Neurovascular and hemodynamic responses to mental stress and exercise in severe COVID-19 survivors

• DOI: 10.1152/ajpregu.00111.2023
• Publication Date: 2023-07-14T13:12:46Z
• Authors: Diego Faria; Renata Moll-Berna...; Laura Testa; Camila M. V. Moniz; Erika C. Rodrigues; Jose M. Mota; Francis R. Souza; Maria Janieire N....; Bruna E. Ono; João E. Izaias; Artur O. Sales; Thais S. Rodrigues; Vera M. C. Salemi; Camila P. Jordão; Katia De Angelis; Daniel H. Craighead; Matthew J. Rossman; Luiz A. Bortolotto; Fernanda M. Conso...; Maria C. C. Irigoyen; Douglas R. Seals; Carlos E. Negrão; Allan R. K. Sales
• Keywords: Adult; Forearm; Sympathetic Nervous System; Hand Strength; Heart Rate; Hemodynamics; Humans; COVID-19; Blood Pressure; Middle Aged; Muscle, Skeletal; Exercise; 3. Good health

Previous studies show that COVID-19 survivors have elevated muscle sympathetic nerve activity (MSNA), endothelial dysfunction, and aortic stiffening. However, the neurovascular responses to mental stress and exercise are still unexplored. We hypothesized that COVID-19 survivors, compared with age- and body mass index (BMI)-matched control subjects, exhibit abnormal neurovascular responses to mental stress and physical exercise. Fifteen severe COVID-19 survivors (aged: 49 ± 2 yr, BMI: 30 ± 1 kg/m2) and 15 well-matched control subjects (aged: 46 ± 3 yr, BMI: 29 ± 1 kg/m2) were studied. MSNA (microneurography), forearm blood flow (FBF), and forearm vascular conductance (FVC, venous occlusion plethysmography), mean arterial pressure (MAP, Finometer), and heart rate (HR, ECG) were measured during a 3-min mental stress (Stroop Color-Word Test) and during a 3-min isometric handgrip exercise (30% of maximal voluntary contraction). During mental stress, MSNA (frequency and incidence) responses were higher in COVID-19 survivors than in controls ( P < 0.001), and FBF and FVC responses were attenuated ( P < 0.05). MAP was similar between the groups ( P > 0.05). In contrast, the MSNA (frequency and incidence) and FBF and FVC responses to handgrip exercise were similar between the groups ( P > 0.05). MAP was lower in COVID-19 survivors ( P < 0.05). COVID-19 survivors exhibit an exaggerated MSNA and blunted vasodilatory response to mental challenge compared with healthy adults. However, the neurovascular response to handgrip exercise is preserved in COVID-19 survivors. Overall, the abnormal neurovascular control in response to mental stress suggests that COVID-19 survivors may have an increased risk to cardiovascular events during mental challenge.