Background: The long-term consequences of COVID-19 infection are becoming increasingly evident in recent studies. This repeated cross-sectional study aimed to explore the long-term health and cognitive effects of COVID-19, focusing on how virus variants, vaccination, illness severity, and time since infection impact post-COVID-19 outcomes. Methods: We examined three cohorts of university students (N = 584) and used non-parametric methods to assess correlations of various health and cognitive variables with SARS-CoV-2 infection, COVID-19 severity, vaccination status, time since infection, time since vaccination, and virus variants. Results: Our results suggest that some health and cognitive impairments may persist, with some even appearing to progressively worsen-particularly fatigue in women and memory in men-up to four years post-infection. The data further indicate that the ancestral SARS-CoV-2 variant may have the most significant long-term impact, while the Omicron variant appears to have the least. Interestingly, the severity of the acute illness was not correlated with the variant of SARS-CoV-2. The analysis also revealed that individuals who contracted COVID-19 after vaccination had better health and cognitive outcomes compared to those infected before vaccination. Conclusions: Overall, our results indicate that even in young individuals who predominantly experienced only mild forms of the infection, a gradual decline in health and fitness can occur over a span of four years post-infection. Notably, some negative trends-at least in men-only began to stabilize or even reverse during the fourth year, whereas in women, these trends showed no such improvement. These findings suggest that the long-term public health impacts of COVID-19 may be more severe and affect a much broader population than is commonly assumed.

• Klíčová slova
• SARS-CoV-2, cognition, long COVID, long-term effects, mental health,
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Persistent post-COVID syndrome, also referred to as long COVID, is a pathologic entity that involves persistent physical, medical, and cognitive sequelae following COVID-19. Decreased fitness has repeatedly been reported in numerous studies dealing with post-COVID syndrome, however, it is still not fully clear which groups of patients may be more susceptible for persisting symptoms. AIM: The aim of our study was to evaluate the number of post-COVID patients with cardiac symptoms, where these patients were evaluated by CPET and the results compared with a control group of patients. METHODS: Follow-up of patients in post-COVID outpatient clinic from 1 March 2020 to 31 May 2022. Inclusion criteria were positive PCR test for SARS-CoV-2 and age 18-100. The initial examination was performed 4-12 weeks after the disease onset. All patients with possible cardiac symptoms had completed cardiopulmonary exercise testing. The control group was randomly selected from a database of clients in 2019, with the preventive reason for evaluation. RESULTS: From 1 March 2020 to 31 May 2022, 2732 patients (45.7% males) were evaluated with a mean age of 54.6 ± 14.7. CPET was indicated only in 97 patients (3.5%). Seventy-four patients (26 male) achieved the exercise maximum and a comparison were made with a control group (same age (p = 0.801), BMI (p = 0.721), and sex ratio). No significant dependence between the parameter VO2 max mL/kg/min and post-COVID disability was demonstrated (p = 0.412). Spearman's correlation analysis did not show a significant relationship between the parameter VO2 max mL/kg/min and the severity of COVID-19 (p = 0.285). CONCLUSIONS: Cardiac symptoms occurred in only a small percentage of patients in our study. There is a need for further studies that would objectively evaluate the effect of COVID-19 disease on the patient's health.

• Klíčová slova
• cardiopulmonary exercise testing, post-COVID syndrome,
• Publikační typ
• časopisecké články MeSH

The aim of this study was to determine the relationship between physical fitness, cardiopulmonary function and patient-reported severity of symptoms in people with post-COVID-19 condition. We examined ambulatory patients (n = 72) with post-COVID-19 condition who had a chronic symptomatic phase lasting > 12 weeks from the onset of symptoms, but had not been hospitalized for acute COVID-19. A comprehensive medical screening was conducted, including clinical history, symptomatology, comorbidities, body composition and physical activity levels. We then identified the relationship between physical fitness (cardiorespiratory fitness and muscular strength), cardiopulmonary function (echocardiographic and spirometry parameters) and patient-reported severity of symptoms (fatigue, dyspnea, health-related quality of life, anxiety, and depression). Age, body mass index, sex, number of comorbidities and duration of symptoms were included as potential confounders. Results showed that greater physical fitness and cardiopulmonary function were associated with lower severity of symptoms in people with post-COVID-19 condition. Cardiorespiratory fitness, lower-limb muscle strength, maximal voluntary ventilation and left ventricular ejection fraction account for reducing fatigue and dyspnea. Greater physical activity levels were associated with fewer symptoms and less-severe fatigue and dyspnea. In conclusion, preserving better cardiopulmonary health and physical condition during the course of the disease-even in mild cases-was related to a lower intensity of symptoms in non-hospitalized people with post-COVID-19 condition. It is probable that exercise and physical conditioning are valuable pre- and post-COVID-19 countermeasures that could help decrease the severity, not only of acute infection, but of post-COVID-19 persistent symptoms and prognosis.

• Klíčová slova
• Breathlessness, Fatigue, Long COVID-19, Post-COVID-19 syndrome, Post-exercise malaise, Rehabilitation,
• MeSH
• COVID-19 * epidemiologie   MeSH
• dyspnoe etiologie   MeSH
• funkce levé komory srdeční MeSH
• kvalita života * MeSH
• lidé MeSH
• tělesná výkonnost MeSH
• tepový objem MeSH
• únava etiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

AIM: We focused on the clinical picture, severity and prognosis of children who experienced long-term respiratory issues after COVID-19. METHODS: This was a national Czech multicentre study of paediatric post-COVID syndrome, which used a standard protocol to evaluate structural and functional anomalies and exclude alternative diagnoses. From 6 January to 30 June 2021, 11 paediatric pulmonologists enrolled all paediatric referrals aged 2-18 years with persistent respiratory symptoms more than 12 weeks after COVID-19, namely cough, dyspnoea and chest pain. Medical histories were taken, and physical examinations, lung function testing, chest X-ray and blood tests were performed. RESULTS: The dominant symptoms in the 39 children (56.4% girls) were exertional dyspnoea (76.9%) and a chronic cough (48.7%), while dyspnoea at rest (30.8%) and chest pain (17.9%) were less prevalent. More than half (53.8%) reported more than 1 symptom, and 38.5% had abnormal results for 1 of the following tests: lung function, chest X-ray or D-dimers. The median age of the children was 13.5 years (interquartile range ±4.8 years), and the median recovery time was 4 months (range 1.5-8 months). CONCLUSION: Our initial data suggest that the long-term respiratory impact of COVID-19 was relatively mild in our cohort, with a favourable prognosis.

• Klíčová slova
• COVID-19, chronic cough, coronavirus, dyspnoea, post-COVID syndrome,
• MeSH
• bolesti na hrudi MeSH
• COVID-19 * komplikace   MeSH
• dítě MeSH
• dyspnoe MeSH
• kašel MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• SARS-CoV-2 MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH