= -0,374 - -0,706; p<0,01). Fever and loss of smell or taste perception were not associated with maximum MET, pulse reaction, blood pressure or changes in systolic and diastolic blood pressure. Cough was significantly related to pulse rates in stage 3 and stage 4 (p<0,05), participants reporting cough during COVID-19 infection had significantly lower pulse rates in the last two stages of examination. Fatigue was significantly associated (p<0,05) to the % of the age-adjusted vitamax pulse in stage 0, stage ½, stage 2, and to pulse rate in stage ½ (fatigue had marginally significant effect on pulse rates in stage 0, stage 1, stage 2, and on the % of the age-adjusted vitamax pulse in stage 1). Nevertheless, cough and fatigue had no effect on maximum MET, blood pressure and changes in systolic and diastolic blood pressure during the test. Participants having a chronic disease had significantly higher pulse rates in stage 0, stage ½ and stage 1, and marginally lower maximum MET. Having a chronic disease was significantly associated with having fever during COVID-19 infection (p<0,05), but not with other symptoms.}

^{Discussion: Our preliminary data suggest that among the typical symptoms of COVID-19 infection, fever or loss of taste and smell do not have significant effect on physical performance after approximately 2 months following the infection. Opposingly, the presence of subjective complain of fatigue and cough may have a significant impact on physical performance at the same time interval. Moreover it seems that this modified Bruce treadmill protocol is a safe way to measure the physical condition and may help to determine the date of safely returning to training or help to define the level of rehabilitation in case of more severe COVID-19 infection in gradual training programs.}