Using Wearable Devices to Track Effects of SARS-Cov-2 (COVID-19) on Health and Fitness
- Rafa
- May 23, 2021
- 3 min read
The 3 main factors affecting VO2max are
1. How much oxygenated blood your heart can pump
2. How much of it reaches your muscles
3. And finally, how much of it is actually utilized by your muscles.
Any pathology affecting one of these components will have a deleterious effect on an individual’s VO2max. Crameri et al. performed a well-established and validated physical fitness test before and after an outbreak of COVID-19 among young adult Swiss Air Force recruits by measuring the change in predicted maximal aerobic capacity (VO2 max) of not infected, asymptomatically infected and convalescent COVID-19 individuals in which found a decrease in VO2 max among COVID-19 convalescent but not among asymptomatically and not infected recruits[1]. In a prospective study by Dorelli et al. to establish the importance of cardiopulmonary exercise testing amongst patients recovering from COVID-19, more than one-fourth of post-COVID subjects presented with an exercise ventilatory inefficiency related to lower heart rate recovery which may signify systemic alterations present in these subjects[2]. While the exact pathophysiology behind these findings are yet to be fully explained, a reduced VO2 max is a hallmark of interstitial lung disease[3]. SARS-CoV-2 infection has been described to induce lung damage, even in asymptomatic cases[4]. This indicates the importance of further long-term follow-up studies to evaluate the extent and duration of the sequelae, as well as of preventive measures avoid these long-term consequences.
Aerobic exercise is related to improved cardiorespiratory fitness, which can be perceived by a greater oxygen consumption (VO2max) in ergonometric test. The VO2max, has also been shown to be an important indicator for risk stratification of surgical complications, interventions and hospital admissions[5]. If it is available, VO2max could be added to existing ‘triage’ criteria such as age and clinical background. While this idea is yet to be tested on a larger scale, the current COVID-19 outbreak has challenged physicians to think of new ways to ensure just and equitable admission criteria. It would allow clinicians to make objective decisions on a case-by-case basis that takes into account patients’ biological age and premorbid condition[6]. A low VO2 max could be used to identify patients who are unlikely to tolerate the physical demands of an intensive care admission and post-admission rehabilitation.
Conversely, when individuals with restrictive lung diseases are given pulmonary rehabilitation in the form of deep breathing exercises, it has shown to improve their VO2max[7].
1. Crameri GAG, Bielecki M, Zust R, Buehrer TW, Stanga Z, Deuel JW; Reduced maximal aerobic capacity after COVID-19 in young adult recruits, Switzerland, May. Eurosurveillance.. Sept 2020; 25(36)
2. Dorelli G et. al. Importance of Cardiopulmonary Exercise Testing amongst Subjects Recovering from COVID-19. Diagnostics 2021, 11, 507
file:///C:/Users/USER/Downloads/diagnostics-11-00507-v3.pdf
3. Wehr KL, Johnson RL Jr. Maximal oxygen consumption in patients with lung disease. J Clin Invest. 1976;58(4):880-90. https://doi.org/10.1172/JCI108541 PMID: 965494
4. Meng H, Xiong R, He R, Lin W, Hao B, Zhang L, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect. 2020;81(1):e33-9. https://doi.org/10.1016/j.jinf.2020.04.004 PMID: 32294504
5. West MA et. al. Validation of preoperative cardiopulmonary exercise testing-derived variables to predict in-hospital morbidity after major colorectal surgery. Br J Surg 2016 May;103(6):744-752. DOI: 10.1002/bjs.10112
6. Ahmed I (2020) COVID-19—does exercise prescription and maximal oxygen uptake (VO2 max) have a role in risk-stratifying patients? Clin Med 20: 282-284. doi: 10.7861/clinmed.2020-0111
7. Nurhasanah, Lisa & Setiawati, Erna & AP, Rahmi. (2019). Improvement of VO2 max in Patient with Restrictive Pulmonary Disorder after Deep Breathing Exercise. Indonesian Journal of Physical Medicine & Rehabilitation. 7. 10.36803/ijpmr.v7i01.129. https://www.researchgate.net/publication/337013965_Improvement_of_VO2_max_in_Patient_with_Restrictive_Pulmonary_Disorder_after_Deep_Breathing_Exercise
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