Name: GRAZYELLE MARIA SILVA PEREIRA DE MORAES
Publication date: 08/04/2025
Examining board:
Name |
Role |
|---|---|
| RAFAEL DE OLIVEIRA ALVIM | Examinador Externo |
| VERONICA LOURENCO WITTMER PASCOAL | Examinador Interno |
Summary: Introduction: Long COVID is a new clinical entity found in patients with a history of
COVID-19, characterized by symptoms that persist from the acute phase or new symptoms
that appear three months after the resolution of the acute phase of the disease. These
symptoms last for at least two months and cannot be explained by an alternative diagnosis.
Fatigue is one of the most common symptoms of Long COVID. Studies have shown
impairment in respiratory function and muscle strength during the acute infection phase and
early recovery stages, which may persist even after disease resolution.
Objectives: To investigate the frequency of symptoms associated with Long COVID and
their relationship with objective parameters of pulmonary and muscular function in
participants of Wave 4 of the ELSA-Brasil study, with and without a history of a previous
episode of COVID-19.
Methods: This was an observational, cross-sectional, and descriptive study conducted with
participants of Wave 4 of the ELSA-Brasil examinations, attended at the Cardiovascular
Investigation Clinic in Vitória-ES, in the years 2022 and 2023. Participants who came in for
examinations were invited to participate in a supplementary study on respiratory assessment.
Of the 209 who agreed, 121 attended and completed a structured questionnaire to obtain
personal data, history of previous COVID-19 episodes, vaccination status, and underwent
respiratory function assessment through spirometry, respiratory muscle strength assessment
through manovacuometry, and handgrip strength evaluation through manual dynamometry.
Data are presented as mean ± standard deviation for normally distributed variables and
median with interquartile range (IQR) for non-normally distributed variables, along with the
number and percentage of individuals. Statistical significance was set at p<0.05.
Results: The 121 participants had a mean age of 64.7 ± 7.9 years, with no significant
difference (p>0.05) between the groups with COVID (n = 79) and without COVID (n = 42) in
terms of age and sex distribution (56.7% female). Among the 79 participants with COVID, 73
had one or more mild cases of the disease (without the need for hospitalization). Of the six
who were hospitalized, none required assisted ventilation. The most prevalent symptoms in
the group without reported COVID-19 were neuropsychiatric symptoms, such as weaker
memory (42.8%), anxiety (35.7%), and sleep disturbances (33.3%). In the COVID group, the
most prevalent symptoms were weaker memory (41.7%), fatigue (39.2%), and hair loss
(32.9%). The median maximum inspiratory pressure in the COVID-19 group was -96 cmH2O
(IQR 78-116), and in the non-COVID group, -95 cmH2O (IQR 62-120) (p>0.05). The median
maximum expiratory pressure in the COVID-19 group was 112 cmH2O (IQR 90-120), and in
the non-COVID group, 116 cmH2O (IQR 92-120) (p>0.05). The median percentage of
predicted forced vital capacity in the spirometry test was 96% (89-102) in the COVID group
and 95% (82-101) in the non-COVID group (p>0.05). For forced expiratory volume in one
second the median predicted percentage was 96% (87-105) in the COVID group and 91%
(83-104) in the non-COVID group (p>0.05). There was also no difference between groups in
terms of handgrip strength.
Conclusion: The data suggest that persistent symptoms after COVID-19 are not related to
impaired pulmonary or muscular function and are not associated with a prior history of the
disease.
Funding: This study was supported by resources from the Ministry of Health/Decit and
CNPq. GMSP Moraes received a master's scholarship from FAPES.
