Perception of verticality in the post-COVID-19 condition correlates to infection severity

Bruno Henrique de Souza Fonseca; Pedro Henrique Sousa de Andrade; Maria Eduarda Salum Aveiro Henrique; Jussara Almeida de Oliveira Baggio; Rodrigo Bazan; Luciane Aparecida Pascucci Sande de Souza; Gustavo José Luvizutto

doi:10.1177/11795735231195693

Perception of verticality in the post-COVID-19 condition correlates to infection severity

J Cent Nerv Syst Dis. 2023 Aug 16:15:11795735231195693. doi: 10.1177/11795735231195693. eCollection 2023.

Authors

Bruno Henrique de Souza Fonseca¹, Pedro Henrique Sousa de Andrade¹, Maria Eduarda Salum Aveiro Henrique¹, Jussara Almeida de Oliveira Baggio², Rodrigo Bazan³, Luciane Aparecida Pascucci Sande de Souza¹, Gustavo José Luvizutto¹

Affiliations

¹ Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Brazil.
² Department of Medicine, Federal University of Alagoas, Maceió, Brazil.
³ Department of Neurology, Psychology, and Psychiatry, Botucatu Medical School, Botucatu, Brazil.

Abstract

Background: SARS-CoV-2 infection affects multiple systems, including musculoskeletal, neurological, and respiratory systems. Changes associated with physical inactivity due to prolonged hospitalization can affect the functional capacity of individuals with long coronavirus disease 2019 (COVID-19) or post-COVID-19 condition and may cause changes in some postural control functions, such as verticality.

Objectives: This study aimed to evaluate the perception of verticality in individuals with long COVID.

Design: Cross-sectional study.

Methods: This study included 60 participants with post-COVID-19 condition divided into 2 groups: hospitalized group (n = 24), those hospitalized owing to SARS-CoV-2 infection; and non-hospitalized group (n = 36), those infected with SARS-CoV-2 but not hospitalized. All participants were examined using a post-COVID-19 functional status (PCFS), sit-to-stand test, grip strength assessment, painful and tactile sensory assessments, visual acuity assessment, and vestibular assessment. Verticality perception was evaluated using the subjective visual vertical (SVV) and subjective haptic vertical (SHV) tests. In both tests, the absolute values (positive values only) and true values (positive and negative values) were considered. To verify potential confounders that could influence the verticality of the results, logistic regression models were used for categorical variables and multiple linear regressions were used for continuous variables. For analysis between groups, the independent samples test (Mann-Whitney U test) was used.

Results: There were no confounders between clinical variables and verticality in either group. There was a significant increase in absolute SVV (mean deviation [MD]: 2.83; P < .0001) and true SVV (MD: -4.18; P = .005) in the hospitalized group compared to the non-hospitalized group. Furthermore, there was a significant increase in the true SHV (MD: -3.6; P = .026) in the hospitalized group compared to that in the non-hospitalized group.

Conclusion: Less accurate visual and haptic verticality perception task performance was observed in hospitalized patients with post-COVID-19 condition.

Keywords: COVID-19; SARS-CoV-2; haptic vertical subjective; subjective visual vertical; verticality.