Longitudinal relationships between physical activity and heart rate in people with post-COVID-19 syndrome

Rodrigo Villar, Rachel Adodo, Sandra Webber, Diana C. Sanchez-Ramirez, Antonio Sarmento Da Nobrega
Purpose:

To investigate the longitudinal relationships between HR and PA in people with PCS, accounting for the presence of ME/CFS symptoms.

Methods:

Adults with PCS (symptoms ≥ 3 months post infection) were assessed for body mass index, lung function (spirometry), and ME/CFS symptoms (DePaul Symptom Questionnaire – short form) according to the Canadian Consensus Criteria. After performing the sit-to-stand and 6-minute walking test, participants were instructed to use two wearable devices (ActiGraph accelerometer and Garmin smartwatch) over 4 days while performing daily activities. Average HR, percentage of time in tachycardia (i.e., time with HR > 100 bpm), and daily step count were assessed. Daily steps were also used to categorize daily PA levels as sedentary, light intensity, and moderate-to-vigorous (MVPA). 

Results:

Sixteen participants completed the study (13 females, mean age of 51 ± 12 years) and walked an average of 3462 ± 1831 daily steps.   Although average HR was 85 ± 7 bpm, individuals spent 13.7 ± 10% of the time in tachycardia. Performance in the sit-to-stand and 6-minute walking test (in absolute and predicted values) was lower in individuals with ME/CFS symptoms (p 0.05). Daily step count was inversely correlated with average daily HR (r = -0.544, p = 0.03). Generalized linear mixed models adjusted by age, sex, and ME/CFS symptoms (yes and no) showed that average daily HR gradually increased across PA levels from sedentary to MVPA (p 0.01). However, the percentage of time spent in tachycardia was significantly lower during MVPA than during sedentary time (p = 0.03).

Conclusion(s):

Even accounting for ME/CFS symptoms, HR increased with PA level in people with PCS whereas the time in tachycardia was higher while performing little to no activity than when they were engaged in moderate-to-vigorous activities. 

Implications:

These findings may enhance the understanding of the relationship between HR responses and PA in individuals with PCS. While ME/CFS symptoms did not appear to affect the results, health professionals should consider screening for these symptoms in individuals with PCS and tailor rehabilitation protocols accordingly. These protocols should incorporate carefully monitored, safe levels of physical activity, aiming to achieve an optimal balance between activity and rest to prevent symptom exacerbation. 

Funding acknowledgements:
This work was supported by the Manitoba Lung Association
Keywords:
Post COVID-19 syndrome
physical activity
tachycardia
Primary topic:
Cardiorespiratory
Second topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Biomedical Research Ethics Board at the University of Manitoba
Provide the ethics approval number:
HS25555 (B2022:056)
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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