Sex-Based Differences in Pulmonary Function and Cardiopulmonary Response 30 Months Post-COVID-19: A Brazilian Multicentric Study

Cássia da Luz Goulart, Guilherme Peixoto Tinoco Arêas, Mauricio Milani, Fernanda Facioli dos Reis Borges, Juliana Ribeiro Magalhães, Guilherme Dionir Back, Audrey Borghi-Silva, Luciano Fonseca Lemos Oliveira, André Ribeiro de Paula, Carolina Coimbra Marinho, Déborah Pereira Prado, Celso Nascimento de Almeida, Cristiane Maria Carvalho Costa Dias, Vinícius Afonso Gomes, Luiz Eduardo Fonteles Ritt, Leandro Tolfo Franzoni, Ricardo Stein, Mansueto Gomes Neto, Gerson Cipriano Junior and Fernando Almeida-Val ()
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Cássia da Luz Goulart: Physiological Science Department, Universidade Federal do Amazonas, Manaus 69067-005, Brazil
Guilherme Peixoto Tinoco Arêas: Physiological Science Department, Universidade Federal do Amazonas, Manaus 69067-005, Brazil
Mauricio Milani: Research Group on Cardiopulmonary Rehabilitation (GPRC), University of Brasilia (UnB), Brasilia 70910-900, Brazil
Fernanda Facioli dos Reis Borges: Physiological Science Department, Universidade Federal do Amazonas, Manaus 69067-005, Brazil
Juliana Ribeiro Magalhães: Physiological Science Department, Universidade Federal do Amazonas, Manaus 69067-005, Brazil
Guilherme Dionir Back: Cardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos, São Carlos 13565-905, Brazil
Audrey Borghi-Silva: Cardiopulmonary Physical Therapy Laboratory, Federal University of São Carlos, São Carlos 13565-905, Brazil
Luciano Fonseca Lemos Oliveira: Department of Internal Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
André Ribeiro de Paula: Department of Internal Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Carolina Coimbra Marinho: Department of Internal Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Déborah Pereira Prado: Department of Internal Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Celso Nascimento de Almeida: Bahiana Cardiorespiratory Physiotherapy Research Group, Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Brazil
Cristiane Maria Carvalho Costa Dias: Bahiana Cardiorespiratory Physiotherapy Research Group, Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Brazil
Vinícius Afonso Gomes: Bahiana Cardiorespiratory Physiotherapy Research Group, Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Brazil
Luiz Eduardo Fonteles Ritt: Bahiana Cardiorespiratory Physiotherapy Research Group, Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Brazil
Leandro Tolfo Franzoni: Department of Clinical Medicine, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, Brazil
Ricardo Stein: Department of Clinical Medicine, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, Brazil
Mansueto Gomes Neto: Physiotherapy Research Group, Federal University of Bahia, Salvador 40170-110, Brazil
Gerson Cipriano Junior: Research Group on Cardiopulmonary Rehabilitation (GPRC), University of Brasilia (UnB), Brasilia 70910-900, Brazil
Fernando Almeida-Val: Physiological Science Department, Universidade Federal do Amazonas, Manaus 69067-005, Brazil

IJERPH, 2024, vol. 21, issue 10, 1-10

Abstract: Aim : (I) to verify if there are sex differences in respiratory function, respiratory muscle strength, and effort limitation in individuals recovered from severe acute COVID-19 30 months after the initial infection, and (II) to evaluate the influence of length of stay on cardiorespiratory capacity among men and women. Methods : Cross-sectional observational multicentric study with participants from five Brazilian states (São Paulo, Amazonas, Minas Gerais, Bahia, and Brasília). We assessed lung function and respiratory muscle strength by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and cardiorespiratory fitness by cardiopulmonary exercise test (CPET). Results : 86 individuals were stratified by sex (48 women and 38 men). Females had significantly longer hospitalization for acute COVID-19 ( p < 0.05) and showed a marked reduction in MIP (cmH 2 O and % predicted). Regarding the CPET, women presented lower V ˙ O 2 % predicted, O 2 pulse, and oxygen uptake efficiency slope (OUES, % predicted) ( p < 0.05). In addition, women also had greater abnormal combinations between RER < 1.10, OUES < 80% predicted, VE/VVM < 15% [3 (6.2%)] and V ˙ O 2 % predicted < 80%, V ˙ E/ V ˙ CO 2 slope and V ˙ O 2 /workload < 8.4 mL/min/W [8 (17%)]. The regression analysis showed a significant influence of age, length of hospitalization (< and >10 days), and FEV 1 /FVC (%) on the V ˙ O 2 peak (mL·kg −1 ·min −1 ). Secondarily, we found that women hospitalized for more than 10 days had worse O 2 pulse ( p = 0.03), OUES % predicted ( p < 0.001), and worse V ˙ O 2 % predicted ( p < 0.009). Conclusion : Women exhibited more pronounced impairments in several key indicators of cardiopulmonary function 30 months post-infection.

Keywords: COVID-19; long-COVID; cardiopulmonary health; exercise test; cardiorespiratory fitness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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