RESUMEN
Objective: This study aims to systematically assess physical exercise-related symptoms of post-acute sequelae of SARS-CoV-2 infection (PASC or long COVID) in coronavirus disease 2019 (COVID-19) survivors. Methods: Eight databases were systematically searched on March 03, 2024. Original studies that compared physical exercise-related parameters measured by exercise testing between COVID-19 survivors who recovered from SARS-CoV-2 infection over 3 months and non-COVID-19 controls were included. A random-effects model was utilized to determine the mean differences (MDs) or standardized MDs in the meta-analysis. Results: A total of 40 studies with 6241 COVID-19 survivors were included. The 6-min walk test, maximal oxygen consumption (VO2max), and anaerobic threshold were impaired in COVID-19 survivors 3 months post-infection compared with non-COVID-19 controls in exercise testing, while VO2 were comparable between the two groups at rest. In contrast, no differences were observed in SpO2, heart rate, blood pressure, fatigue, and dyspnea between COVID-19 survivors and non-COVID-19 controls in exercise testing. Conclusion: The findings suggest an underestimation of the manifestations of PASC. COVID-19 survivors also harbor physical exercise-related symptoms of PASC that can be determined by the exercise testing and are distinct from those observed at rest. Exercise testing should be included while evaluating the symptoms of PASC in COVID-19 survivors.
RESUMEN
Background: Time-restricted feeding (TRF), a form of intermittent fasting, limits daily caloric intake to a 6-12 hour window and has been shown to effectively promote weight loss and improve overall health. This systematic review and meta-analysis aimed to compare the effects of TRF versus normal diet (ND) on physical performance and body composition in healthy adults with regular exercise habits. Methods: MEDLINE, PubMed, Embase, SPORTDiscus, Web of Science, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases were searched for relevant records. Subgroup analyses were conducted based on the duration of intervention and type of exercise. Physical performance was analysed using standardised mean differences (SMDs) and 95% CIs, whereas body composition parameters were analysed using mean differences (MDs) and 95% CIs. The quality of the included studies was examined using the Cochrane risk-of-bias tool version 2. Results: 15 randomised controlled trials with 361 participants were included in the systematic review. In comparison with the ND group, TRF significantly decreased body weight (MD=-1.76 kg, 95% CI -3.40 to -0.13, p=0.03, I2=11.0%) and fat mass (MD=-1.24 kg, 95% CI -1.87 to -0.61, p<0.001, I2=0.0%). No between-group differences in physical performance-related variables and fat-free mass were found. According to the result of the risk-of-bias assessment, one study showed a low risk of bias, 13 showed some concerns, and one showed a high risk of bias. Conclusion: TRF may be a valuable nutritional strategy to optimise body composition and maintain physical performance in healthy adults engaged in regular exercise. PROSPERO registration number: CRD42022310140.