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Exercise and Cardiovascular Response01:20

Exercise and Cardiovascular Response

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Habitual physical activity and COVID-19.

Beth W Glace1, Ian J Kremenic2, Daniel E Hogan2

  • 1Nicholas Institute of Sports Medicine and Athletic Trauma, Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA - lb@nismat.org.

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Regular physical activity (PA) before COVID-19 reduced hospitalization risk but not Long COVID (LC). Many individuals struggle to regain pre-infection PA levels, highlighting a public health concern.

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Area of Science:

  • Public Health
  • Epidemiology
  • Exercise Science

Background:

  • Physical activity (PA) is associated with reduced COVID-19 risk factors and attenuated viral infection symptoms.
  • Post-COVID-19, individuals frequently report exercise difficulty and fatigue.
  • The impact of pre-infection habitual PA on COVID-19 outcomes and recovery time is not well understood.

Purpose of the Study:

  • To investigate the association between pre-infection habitual physical activity and COVID-19 outcomes.
  • To determine the time course of physical activity recovery after COVID-19 infection.
  • To identify factors influencing physical activity recovery post-COVID-19.

Main Methods:

  • A cohort of 21,933 adults infected with SARS-CoV-2 between March 2020 and February 2021 were invited to participate.
  • Participants completed baseline surveys, including the Physical Activity History (PAH) questionnaire, and monthly follow-up surveys for up to 23 months.
  • Long COVID (LC) was defined as persistent or recurring symptoms 9 months post-diagnosis. Moderate and heavy PA scores were calculated.

Main Results:

  • Of 993 participants, 28% were hospitalized; higher pre-diagnosis PA was linked to reduced hospitalization odds (P<0.05) but not LC.
  • At 9 months post-infection, one-third of participants recovered to pre-infection PA levels, increasing to 65% at one year and 90% at two years.
  • Factors predicting poor PA recovery included higher pre-diagnosis PA, shortness of breath, and fatigue during acute illness and chronically. Ongoing symptoms correlated with poorer PA recovery.

Conclusions:

  • Habitual physical activity before COVID-19 infection is associated with a lower risk of hospitalization but does not prevent Long COVID.
  • A significant proportion of individuals (35%) do not return to their pre-COVID-19 PA levels within one year, indicating a substantial public health issue.
  • Persistent fatigue and other chronic symptoms significantly impede physical activity recovery post-COVID-19.