Impact of physical activity and body composition on cardio-vascular health post-COVID-19 in Guayaquil
DOI:
https://doi.org/10.56294/saludcyt20251894Keywords:
physical activity, body composition, cardiovascular health, principal component analysis, Biplot, K-meansAbstract
The COVID-19 pandemic has left persistent health consequences among survivors, particularly cardiovascular complications. In this context, understanding the role of physical activity and body composition in recovery is crucial. This study aimed to analyze the impact of physical activity and body composition on cardiovascular health in COVID-19 survivors in Guayaquil, Ecuador. A cross-sectional, quantitative, and multivariate study was conducted with a sample of 200 health sciences students who had recovered from COVID-19. Data were collected through validated questionnaires and anthropometric measurements, including BMI, body fat percentage, and blood pressure. Statistical analyses included Principal Component Analysis (PCA) and K-means clustering to identify latent patterns and subgroups. The results showed that higher frequency and intensity of physical activity were significantly associated with better cardiovascular indicators and improved post-COVID-19 recovery. Individuals with unfavorable body composition, particularly high body fat, had increased cardiovascular risk. PCA identified two main components explaining 78.2% of the variance, while K-means revealed three distinct health profiles among participants. In conclusion, physical activity and body composition are critical factors influencing cardiovascular health in post-COVID-19 individuals. The findings highlight the need for tailored intervention strategies focused on promoting active lifestyles and body composition control to improve long-term cardiovascular outcomes. These insights are particularly relevant for vulnerable urban populations in Latin America.
References
1. Jiang DH, McCoy RG. Planning for the Post-COVID Syndrome: How Payers Can Mitigate Long-Term Complications of the Pandemic. Journal of General Internal Medicine. 2020;35(10):3036–9. https://doi.org/10.1007/s11606-020-06042-3
2. Kapur A, Hod M. Maternal health and non-communicable disease prevention: An investment case for the post COVID-19 world and need for better health economic data. International Journal of Gynecology & Obstetrics. 2020;150(2):151–8. https://doi.org/10.1002/ijgo.13198
3. Rodríguez López JR, Ochoa Escobar LM, Mariscal Rosado ZM. Commercial strategies to improve management in the Ecuadorian micro enterprises post COVID-19. Universidad y Sociedad. 2020;12(S1):191–6.
4. Demarie S, Galvani C, Billat VL. Horse-Riding Competitions Pre and Post COVID-19: Effect of Anxiety, sRPE and HR on Performance in Eventing. International Journal of Environmental Research and Public Health. 2020;17(22):8648. https://doi.org/10.3390/ijerph17228648
5. Zambrano CE, Arias MSA. And prices of hard corn pre and post COVID-19 in productivity Ecuador. Universidad y Sociedad. 2021;13(4):143–50.
6. Galarza Villalva MF, Cruz Piza IA, Castro Patarón EK, Marcial Coello CR. Administrative management and competitiveness of micro-enterprises during and post COVID-19. Universidad y Sociedad. 2020;12(S1):100–5.
7. Dayton JD, Ford K, Carroll SJ, Flynn PA, Kourtidou S, Holzer RJ. The Deconditioning Effect of the COVID-19 Pandemic on Unaffected Healthy Children. Pediatric Cardiology. 2021;42(3):554–9. https://doi.org/10.1007/s00246-020-02513-w
8. Banerjee A, Chen S, Pasea L, Lai AG, Katsoulis M, Denaxas S, et al. Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic. European Journal of Preventive Cardiology. 2021;28(14):1599–609. https://doi.org/10.1093/eurjpc/zwaa155
9. Afroz S, Fairuz S, Joty JA, Uddin MN, Rahman MA. Virtual screening of functional foods and dissecting their roles in modulating gene functions to support post COVID‐19 complications. Journal of Food Biochemistry. 2021;45(12):e13961. https://doi.org/10.1111/jfbc.13961
10. Peghin M, Palese A, Venturini M, De Martino M, Gerussi V, Graziano E, et al. Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients. Clinical Microbiology and Infection. 2021;27(10):1507–13. https://doi.org/10.1016/j.cmi.2021.05.033
11. Rasmussen IE, Kjær A, Fagerland MW, Møller JE, Ravn HB, Hostrup M, et al. Protective potential of high-intensity interval training on cardiac structure and function after COVID-19: protocol and statistical analysis plan for an investigator-blinded randomised controlled trial. BMJ Open. 2021;11(11):e048281. https://doi.org/10.1136/bmjopen-2020-048281
12. Leso V, Fontana L, Iavicoli I. Susceptibility to Coronavirus (COVID-19) in Occupational Settings: The Complex Interplay between Individual and Workplace Factors. International Journal of Environmental Research and Public Health. 2021;18(3):1030. https://doi.org/10.3390/ijerph18031030
13. Nørgård BM, Zegers FD, Nielsen J, Kjeldsen J. Post COVID-19 hospitalizations in patients with chronic inflammatory diseases – A nationwide cohort study. Journal of Autoimmunity. 2021;125:102739. https://doi.org/10.1016/j.jaut.2021.102739
14. Kapelios CJ, Siafarikas C, Bonou M, Liatis S, Barbetseas J. The effect of the COVID-19 pandemic on acute coronary syndrome hospitalizations and out-of-hospital cardiac arrest in Greece. Public Health. 2021;191:17–9. https://doi.org/10.1016/j.puhe.2020.12.006
15. Nanditha A, Unnikrishnan R, Ranjani H, Ramya S, Mohan V. Management of hyperglycemia in COVID-19 and post-COVID-19 syndrome - proposed guidelines for India. Journal of the Association of Physicians of India. 2021;69(9):11–5.
16. Desta AA, Woldearegay TW, Gebremichael DY, Alemayehu M, Getachew T, Gebregzabiher G, et al. Impacts of COVID-19 on essential health services in Tigray, Northern Ethiopia: A pre-post study. PLOS ONE. 2021;16(8):e0256330. https://doi.org/10.1371/journal.pone.0256330
17. Chioh FWJ, Young BE, Wu K-X, Sia WR, Loh J, Yan B, et al. Convalescent COVID-19 patients are susceptible to endothelial dysfunction due to persistent immune activation. eLife. 2021;10:e64909. https://doi.org/10.7554/eLife.64909
18. Tunescu M, Popescu A, Georgescu T, Dima A, Filipescu D. The preoperative evaluation of post-COVID-19 patients scheduled for elective surgery – What is important not to miss! European Review for Medical and Pharmacological Sciences. 2021;25(23):7607–15. https://doi.org/10.26355/eurrev_202112_27459
19. Felbel D, Haase M, Wiesbauer F, Weiss TW. Deferral of Non-Emergency Cardiovascular Interventions Triggers Increased Cardiac Emergency Admissions—Analysis of the COVID-19 Related Lockdown. International Journal of Environmental Research and Public Health. 2022;19(24):16579. https://doi.org/10.3390/ijerph192416579
20. Nassif THA, Daou KN, Tannoury T, Majdalani M. Cardiac involvement in a child post COVID-19: a case from Lebanon. BMJ Case Reports CP. 2021;14(6):e242084. https://doi.org/10.1136/bcr-2021-242084
21 Norton CK, Brown A, Benedetto HN, Granitto M. The “Heart” of COVID-19: Brugada Syndrome and Post-SARS-CoV-2 Virus Cardiac Nursing Care. Advanced Emergency Nursing Journal. 2022;44(3):220–6. https://doi.org/10.1097/TME.0000000000000417
22. Važgėlienė D, Kubilius R, Bileviciute-Ljungar I. Do Comorbidities and Daily Medication before SARS-CoV-2 Infection Play a Role in Self-Reported Post-Infection Symptoms? Journal of Clinical Medicine. 2022;11(21):6278. https://doi.org/10.3390/jcm11216278
23. Azizi A, Achak D, Saad E, Hilali A, Youlyouz-Marfak I, Marfak A. Post-COVID-19 mental health and its associated factors at 3-months after discharge: A case-control study. Clinical Epidemiology and Global Health. 2022;17:101141. https://doi.org/10.1016/j.cegh.2022.101141
24. Tereshchenko LG, Axelsson A, Zhao J, Lu J, Sotoodehnia N, Darbar D, et al. Risk of Cardiovascular Events After COVID-19. American Journal of Cardiology. 2022;179:102–9. https://doi.org/10.1016/j.amjcard.2022.06.023
25. Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz Martínez BJ, et al. Rehabilitation for post-COVID-19 condition through a supervised exercise intervention: A randomized controlled trial. Scandinavian Journal of Medicine & Science in Sports. 2022;32(12):1791–801. https://doi.org/10.1111/sms.14240
26. Bhakaney PR, Vishnu Vardhan GD. Nordic walking, a novel regime’s impact on functional capacity, quality of life and depression and anxiety in Post Covid-19 patients. Journal of Medical and Pharmaceutical Allied Sciences. 2022;11(4):5197–200. https://doi.org/10.55522/jmpas.V11I4.1316
27. Lemos MM, Pires C, Antunes A, Osório R, Matos R, Soares L, et al. Body composition and cardiorespiratory fitness in overweight or obese people post COVID-19: A comparative study. Frontiers in Physiology. 2022;13:949351. https://doi.org/10.3389/fphys.2022.949351
28. Hurtado Yugcha JP, Mancheno Saá MJ, Gamboa Salinas JM, Quisimalin Santamaría M. Comportamiento del consumidor post-pandemia en el sector comercial de Ecuador. Revista Venezolana de Gerencia. 2023;28(Extra 10):1415–34.
29. Guamán Guevara MD, Teneda Llerena WF. Teachers’ mental health issues associated with the university reopening at the onset of the post-COVID-19 era in Ecuador. Revista Venezolana de Gerencia. 2023;28(Extra 9):796–809.
30. Masadeh MA, Qowar MMM, Binsaddig R. The Impact of Emotional Intelligence on the Effectiveness of Decision-Making—A Field Study: The Jordanian Microfinance Sector. In: Musleh Al-Sartawi AMA, Nour AI, editors. Artificial Intelligence and Economic Sustainability in the Era of Industrial Revolution 5.0. Cham: Springer Nature Switzerland; 2024. p. 1211–24. https://doi.org/10.1007/978-3-031-56586-1_88
31. Ruiz-Fincias MI, Grimaldo-Santamaría R-O. Análisis multivariante del sentimiento de inseguridad generado por menores nacionales y extranjeros: Encuesta a Fuerzas y Cuerpos de Seguridad del Estado, Profesionales de Intervención Directa con Menores y Población General. Humanidades. Revista Internacional de Humanidades. 2023;20(1):1–12. https://doi.org/10.37467/revhuman.v20.4937
32. Ahmad Tajuddin SNA, Bahari KA, Al-Majdhoub FM, Maliki NK, Baboo SB. Developing and measuring an assessment instrument for media literacy among digital natives using Digital Intelligence (DQ) framework. Journal of Media Literacy Education. 2024;16(2):29–45. https://doi.org/10.23860/JMLE-2024-16-2-3
33. García-García JA, Reding-Bernal A, López-Alvarenga JC. Cálculo del tamaño de la muestra en investigación en educación médica. Investigación en Educación Médica. 2013;2(8):138–43. https://doi.org/10.1016/S2007-5057(13)72715-7
34. Lacomba Trejo L, Valero Moreno S, Coello MF, Montoya Castilla I, Pérez Marín M. Mental health, suicide risk and the important role of self-esteem in adolescents before and during coexistence with COVID-19 in Ecuador. Revista Latinoamericana de Psicología. 2023;55:130–9.
35. Gabriel KR. The Biplot Graphic Display of Matrices with Application to Principal Component Analysis. Biometrika. 1971;58(3):453–67. https://doi.org/10.2307/2334381
36. Nariswari R, Prakoso TS, Hafiz N, Pudjihastuti H. Biplot analysis: a study of the change of customer behaviour on e-commerce. Procedia Computer Science. 2023;216:524–30. https://doi.org/10.1016/j.procs.2022.12.165
37. Nariswari R, Prakoso TS, Hafiz N, Pudjihastuti H. Biplot analysis: a study of the change of customer behaviour on e-commerce. Procedia Computer Science. 2023;216:524–30. https://doi.org/10.1016/j.procs.2022.12.165
38. Guanolema BRP. Analysis of contribution to economic reactivation post-COVID-19 of the agricultural sector in the province of Chimborazo, Ecuador. Universidad y Sociedad. 2022;14(4):493–503.
39. Menéndez Delgado E, Díaz Ortega MR, López Sánchez JA. Are There Opportunities for Sustainable Tourism in the Province of Manabí-Ecuador after COVID-19? The Case Study of Puerto Lopez. International Journal of Sustainable Development and Planning. 2021;16(8):1415–23. https://doi.org/10.18280/ijsdp.160802
40. Morocho Macas A, Serpa N, Aguirre V, Urgiles C, Urgiles U. Prevalence of stress among dentistry students. African Journal of Biological Sciences. 2024;6:1555–65.
41. Garcés LEG, Freire EJS, Díaz ECS, Pérez SA. Digital Transformation and Resilience in Higher Education: Impact on Strategic Management and Human Talent in Ecuador. Salud, Ciencia y Tecnología – Serie de Conferencias. 2024;3:811. https://doi.org/10.56294/sctconf2024811
42. Morillo Cano JR, Navarrete Arboleda ED, Noroña Noroña DR. Interconnections between psychosocial factors in post-COVID-19 pandemic health personnel in Ecuador. Revista Cubana de Investigaciones Biomédicas. 2023;42.
43. Llerena Cepeda ML, Quilambaque JVP, Quispe AMN, Álvarez ETM, Pérez JFR. Hermeneutical Analysis of the Determinants of Obesity using Neutrosophic Cognitive Maps. Neutrosophic Sets and Systems. 2021;44:90–9.
44. Wallukat G, Hohberger B, Wenzel K, Fürst J, Schulze-Rothe S, Wallukat A, et al. Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms. Journal of Translational Autoimmunity. 2021;4:100100. https://doi.org/10.1016/j.jtauto.2021.100100
45. Mainous AG, Rooks BJ, Orlando FA. Risk of New Hospitalization Post-COVID-19 Infection for Non-COVID-19 Conditions. Journal of the American Board of Family Medicine. 2021;34(5):907–13. https://doi.org/10.3122/jabfm.2021.05.210170
46. Afroz S, Fairuz S, Joty JA, Uddin MN, Rahman MA. Virtual screening of functional foods and dissecting their roles in modulating gene functions to support post COVID-19 complications. Journal of Food Biochemistry. 2021;45(12):e13961. https://doi.org/10.1111/jfbc.13961
47. Nurek M, Rayner C, Freyer A, Taylor S, Jovic S, Greenhalgh T, et al. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study. British Journal of General Practice. 2021;71(712):e815–25. https://doi.org/10.3399/BJGP.2021.0265
48. Beydoun HA, Beydoun MA, El-Hajj Z, Weiss J, Zonderman AB. COVID-19 Pandemic Impact on Trajectories in Cardiometabolic Health, Physical Activity, and Functioning Among Adults from the 2006–2020 Health and Retirement Study. Journal of Gerontology: Series A. 2022;77(7):1371–9. https://doi.org/10.1093/gerona/glac028
49. Bhakaney PR, Vishnu Vardhan GD. Nordic walking, a novel regime’s impact on functional capacity, quality of life and depression and anxiety in Post Covid-19 patients. Journal of Medical and Pharmaceutical Allied Sciences. 2022;11(4):5197–200. https://doi.org/10.55522/jmpas.V11I4.1316
50. Martínez Rolando L, Villafañe JH, Cercadillo García S, Sanz Argüello A, Villanueva Rosa M, Sánchez Romero EA. Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up. International Journal of Environmental Research and Public Health. 2022;19(19):12396. https://doi.org/10.3390/ijerph191912396
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Copyright (c) 2025 Vilma Raffo-Babici , María Paltin-Pindo, Dennis Alfredo Peralta-Gamboa, Juan Calderon-Cisneros (Author)

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