Daily-life and work activities are more impaired in individuals with long covid who present cardiopulmonary symptoms: preliminary results from a cross-sectional assessment
Authors: Fonseca De Almeida E Val F , Cassia Da Luz Goulart C L G , Jefferson Valente J V , Anna Gabriela Rezende A G R , Bernardo Maia Da Silva B M S , Alexandre Vilhena Neto A V N , Guilherme Peixoto Tinoco Areas G P T A 
Published: June 2024

Abstract

Introduction
The persistence of symptoms for at least four weeks since the acute phase of Coronavirus disease 2019 (COVID-19) is characterized as Long Covid (LC). LC affects millions of people worldwide with multisystem impairments that may occur individually or concomitantly, such as memory loss, sleep difficulties, changes in smell and taste, cognitive changes, and cardiopulmonary morbidity such as arrhythmias, palpitations, chest pain, extreme fatigue, and post-exercise malaise.

Objective
To evaluate the impacts on daily life and work activities in individuals with LC who present cardiopulmonary symptoms (LCCP) compared to individuals without cardiopulmonary symptoms (LCnoCP).

Methods nd results
This study consisted of a cross-sectional assessment of the clinical profile presented by individuals living in Manaus, Amazonas, Brazil, after acute COVID-19 infection. Data were collected through phone interviews with a semi-structured questionnaire, covering sociodemographic and clinical information, in addition to the description of persistent COVID-19 symptoms and the difficulties related to them. The questions addressed the level of difficulty that individuals faced in different activities, such as: going to/attending work or studies; concentrating on things; taking self-care; taking care of family; doing necessary daily activities outside and engaging in activities they enjoy. The answers could be "Yes, a lot of difficulties", "Yes, a little difficulty" and "Not difficulties at all". 534 individuals were initially contacted. The participants were stratified into two groups: those reporting cardiopulmonary symptomology two years after acute COVID-19 (LCCP, n=354) and those without (LCnoCP, n=180). Reported cardiopulmonary symptoms were arrhythmia, systemic arterial hypertension, chest pain, fatigue, post-exercise malaise, and palpitations. Age and sex were similar between groups (44±7 vs 43±6 years, 70.6% vs 66.1% women, in LCCP and LCnoCP, respectively). The BMI ≥ 30 was significant between groups, with a higher proportion among the LCCP group: 82.7% vs 73.3%, p=0.01, indicating that obesity could be an important factor in developing cardiopulmonary complications after COVID-19. Regarding difficulties in daily life and work activities, the responses of both groups are shown in Figure 1. The LCCP group presented the highest proportions of great difficulty in work/study activities (49.4% vs 27.2%, p&lt;0.001) and moderate difficulty in concentration activities (37.8% vs 31.6%, p&lt;0.001).

Conclusion
Our results indicate that individuals with persistent cardiopulmonary symptoms after COVID-19 have more difficulties in work/study activities and concentrating, when compared to individuals without cardiopulmonary symptoms. Obesity (BMI ≥ 30) was more predominant in the group with cardiopulmonary symptoms.
Figure 1. Difficulties in daily life experienced by participants due to Long Covid symptoms: A) LCCP group, B) LCnoCP group.