887. Habitual Physical Activity Does Not Prevent Long COVID

Beth Glace, Ian Kremenic, Daniel Hogan. 

NISMAT, New York, NY. (Sponsor: Malachy McHugh, FACSM)


PURPOSE: Physical activity’s role in prevention of excess body mass may be an important means of facilitating recovery after COVID-19. Independent of exercise’s effect on body mass, moderate habitual physical activity (PA) directly stimulates the immune system while a sedentary lifestyle increases risk of viral infections. Thus, habitual PA may be an effective and modifiable lifestyle behavior that improves immune response and lessens COVID-19 disease severity. Therefore, in this study we sought to determine the role of pre-infection habitual (pre-dx) PA in moderating long-term sequelae of COVID-19. 

METHODS: Invitations were emailed to 21,933 adults who were SARS-CoV-2 positive in a large healthcare system between March, 2020 and February, 2021. Participants (n=492) completed a medical history and a Physical Activity History (PAH) questionnaire regarding PA during the 3-months pre-dx. Monthly thereafter they were emailed questionnaires regarding any on-going symptoms and the PAH survey. Long COVID (LC) was defined as the presence of COVID-related symptoms at 9 mos post-diagnosis. Logistic regressions were used to assess if PA pre-dx was protective against LC. Covariates were BMI, age, hospitalization (yes/no), and comorbidities that were different (p<0.05) between those that did or did not have LC. 

RESULTS: Forty percent of subjects had LC at 9 mos: 34% of men and 44% of women, p=0.022. PA pre-dx did not protect against LC (p=0.299), however PA at 9 mos was significantly lower in the LC group (p<0.001). The following factors increased the odds ratio (OR) of LC: higher BMI (p=0.001; OR=1.049, 95% CI=1.019-1.081 per unit BMI), hospitalization (p=0.008; OR=1.756, 95% CI=1.161-2.656), and diabetes (p=0.021; OR=3.134, 95% CI=1.186-8.278). 

CONCLUSIONS: Since LC markedly limited PA and pre-dx PA did not protect against LC, individuals with a high pre-dx PA had difficulty returning to baseline PA levels. BMI and diabetes, known to be modulated by PA, greatly increased the odds of LC. Health professionals should be aware that symptoms commonly linger even 9 mos after COVID, particularly for women, and limit PA.