The following is a summary of “Association of SARS‐CoV‐2 Infection and Cardiopulmonary Long COVID With Exercise Capacity and Chronotropic Incompetence Among People With HIV,” published in the October 2023 issue of Cardiology by Durstenfeld et al.

The study aimed to investigate the impact of SARS‐CoV‐2 infection and Postacute sequelae of COVID‐19 (PASC) on exercise capacity and chronotropic incompetence in patients with HIV (PWH). Though both PASC and HIV are associated with decreased exercise capacity, their combined influence remains unclear. In this cross‐sectional study, the researchers conducted cardiopulmonary exercise testing within a COVID recovery cohort, including PWH with or without prior SARS‐CoV‐2 infection and individuals without HIV who had previous SARS‐CoV‐2 infection (controls). 

Among the 83 participants (median age, 54 years; 35% women; 37 PWH), peak oxygen consumption was notably lower in PWH compared to controls (80% predicted versus 99%, P=0.005), indicating a difference of 5.5 mL/kg per minute (95% CI, 2.7–8.2; P<0.001). Chronotropic incompetence was more prevalent in PWH, with a higher proportion experiencing reduced adjusted heart rate reserve (60% versus 83%, P<0.0001) compared to controls. While SARS‐CoV‐2 coinfection and PASC didn’t significantly impact exercise capacity among PWH, chronotropic incompetence was more frequent in PWH with PASC (64% with PASC versus 27% without PASC, P=0.04). 

Overall, the findings suggest that exercise capacity and chronotropy are significantly lower in PWH compared to individuals with SARS‐CoV‐2 infection but without HIV. Despite no strong association observed between SARS‐CoV‐2 infection, PASC, and reduced exercise capacity among PWH, chronotropic incompetence emerges as a potentially common, yet often overlooked, factor contributing to exercise intolerance, particularly in those with cardiopulmonary PASC.

Source: ahajournals.org/doi/10.1161/JAHA.123.030896