Late Breaking Abstract - Muscle Oxygenation Kinetics Are Impaired in Long COVID: A Case-Control Study Using NIRS

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Objective: to evaluate the kinetics of oxyhemoglobin (oxy-[Hb/Mb]) and deoxyhemoglobin (deoxy-[Hb/Mb]) in individuals with Post-Acute Sequelae of SARS-CoV-2 infection (PASC), compared to a control group. Methods: This observational case-control study included individuals with PASC (n=30) and a matched control group (n=10) who had tested positive for COVID-19 but were either asymptomatic. Participants underwent constant-load exercise tests, with near-infrared spectroscopy (NIRS) used to measure oxy- and deoxy-[Hb/Mb] kinetics in the vastus lateralis muscle. Results: The most prevalent comorbidities among long COVID patients were hypertension (70%) and obesity (43%). All participants receiving at least two doses of a COVID-19 vaccine. Our findings revealed that individuals with long COVID exhibited significantly slower mean response time (MRT) in both oxy-[Hb/Mb] and deoxy-[Hb/Mb] kinetics compared to controls (p<0.05). Body adiposity was correlated with both oxy-[Hb/Mb] τ (r=0.488) and MRT (r=0.431). Multivariate regression analysis demonstrated that BMI was the primary factor influencing delayed τ (β = 5.8; 95% CI: 1.3 to 10.3; p = 0.012) and MRT (β = 7.6; 95% CI: 1.1 to 14.1; p = 0.023) of oxy-[Hb/Mb]. Obesity was also identified as a significant independent predictor of these kinetic impairments, irrespective of sex or COVID-19 severity, and had notably slowered τ and MRT responses (p<0.001). Conclusion: This study identified significant impairments in muscle oxygenation and cardiorespiratory kinetics during exercise in individuals with PASC, particularly those with comorbid obesity.

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