症状前 COVID-19 对血管和骨骼肌功能的影响：案例研究。应用生理学杂志
Impact of presymptomatic COVID-19 on vascular and skeletal muscle function: a case study
Keywords：Blood flow, Endothelium, Mitochondria, Muscle strength, SARS-CoV-2 virus
关键词：血流、内皮、线粒体、肌肉力量、SARS-CoV-2 病毒
哺乳动物：人
组织：骨骼肌
作者：Trinity Joel D、Craig Jesse C、Fermoyle Caitlin C、McKenzie Alec I、Lewis Matthew T、Park Soung Hun、Rondina Matthew T、Richardson Russell S
出版期刊：《J Appl Physiol》 （2021）
Abstract：
The impact of COVID-19 has been largely described after symptom development. Although the SARS-CoV-2 virus elevates heart rate (HR) prior to symptom onset, whether this virus evokes other presymptomatic alterations is unknown. This case study details the presymptomatic impact of COVID-19 on vascular and skeletal muscle function in a young woman [24 yr, 173.5 cm, 89 kg, body mass index (BMI): 29.6 kg·m-2]. Vascular and skeletal muscle function were assessed as part of a separate study with the first and second visits separated by 2 wk. On the evening following the second visit, the participant developed a fever and a rapid antigen test confirmed a positive COVID-19 diagnosis. Compared with the first visit, the participant presented with a markedly elevated HR (∼30 beats/min) and a lower mean blood pressure (∼8 mmHg) at the second visit. Vascular function measured by brachial artery flow-mediated dilation, reactive hyperemia, and passive leg movement were all noticeably attenuated (25%-65%) as was leg blood flow during knee extension exercise. Muscle strength was diminished as was ADP-stimulated respiration (30%), assessed in vitro, whereas there was a 25% increase in the apparent Km. Lastly, an elevation in IL-10 was observed prior to symptom onset. Notably, 2.5 mo after diagnosis symptoms of fatigue and cough were still present. Together, these findings provide unique insight into the physiological responses immediately prior to onset of COVID-19 symptoms; they suggest that SARS-CoV-2 negatively impacts vascular and skeletal muscle function prior to the onset of common symptoms and may set the stage for the widespread sequelae observed following COVID-19 diagnosis.NEW & NOTEWORTHY This unique case study details the impact of SARS-CoV-2 infection on vascular and skeletal muscle function in a young predominantly presymptomatic woman. Prior to COVID-19 diagnosis, substantial reductions in vascular, skeletal muscle, and mitochondrial function were observed along with an elevation in IL-10. This integrative case study indicates that the presymptomatic impact of COVID-19 is widespread and may help elucidate the acute and long-term sequelae of this disease.
文章摘要：
COVID-19 的影响主要是在症状发展后描述的。尽管 SARS-CoV-2 病毒会在症状出现之前提高心率 (HR)，但这种病毒是否会引起其他症状前的改变尚不清楚。本案例研究详细介绍了 COVID-19 对一名年轻女性 [24 岁，173.5 cm，89 kg，体重指数 (BMI)：29.6 kg·m -2的症状前影响]。血管和骨骼肌功能作为单独研究的一部分进行评估，第一次和第二次访问相隔 2 周。在第二次访问后的晚上，参与者发烧，快速抗原检测证实 COVID-19 诊断呈阳性。与第一次就诊相比，参与者在第二次就诊时出现明显升高的 HR（~30 次/分钟）和更低的平均血压（~8 mmHg）。通过肱动脉血流介导的扩张、反应性充血和被动腿部运动测量的血管功能均明显减弱 (25%-65%)，膝关节伸展运动期间的腿部血流也是如此。体外评估的肌肉力量和 ADP 刺激的呼吸 (30%) 一样减弱，而表观公里增加了 25%。最后，在症状出现之前观察到 IL-10 升高。值得注意的是，诊断后 2.5 个月仍存在疲劳和咳嗽症状。总之，这些发现为 COVID-19 症状发作前的生理反应提供了独特的见解；他们认为 SARS-CoV-2 在常见症状出现之前会对血管和骨骼肌功能产生负面影响，并可能为 COVID-19 诊断后观察到的广泛后遗症奠定基础。新的和值得注意的这个独特的案例研究详细介绍了 SARS 的影响-CoV-2 感染对一名症状前年轻女性的血管和骨骼肌功能的影响。在 COVID-19 诊断之前，血管、骨骼肌、观察到线粒体功能以及 IL-10 的升高。这一综合案例研究表明，COVID-19 的症状前影响是广泛的，可能有助于阐明这种疾病的急性和长期后遗症。
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