Key result
Baseline LV GLS predicts 12-month VO2 peak changes in post-COVID athletes but weakens after adjustment.
Why the study?
Longitudinal data evaluating whether baseline LV GLS can predict future changes in VO2 peak are lacking, especially in populations such as post-COVID-19 athletes.
Does baseline LV GLS predict longitudinal changes in VO2 peak in athletes with prior SARS-CoV-2 infection?
Cohort (n=48)
No
Does baseline LV GLS predict longitudinal changes in VO2 peak in athletes with prior SARS-CoV-2 infection?
Effect estimate: β = -2.24 (95% CI -3.84 to -0.65)
p-value: p=0.007
Baseline LV GLS shows a trend toward predicting long-term cardiopulmonary performance in post-COVID athletes, but the association is confounded by age, sex, and BMI.
Baseline LV GLS should not yet guide management in post-COVID athletes; leaves open its independent value for VO2 peak prediction after adjustment.
Background Left ventricular global longitudinal strain (LV GLS) is a sensitive echocardiographic marker for detecting subclinical myocardial dysfunction before a decline in LV ejection fraction (EF) occurs. Cross-sectional studies have demonstrated associations between LV GLS and cardiopulmonary performance, particularly peak oxygen uptake (VO2 peak). However, longitudinal data evaluating on whether baseline LV GLS can predict future changes in VO2 peak are currently lacking, especially in at-risk populations such as post-COVID-19 patients, cancer survivors, and elite athletes. Purpose The pilot study investigates whether baseline LV GLS predicts longitudinal changes in VO2 peak among athletes with a history of SARS-CoV-2 infection. Methods In this single-center substudy, elite and recreational athletes from endurance, strength and mixed sports disciplines underwent transthoracic echocardiography, including speckle-tracking strain imaging, and cardiopulmonary exercise testing at baseline (t1) and after 12 months (t2). Univariable and multivariable regression analyses were performed to assess the predictive value of baseline LV GLS for changes in VO2 peak. Moderation analyses tested for interaction effects by sex or body mass index (BMI). Results A total of 48 post-COVID athletes (25 male; age 34 ± 12 years, VO2 peak 38 ± 11.3 mL/min/kg) were included. Baseline LV GLS significantly predicted VO2 peak after 12 months (β = –2,24, 95 %-CI [–3,84; –0,65], p = 0.007), but after adjusting for sex, age, and BMI, the association was no longer significant, though a trend remained (β = –1,26, 95 %-KI [–2,69; 0,16], p = 0.080). Moderation analysis did not reveal significant interaction effects, suggesting that the predictive value of LV GLS for VO2 peak was consistent across BMI levels and sexes (LV GLS x BMI: β = 0.26, 95 %-CI [–0.21; 0.72], p = 0.276; LV GLS x sex: β = 0.98, 95 %-CI [–2.05; 4.00], p = 0.519). Conclusion Baseline LV GLS was associated with VO2 peak after 12 months, but this relationship was attenuated after adjustment for sex, age, and BMI. No significant interaction effects with BMI or sex were observed, indicating a consistent predictive value of LV GLS across subgroups. These findings suggest a potential prognostic role of LV GLS in athletes recovering from COVID-19, warranting confirmation in larger cohorts.
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Schellenberg et al. (2026) conducted a cohort in Prior SARS-CoV-2 infection in athletes (n=48). Baseline LV GLS was evaluated on VO2 peak after 12 months (β = -2.24, 95% CI -3.84 to -0.65, p=0.007). Baseline LV GLS predicted VO2 peak at 12 months in athletes with prior SARS-CoV-2 infection (β = -2.24; 95% CI -3.84 to -0.65; p=0.007), though this was attenuated after adjustment.
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