The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals

Sophie L Russell; Nduka C Okwose; Mushidur Rahman; Ben J Lee; Gordon McGregor; Stuart M Raleigh; Hardip Sandhu; Laura C Roden; Prithwish Banerjee; Djordje G Jakovljevic

doi:10.1080/14017431.2025.2468339

The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals

Sophie L Russell
, Nduka C Okwose
, Mushidur Rahman
, Ben J Lee
, Gordon McGregor
, Stuart M Raleigh
, Hardip Sandhu
, Laura C Roden
, Prithwish Banerjee
, Djordje G Jakovljevic

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

50 Downloads (Pure)

Abstract

AIMS: Coronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.

METHODS: This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.

RESULTS: There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12%, non-COVID-19: 29.2 ± 8.44%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m 2, non-COVID-19: 2.79 ± 0.37 L/min/m 2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m 2, non-COVID-19: 47.0 ± 7.59 mL/m 2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O 2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m 2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m 2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m 2, p = 0.028).

CONCLUSION: Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise.

Original language	English
Article number	2468339
Number of pages	6
Journal	Scandinavian Cardiovascular Journal
Volume	59
Issue number	1
Early online date	28 Feb 2025
DOIs	https://doi.org/10.1080/14017431.2025.2468339
Publication status	Published - 31 Dec 2025

Bibliographical note

This is an open access article distributed under the terms of the creative commons attribution-noncommercial license (http://creativecommons.org/licenses/by-nc/4.0/), which permitsunrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funding

The study was supported by Coventry University COVID-19 Research and Innovation fund for the PhD Studentship developed by Professor Djordje Jakovljevic and awarded to SLR. DGJ, NO, and PB receive funding from the European Union\u2019s Horizon Europe research and innovation programme under grant agreement No 101080905 and United Kingdom Research and Innovation grant award with reference No 10073472. The design of the study, data collection, analyses, interpretation of data, and drafting of the manuscript do not reflect the views and opinions of the funders. Authors would like to thank participants for their time in undertaking the present study.

Funders	Funder number
Coventry University
Horizon Europe	101080905
UK Research and Innovation	10073472

Keywords

COVID-19
arterial function
cardiovascular function
exercise tolerance
oxygen consumption;
anaerobic threshold
arterial stiffness

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1080/14017431.2025.2468339Licence: CC BY-NC

Lee2025VORFinal published version, 1.32 MBLicence: CC BY-NC

Cite this

Russell, S. L., Okwose, N. C., Rahman, M., Lee, B. J., McGregor, G., Raleigh, S. M., Sandhu, H., Roden, L. C., Banerjee, P., & Jakovljevic, D. G. (2025). The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals. Scandinavian Cardiovascular Journal, 59(1), Article 2468339. https://doi.org/10.1080/14017431.2025.2468339

@article{f5c3df1f44a749bb85b20ec9a9f6d8c7,

title = "The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals",

abstract = "AIMS: Coronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.METHODS: This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8\% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5\% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.RESULTS: There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12\%, non-COVID-19: 29.2 ± 8.44\%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m 2, non-COVID-19: 2.79 ± 0.37 L/min/m 2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m 2, non-COVID-19: 47.0 ± 7.59 mL/m 2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O 2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m 2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m 2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m 2, p = 0.028). CONCLUSION: Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise.",

keywords = "COVID-19, arterial function, cardiovascular function, exercise tolerance, oxygen consumption;, anaerobic threshold, arterial stiffness",

author = "Russell, \{Sophie L\} and Okwose, \{Nduka C\} and Mushidur Rahman and Lee, \{Ben J\} and Gordon McGregor and Raleigh, \{Stuart M\} and Hardip Sandhu and Roden, \{Laura C\} and Prithwish Banerjee and Jakovljevic, \{Djordje G\}",

note = "This is an open access article distributed under the terms of the creative commons attribution-noncommercial license (http://creativecommons.org/licenses/by-nc/4.0/), which permitsunrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ",

year = "2025",

month = dec,

day = "31",

doi = "10.1080/14017431.2025.2468339",

language = "English",

volume = "59",

journal = "Scandinavian Cardiovascular Journal",

issn = "1401-7431",

publisher = "Taylor and Francis",

number = "1",

}

TY - JOUR

T1 - The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals

AU - Russell, Sophie L

AU - Okwose, Nduka C

AU - Rahman, Mushidur

AU - Lee, Ben J

AU - McGregor, Gordon

AU - Raleigh, Stuart M

AU - Sandhu, Hardip

AU - Roden, Laura C

AU - Banerjee, Prithwish

AU - Jakovljevic, Djordje G

N1 - This is an open access article distributed under the terms of the creative commons attribution-noncommercial license (http://creativecommons.org/licenses/by-nc/4.0/), which permitsunrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

PY - 2025/12/31

Y1 - 2025/12/31

N2 - AIMS: Coronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.METHODS: This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.RESULTS: There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12%, non-COVID-19: 29.2 ± 8.44%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m 2, non-COVID-19: 2.79 ± 0.37 L/min/m 2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m 2, non-COVID-19: 47.0 ± 7.59 mL/m 2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O 2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m 2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m 2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m 2, p = 0.028). CONCLUSION: Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise.

AB - AIMS: Coronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.METHODS: This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.RESULTS: There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12%, non-COVID-19: 29.2 ± 8.44%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m 2, non-COVID-19: 2.79 ± 0.37 L/min/m 2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m 2, non-COVID-19: 47.0 ± 7.59 mL/m 2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O 2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m 2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m 2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m 2, p = 0.028). CONCLUSION: Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise.

KW - COVID-19

KW - arterial function

KW - cardiovascular function

KW - exercise tolerance

KW - oxygen consumption;

KW - anaerobic threshold

KW - arterial stiffness

UR - https://www.scopus.com/pages/publications/105000549591

U2 - 10.1080/14017431.2025.2468339

DO - 10.1080/14017431.2025.2468339

M3 - Article

C2 - 39951893

SN - 1401-7431

VL - 59

JO - Scandinavian Cardiovascular Journal

JF - Scandinavian Cardiovascular Journal

IS - 1

M1 - 2468339

ER -

The effect of COVID-19 on cardiovascular function and exercise tolerance in healthy middle-age and older individuals

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this