Ian J. Kremenic, Daniel E. Hogan, Beth W. Glace.
NISMAT, New York, NY. (Sponsor: Malachy McHugh, FACSM)
Abstract
PURPOSE: Approximately 20% of COVID-19 patients report not feeling confident returning to work, or have not returned to usual activities of daily living or normal exercise level 8 mos post-diagnosis. Physical activity (PA) is known to decrease the risk of obesity, hypertension, diabetes and cardiovascular disease, which are known comorbidities in COVID-19. PA’s role in regulating body mass may be important to facilitate recovery after COVID-19. Independent of PA’s effect on body mass, PA stimulates the immune system and attenuates symptoms of viral infections. Prior PA may predict faster recovery of habitual PA. We examined resumption of PA following COVID-19 and symptoms associated with recovery of PA.
METHODS: Invitations were emailed to 21,933 adults who were SARS-CoV-2 positive in the Northwell Health system between March, 2020 and February, 2021. Participants (n=703) completed a medical history and a Physical Activity History (PAH) survey for the 3-months pre-diagnosis (pre-dx). Monthly thereafter they were emailed links to the PAH. To estimate the time to recover PA after COVID-19, a Kaplan-Meier model was used. Full recovery was defined as the first month in which PA was ≥ pre-dx PA. A linear mixed-effect model assessed factors predictive of PA recovery. Percent of pre-dx PA was modeled using PA pre-COVID-19, hospitalization due to COVID-19, age, BMI, comorbidities, and most common symptoms. Univariate models were run with each predictor; variables that predicted PA recovery were used in a multivariate model to determine which variables best predicted PA recovery.
RESULTS: The probability of recovering prior PA level was 30% at 9 mos post-COVID; 50% at 12 mos; 63% at 18 mos; 70% at 21 mos. Greater pre-dx PA predicted difficulty recovering to the original high level of activity. The symptoms associated with poor recovery of PA are fatigue and shortness of breath acutely and fatigue chronically. No comorbidities predicted PA recovery.
CONCLUSIONS: Individuals may take years to recover their pre-dx PA. Lingering symptoms may limit the ability of the very active to meet the previous demands of their active lifestyle. The inability of a third of individuals to recover PA nearly 2 years post-COVID is a major public health crisis. Health and fitness professionals need to take these physical limitations into consideration.