The effect of mild to moderate COVID-19 infection on the cardiorespiratory fitness of firefighters

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Abstract

Introduction

An adequate level of cardiorespiratory fitness (CRF) is critical for firefighters to perform the strenuous and physiologically demanding work of firefighting safely and effectively. The coronavirus disease 2019 (COVID-19) has been shown to negatively impact CRF in both the acute phase and longer-term following infection. This study aimed to determine changes to the CRF of firefighters pre- to post-mild to moderate COVID-19 infection and to investigate the impact of days past COVID-19 infection on change in CRF.

Methods

CRF measures from cardiopulmonary exercise testing (CPET) at annual occupational health exams that occurred pre-COVID-19 infection in 2019 were obtained for firefighters from seven Arizona fire departments. Measures were compared to CPET evaluations from annual health exams the following year in a cohort of firefighters who self-reported mild to moderate illness following COVID-19 infection between exams.

Results

Among a cohort of 103 firefighters, mean age 40 ± 9 years, CRF [as measured by peak oxygen consumption (VO ₂)] declined by an average of 2.55 ml·kg ⁻¹·min ⁻¹ or 7.3% ( d = −0.38, p < 0.001) following COVID-19 infection (mean time from COVID-19 infection to CPET was 110 ± 78 days). The number of days past COVID-19 infection showed a small, yet significant, relationship to peak VO ₂ ( r = 0.250, p = 0.011). Estimated marginal effects indicated that when biological sex, age, and BMI are controlled for, predicted peak VO ₂ returned to pre-COVID-19 values ~300 days after COVID-19 infection.

Conclusion

Peak VO ₂ (ml·kg ⁻¹·min ⁻¹) declined 7.3% among firefighters an average of 110 days past reporting mild to moderate COVID-19 infection. This decrease has implications for the operational readiness and safety of firefighters.

Related collections

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Is Open Access

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

Barry M. Popkin, Shufa Du, William D. Green … (2020)

Summary The linkage of individuals with obesity and COVID‐19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID‐19, 75 studies were used to conduct a series of meta‐analyses on the relationship of individuals with obesity–COVID‐19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID‐19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID‐19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID‐19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.

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Author and article information

Contributors

Susanne D'Isabel: URI : http://loop.frontiersin.org/people/2534146/overviewRole: Role: Role: Role: Role:

Lauren M. Berny: URI : http://loop.frontiersin.org/people/2561671/overviewRole: Role:

Alex Frost: Role:

Chanhtel Thongphok: Role:

Kepra Jack: Role: Role:

Sundeep Chaudhry: Role: Role:

Ross Arena: Role:

Denise L. Smith: URI : http://loop.frontiersin.org/people/669215/overviewRole: Role: Role: Role: Role: Role: Role:

Journal

Journal ID (nlm-ta): Front Public Health

Journal ID (iso-abbrev): Front Public Health

Journal ID (publisher-id): Front. Public Health

Title: Frontiers in Public Health

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2296-2565

Publication date (Electronic): 30 November 2023

Publication date Collection: 2023

Volume: 11

Electronic Location Identifier: 1308605

Affiliations

[1] ¹First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College , Saratoga Springs, NY, United States

[2] ²Department of Counseling Psychology and Human Services, University of Oregon , Eugene, OR, United States

[3] ³Department of Health and Human Physiological Sciences, Skidmore College , Saratoga Springs, NY, United States

[4] ⁴HeartFit for Duty , Mesa, AZ, United States

[5] ⁵MET-Test , Atlanta, GA, United States

[6] ⁶Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, United States

Author notes

Edited by: Arwel Wyn Jones, Alfred Hospital, Australia

Reviewed by: Eduardo Gutiérrez-Abejón, Universidad de Valladolid, Spain; Akram Falahati, University of Oklahoma, United States

*Correspondence: Denise L. Smith dsmith@ 123456skidmore.edu

Article

DOI: 10.3389/fpubh.2023.1308605

PMC ID: 10724018

PubMed ID: 38106889

SO-VID: 1f0b3066-3990-4c4c-8251-2d9873693231

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 06 October 2023

Date accepted : 13 November 2023

Page count

Figures: 4, Tables: 4, Equations: 0, References: 44, Pages: 11, Words: 7242

Funding

Funded by: Federal Emergency Management Agency, doi 10.13039/100008464;

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by a grant from the Federal Emergency Management Agency [EMW-2020-FP-00243] to the principal investigator (DS).