Journal Article

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

Neto, Mansueto Gomes, Cipriano Junior, Gerson, Stein, Ricardo, Borges, Fernanda Facioli dos Reis, Borghi-Silva, Audrey, Oliveira, Luciano Fonseca Lemos, Back, Guilherme Dionir, Milani, Mauricio, Marinho, Carolina Coimbra, de Paula, André Ribeiro, Ritt, Luiz Eduardo Fonteles, Magalhães, Juliana Ribeiro, Gomes, Vinícius Afonso, Goulart, Cássia da Luz, Prado, Déborah Pereira, Almeida, Celso Nascimento de, Arêas, Guilherme Peixoto Tinoco, Almeida-Val, Fernando, Dias, Cristiane Maria Carvalho Costa, Franzoni, Leandro Tolfo

2024

Overview

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 (cmH2O and % predicted). Regarding the CPET, women presented lower V˙O2% predicted, O2 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˙O2% predicted < 80%, V˙E/V˙CO2 slope and V˙O2/workload < 8.4 mL/min/W [8 (17%)]. The regression analysis showed a significant influence of age, length of hospitalization (< and >10 days), and FEV1/FVC (%) on the V˙O2 peak (mL·kg−1·min−1). Secondarily, we found that women hospitalized for more than 10 days had worse O2 pulse (p = 0.03), OUES % predicted (p < 0.001), and worse V˙O2% predicted (p < 0.009). Conclusion: Women exhibited more pronounced impairments in several key indicators of cardiopulmonary function 30 months post-infection.

• Publisher: MDPI AG,MDPI
• Subject: Adult / Body mass index / Brazil / Carbon dioxide / Cardiorespiratory Fitness - physiology / COVID-19 / COVID-19 - physiopathology / Cross-Sectional Studies / Epidemiology / Exercise Test / Female / Gender differences / Heart rate / Hospitalization / Humans / Infection / Infections / Long COVID / Lung - physiopathology / Male / Medical history / Medical research / Metabolism / Middle Aged / Muscle Strength / Regression analysis / Respiratory Function Tests / Respiratory Muscles - physiopathology / SARS-CoV-2 / Sex Factors / Sexes / Spirometry / Womens health / Workloads