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

• Published in: American journal of physiology. Regulatory, integrative and comparative physiology Vol. 325; no. 3; pp. R269 - R279
• Main Authors: Faria, Diego, Moll-Bernardes, Renata, Testa, Laura, Moniz, Camila M V, Rodrigues, Erika C, Mota, Jose M, Souza, Francis R, Alves, Maria Janieire N N, Ono, Bruna E, Izaias, João E, Sales, Artur O, Rodrigues, Thais S, Salemi, Vera M C, Jordão, Camila P, De Angelis, Katia, Craighead, Daniel H, Rossman, Matthew J, Bortolotto, Luiz A, Consolim-Colombo, Fernanda M, Irigoyen, Maria C C, Seals, Douglas R, Negrão, Carlos E, Sales, Allan R K
• Format: Journal Article
• Language: English
• Published: United States American Physiological Society 01.09.2023
• Subjects: Adult; Blood Pressure - physiology; COVID-19; Exercise - physiology; Forearm - blood supply; Hand Strength; Heart Rate - physiology; Hemodynamics; Humans; Middle Aged; Muscle, Skeletal - innervation; Sympathetic Nervous System; peripheral blood flow; exercise; sympathetic activity; vascular conductance; mental stress
• ISSN: 0363-6119; 1522-1490
• DOI: 10.1152/ajpregu.00111.2023

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/m ) and 15 well-matched control subjects (aged: 46 ± 3 yr, BMI: 29 ± 1 kg/m ) 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 ( < 0.001), and FBF and FVC responses were attenuated ( < 0.05). MAP was similar between the groups ( > 0.05). In contrast, the MSNA (frequency and incidence) and FBF and FVC responses to handgrip exercise were similar between the groups ( > 0.05). MAP was lower in COVID-19 survivors ( < 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.