The post-COVID syndrome poses an unprecedented challenge to modern society, affectingmillions of people worldwide. Persistent fatigue and exercise intolerance are among themost common complaints of these subjects. The mechanisms of exercise intolerance inpost-COVID subjects are remained yet unknown, which make the rehabilitation effortscomplex and challenging. The overall goals of this project are to: 1) improvephysiological understanding of symptoms in this clinical condition, 2) elucidateplausible mechanisms to explain exercise intolerance/symptom exacerbation, and finally 3)provide knowledge that can be directly applied in the clinical setting to improvediagnosis, care, and individualized rehabilitation of subjects with post-COVID syndrome.Post-COVID subjects and age/sex matched healthy controls will undertake a comprehensiveset of physiological and functional assessments, followed by 3 experimental visits (in arandomized order), where acute exercise responses will be assessed in either continuousmoderate intensity aerobic exercise, high intensity interval exercise, or strengthtraining. The same set of physiological assessments will also be performed after 1 yearin both post-COVID subjects and healthy-matched controls to better understand the timecourse of the syndrome. It is hypothesized that the mechanism responsible for exerciseintolerance is linked to specific symptoms and will vary across subjects. However, it isexpected that most post-COVID subjects will respond well to at least one type ofexercise.
Not Provided
Procedure: High-Intensity-Interval-Exercise
Subjects will perform high-intensity-interval exercise, where the acute exercise
responses will be closely monitored, including measurements of O2 saturation, heart rate,
blood pressure, borg scale and blood lactate. In addition, symptoms via multiple
validated questionnaries and blood samples will be collected before, immediately after
each exercise session to describe leukocyte and cytokine release as well as systemic
metabolism. After a 48-hour rest period subjects will return to the laboratory for
symptom assessment, submaximal exercise response (CPET), and blood sampling.
Other Name: HIIE
Procedure: Moderate-Intensity-Continuous-Exercise
Subjects will perform moderate intensity continuous exercise, where the acute exercise
responses will be closely monitored, including measurements of O2 saturation, heart rate,
blood pressure, borg scale and blood lactate. In addition, symptoms via multiple
validated questionnaries and blood samples will be collected before, immediately after
each exercise session to describe leukocyte and cytokine release as well as systemic
metabolism. After a 48-hour rest period subjects will return to the laboratory for
symptom assessment, submaximal exercise response (CPET), and blood sampling.
Other Name: MICE
Procedure: Strength training
Subjects will perform a series of a whole-body resistance exercises, where the acute
exercise responses will be closely monitored, including measurements of O2 saturation,
heart rate, blood pressure, borg scale and blood lactate. In addition, symptoms via
multiple validated questionnaries and blood samples will be collected before, immediately
after each exercise session to describe leukocyte and cytokine release as well as
systemic metabolism. After a 48-hour rest period subjects will return to the laboratory
for symptom assessment, submaximal exercise response (CPET), and blood sampling.
Other Name: Resistance training
Procedure: Baseline assessment
Subjects will perform a series of baseline assessment including neurophysiological
function, circulatory and vascular function, blood volume assessment,
respiratory/ventilatory function, maximal oxygen uptake, strength, physical function and
fitness, blood status and muscle biopsy.
Procedure: 1 year follow-up
Subjects will perform the same series of baseline assessment in 1-year time, including
neurophysiological function, circulatory and vascular function, blood volume assessment,
respiratory/ventilatory function, maximal oxygen uptake, strength, physical function and
fitness, blood status and muscle biopsy.
Inclusion Criteria:
- Verified test of covid-19 infection (PCR, or antigen or antibody before vaccination)
(mandatory only for post-COVID group)
- Symptoms persisting for at least 3 months (validaded with DSQ-PEM questionnarie)
(only for post-COVID group)
Exclusion Criteria:
- Subject's complaints may have been present before March 2020
- Previous history cardiovascular, respiratory disease or other autoimmune disease
- History of general anxiety syndrome or somatic symptom disorder
Karolinska University Hospital Huddinge
Stockholm, Huddinge, Sweden