The research in this VA Merit will examine the effects of obesity and Post-COVIDConditions (PCC) on physical functioning, health-related quality of life, and adiposetissue inflammatory and cellular senescence profiles in older Veterans. Further, it willevaluate whether a weight loss intervention, including dietary modification and exercise,in obese Veterans with and without PCC will reduce systemic and adipose tissueinflammation and senescence and promote PCC recovery.
Findings of post-acute sequelae of Post-COVID Conditions (PCC) manifestations of fatigue,
pain, dyspnea, and muscle weakness, provide a strong rationale for rehabilitation; yet
few formal studies exist and the effects of severe acute respiratory syndrome
coronavirus-2 infection on function are not well described. Notably, two-thirds of
Veterans are overweight and obese, rendering excess adiposity a significant risk factor
and a high-priority area related to PCC prevention and care. Obesity increases the risk
of severe illness in Veterans recovering from PCC, but how it does so is not fully
understood.
Recent research suggests that excess adipose tissue is associated with adverse changes in
adipose cellular function, and that these variations may be involved in the biology of
aging and the etiology of aging-related diseases. Adipose tissue contains cells that have
undergone cellular senescence, which induces inflammation, cytotoxicity, and metabolic
dysfunction in other cells and tissues. However, the precise role of adipose tissue
cellular composition on PCC recovery is limited.
Thus, the investigators propose to evaluate the role of obesity and PCC on physical
functioning, health-related quality of life (HRQOL), and systemic and adipose tissue
inflammatory and cellular senescence profiles in ethnically diverse older Veterans from
the Audie Murphy (San Antonio) and Baltimore VA Medical Centers. Further, the
investigators propose a randomized controlled trial to determine whether a reduction in
body weight and increased physical function by a weight loss intervention (WL), including
dietary modification and exercise, in obese Veterans with PCC will reduce systemic and
adipose tissue inflammation and senescence, which will have important implications for
PCC recovery.
Behavioral: 12-weeks of Weight Loss
Participants will be asked to participate in a 1x/week center-based nutrition diet class,
2x/week center-based exercise classes, and 1x/week exercise session conducted on their
own for 12 weeks.
Behavioral: 12-weeks of Weight Stability
Participants will be asked to participate in a 1x/week center-based health education
class, 2x/week center-based stretching/balance classes, and 1x/week stretching/balance
session conducted on their own for 12 weeks.
Inclusion Criteria:
1. U.S. Veteran
2. No Post-COVID symptoms or at least one Post-COVID symptom lasting >4 weeks
3. Body Mass Index: 19-25 or 30-40 kg/m2
4. Postmenopausal status for women
Exclusion Criteria:
1. Neurologic, musculoskeletal, or other condition that limits subject's ability to
complete study physical assessments
2. Active inflammatory, COVID-19, autoimmune, infectious, hepatic (LFTs > 2.5 x WNL),
renal (eGFR<45), gastrointestinal, malignant, and psychiatric disease
3. Uncontrolled diabetes (HbA1c >10% or the current use of insulin)
4. Weight change within the past month of >5 kg
5. History of keloid formation
6. Self-reported alcohol or drug abuse
7. Anti-coagulant medication usage
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD
Baltimore, Maryland, United States
South Texas Health Care System, San Antonio, TX
San Antonio, Texas, United States
Monica C Serra, PhD
(814) 332-9939
Monica.Serra@va.gov
Tim Calderon, MS
(210) 617-5300 - 13898
tim.calderon@va.gov
Monica C Serra, PhD, Principal Investigator
South Texas Health Care System, San Antonio, TX