[en] The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been classified as a pandemic by the World Health Organization. Based on the characteristics of COVID-19 during the acute phase of the disease, it can be considered as the paradigm of viral sepsis. In daily clinical practice, much attention has been focused on identifying prognostic factors during the acute phase of the disease, with findings similar to those previously described in sepsis. However, these patients may also present metabolic and functional alterations, the exact pathophysiological mechanism of which is currently poorly understood. Research on COVID-19 and its chronicity will allow us to deepen our understanding of these alterations. The main objective is to describe the metabolic alterations and functional sequelae during the follow-up of patients with a previous history of SARS-CoV-2 infection or COVID-19. Secondary objectives include characterizing the behavior of the lipid profile in each phase of the disease, identifying existing prognostic associations, and comparing the functional parameters evaluated in patients with persistent symptoms. Our analysis showed that COVID-19 is associated with a transient decrease in the lipid profile (total cholesterol, LDL-c, and HDL-), likely secondary to increased oxidative stress and inflammation. LDL-c, along with inflammatory markers (C-reactive protein and IL-6), were independent biomarkers associated with all-cause mortality during the acute phase of COVID-19. Furthermore, long-term follow-up revealed an atherogenic profile among COVID-19 survivors with more intense oxidative responses at admission. We also observed that patients with persistent symptoms during follow-up had worse quality of life and a depressed functional class. Findings from the cardiopulmonary exercise testing suggest the presence of ventilatory inefficiency or hyperventilation syndrome.

[es] La enfermedad por coronavirus 2019 (COVID-19) es causada por el virus del síndrome respiratorio agudo grave 2 (SARS-CoV-2) y ha sido declarada como una pandemia por la Organización Mundial de la Salud. Durante la fase aguda de la enfermedad, la COVID-19 comparte características con la sepsis viral. Además de los factores pronósticos comunes a la sepsis, los pacientes también pueden experimentar alteraciones metabólicas y funcionales cuyo mecanismo fisiopatológico aún no se comprende completamente. Estudiar la COVID-19 y su cronicidad nos ayudará a ampliar nuestro conocimiento sobre estas alteraciones. El objetivo principal de este estudio es describir las alteraciones metabólicas y las secuelas funcionales en pacientes con antecedentes de infección por SARS-CoV-2 o COVID-19 durante su seguimiento. Como objetivos secundarios, pretendemos caracterizar el perfil lipídico en cada fase de la enfermedad, identificar asociaciones pronósticas y comparar parámetros funcionales en pacientes con síntomas persistentes. En nuestro análisis, encontramos que la COVID-19 se relaciona con una disminución transitoria del perfil lipídico (colesterol total, LDL-c y HDL-c), posiblemente debido al aumento del estrés oxidativo e inflamación. Durante la fase aguda de la enfermedad, tanto el LDL-c como los marcadores inflamatorios (proteína C-reactiva e IL-6) se asociaron de forma independiente con la mortalidad por todas las causas. En el seguimiento a largo plazo, los supervivientes de la COVID-19 mostraron un perfil lipídico aterogénico y respuestas oxidativas más intensas al momento del ingreso. Además, aquellos pacientes que experimentaron síntomas persistentes presentaron una peor calidad de vida y una capacidad funcional deprimida. Los hallazgos de la ergoespirometría indicaron la presencia de una ineficiencia ventilatoria o síndrome de hiperventilación.