COVID-19 and athletes: Endurance sport and activity resilience study-CAESAR study

Daniel Śliż; Szczepan Wiecha; Katarzyna Ulaszewska; Jakub S Gąsior; Marcin Lewandowski; Przemysław Seweryn Kasiak; Artur Mamcarz

doi:10.3389/fphys.2022.1078763

COVID-19 and athletes: Endurance sport and activity resilience study-CAESAR study

Front Physiol. 2022 Dec 16:13:1078763. doi: 10.3389/fphys.2022.1078763. eCollection 2022.

Authors

Daniel Śliż^{1

2

3

4}, Szczepan Wiecha⁵, Katarzyna Ulaszewska², Jakub S Gąsior⁶, Marcin Lewandowski⁷, Przemysław Seweryn Kasiak^{1

2}, Artur Mamcarz^{1

3}

Affiliations

¹ 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, Warsaw, Poland.
² Students' Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
³ Polish Society of Lifestyle Medicine, Warsaw, Poland.
⁴ School of Public Health, Postgraduate Medical Education Center, Warsaw, Poland.
⁵ Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland.
⁶ Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland.
⁷ Department of Pharmacology and Clinical Pharmacology Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland.

Abstract

Background: The COVID-19 pandemic and imposed restrictions influenced athletic societies, although current knowledge about mild COVID-19 consequences on cardiopulmonary and physiologic parameters remains inconclusive. This study aimed to assess the impact of mild COVID-19 inflection on cardiopulmonary exercise test (CPET) performance among endurance athletes (EA) with varied fitness level. Materials and Methods: 49 EA (n_male = 43, n_female = 6, mean age = 39.94 ± 7.80 yr, height = 178.45 cm, weight = 76.62 kg; BMI = 24.03 kgm^-2) underwent double treadmill or cycle ergometer CPET and body analysis (BA) pre- and post-mild COVID-19 infection. Mild infection was defined as: (1) without hospitalization and (2) without prolonged health complications lasting for >14 days. Speed, power, heart rate (HR), oxygen uptake (VO₂), pulmonary ventilation, blood lactate concentration (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured before and after COVID-19 infection. Pearson's and Spearman's r correlation coefficients and Student t-test were applied to assess relationship between physiologic or exercise variables and time. Results: The anthropometric measurements did not differ significantly before and after COVID-19. There was a significant reduction in VO₂ at the AT and RCP (both p < 0.001). Pre-COVID-19 VO₂ was 34.97 ± 6.43 ml kg·min^-1, 43.88 ± 7.31 ml kg·min^-1 and 47.81 ± 7.81 ml kg·min^-1 respectively for AT, RCP and maximal and post-COVID-19 VO₂ was 32.35 ± 5.93 ml kg·min^-1, 40.49 ± 6.63 ml kg·min^-1 and 44.97 ± 7.00 ml kg·min^-1 respectively for AT, RCP and maximal. Differences of HR at AT (p < 0.001) and RCP (p < 0.001) was observed. The HR before infection was 145.08 ± 10.82 bpm for AT and 168.78 ± 9.01 bpm for RCP and HR after infection was 141.12 ± 9.99 bpm for AT and 165.14 ± 9.74 bpm for RCP. Time-adjusted measures showed significance for body fat (r = 0.46, p < 0.001), fat mass (r = 0.33, p = 0.020), cycling power at the AT (r = -0.29, p = 0.045), and HR at RCP (r = -0.30, p = 0.036). Conclusion: A mild COVID-19 infection resulted in a decrease in EA's CPET performance. The most significant changes were observed for VO₂ and HR. Medical Professionals and Training Specialists should be aware of the consequences of a mild COVID-19 infection in order to recommend optimal therapeutic methods and properly adjust the intensity of training.

Keywords: COVID-19; CPET cardiopulmonary exercise testing; SARS-CoV-2; VO2max (maximal oxygen uptake); endurance athlete; physical activity.