Post-acute sequelae of SARS-CoV-2 associates with physical inactivity in a cohort of COVID-19 survivors
Saulo Gil, Bruno Gualano, Adriana Ladeira De Araújo, Gersiel Nascimento De Oliveira Júnior, Rodolfo Furlan Damiano, Fabio Pinna, Marta Imamura, Vanderson Rocha, Esper Kallas, Linamara Rizzo Batistella, Orestes V Forlenza, Carlos R R De Carvalho, Geraldo Filho Busatto, Hamilton Roschel, Edivaldo Utiyama, Aluisio Segurado, Beatriz Perondi, Anna Miethke Morais, Amanda Montal, Leila Letaif, Solange Fusco, Marjorie Fregonesi Rodrigues Da Silva, Marcelo Rocha, Izabel Marcilio, Izabel Cristina Rios, Fabiane Yumi Ogihara Kawano, Maria Amélia De Jesus, Ésper Georges Kallas, Carolina Carmo, Clarice Tanaka, Heraldo Possolo De Souza, Julio F M Marchini, Carlos Carvalho, Juliana Carvalho Ferreira, Maura Salaroli De Oliveira, Thaís Guimarães, Carolina Dos Santos Lázari, Alberto José Da Silva Duarte, Ester Sabino, Marcello Mihailenko Chaves Magri, Tarcisio E P Barros-Filho, Maria Cristina Peres Braido Francisco
Scientific Reports, doi:10.1038/s41598-022-26888-3
The aim of this study was to determine whether Post-acute Sequelae of SARS-CoV-2 Infection (PASC) are associated with physical inactivity in COVID-19 survivors. This is a cohort study of COVID-19 survivors discharged from a tertiary hospital in Sao Paulo, Brazil. Patients admitted as inpatients due to laboratory-confirmed COVID-19 between March and August 2020 were consecutively invited for a follow-up in-person visit 6 to 11 months after hospitalization. Ten symptoms of PASC were assessed using standardized scales. Physical activity was assessed by questionnaire and participants were classified according to WHO Guidelines. 614 patients were analyzed (age: 56 ± 13 years; 53% male). Frequency of physical inactivity in patients exhibiting none, at least 1, 1-4, and 5 or more symptoms of PASC was 51%, 62%, 58%, and 71%, respectively. Adjusted models showed that patients with one or more persistent PASC symptoms have greater odds of being physically inactive than those without any persistent symptoms (OR: 1.57 [95% CI 1.04-2.39], P = 0.032). Dyspnea (OR: 2.22 [1.50-3.33], P < 0.001), fatigue (OR: 2.01 [1.40-2.90], P < 0.001), insomnia (OR: 1.69 [1.16-2.49], P = 0.007), posttraumatic stress (OR: 1.53 [1.05-2.23], P = 0.028), and severe muscle/joint pain (OR: 1.53 [95% CI 1.08-2.17], P = 0.011) were associated with greater odds of being physically inactive. This study suggests that PASC is associated with physical inactivity, which itself may be considered as a persistent symptom among COVID-19 survivors. This may help in the early identification of patients who could benefit from additional interventions tailored to combat inactivity (even after treatment of PASC), with potential beneficial impacts on overall morbidity/mortality and health systems worldwide. COVID-19 pandemic is raising a devastating impact on public health, resulting in millions of hospitalizations and deaths globally 1 . Among survivors, the high occurrence of patients reporting post-acute sequelae of SARS-CoV-2 (PASC) is a great cause of concern, as it threatens health systems worldwide. This condition, also known as "long COVID", is defined as the illness that occurs in people who have a history of probable or confirmed SARS-CoV-2 infection, usually within 3 months from the onset of COVID-19, with symptoms and effects that last OPEN
Author contributions The authors' contributions were as follows: Designed research: S.G., B.G., R.F.D., F.P., M.I., V.R., E.K., L.R.
Competing interests The authors declare no competing interests.
References
Andersson, Stridsman, Ronmark, Lindberg, Emtner, Physical activity and fatigue in chronic obstructive pulmonary disease: A population based study, Respir. Med,
doi:10.1016/j.rmed.2015.05.007
Boonstra, Schiphorst Preuper, Balk, Stewart, Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain, Pain,
doi:10.1016/j.pain.2014.09.014
Brasil, estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2020
Busatto, Post-acute sequelae of SARS-CoV-2 infection (PASC): A protocol for a multidisciplinary prospective observational evaluation of a cohort of patients surviving hospitalisation in Sao Paulo, Brazil, BMJ Open,
doi:10.1136/bmjopen-2021-051706
Chekroud, Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study, Lancet Psychiatry,
doi:10.1016/S2215-0366(18)30227-X
Delbressine, The impact of Post-COVID-19 Syndrome on self-reported physical activity, Int. J. Environ. Res. Public Health,
doi:10.3390/ijerph18116017
Hamer, O'donovan, Stamatakis, Lifestyle risk factors, obesity and infectious disease mortality in the general population: Linkage study of 97,844 adults from England and Scotland, Prev. Med,
doi:10.1016/j.ypmed.2019.03.002
Harris, Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support, J. Biomed. Inform,
doi:10.1016/j.jbi.2008.08.010
Heesakkers, Clinical outcomes among patients With 1-year survival following intensive care unit treatment for COVID-19, JAMA,
doi:10.1001/jama.2022.0040
Heesch, Miller, Brown, Relationship between physical activity and stiff or painful joints in mid-aged women and older women: A 3-year prospective study, Arthr. Res. Ther,
doi:10.1186/ar2154
Joffe, Gambhir, Chadeau-Hyam, Vineis, Causal diagrams in systems epidemiology, Emerg. Themes Epidemiol,
doi:10.1186/1742-7622-9-1
Lee, Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy, Lancet,
doi:10.1016/S0140-6736(12)61031-9
Morris, Myalgic encephalomyelitis/chronic fatigue syndrome: From pathophysiological insights to novel therapeutic opportunities, Pharmacol. Res,
doi:10.1016/j.phrs.2019.104450
Nasserie, Hittle, Goodman, Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: A systematic review, JAMA Netw. Open,
doi:10.1001/jamanetworkopen.2021.11417
Paterson, Warburton, Physical activity and functional limitations in older adults: A systematic review related to Canada's physical activity guidelines, Int. J. Behav. Nutr. Phys. Act,
doi:10.1186/1479-5868-7-38
Reid, Determinants of physical activity after hospitalization for coronary artery disease: The tracking exercise after cardiac hospitalization (TEACH) study, Eur. J. Cardiovasc. Prev. Rehabilit.: Off. J. Eur. Soc. Cardiol. Work Groups Epidemiol. Prev. Card. Rehabilit. Exerc. Physiol,
doi:10.1097/01.hjr.0000201513.13343.97
Sheshadri, Kittiskulnam, Johansen, Higher physical activity is associated with less fatigue and insomnia among patients on hemodialysis, Kidney Int. Rep,
doi:10.1016/j.ekir.2018.10.014
Weathers, Litz, Herman, Proceedings of the 9th Annual Meeting of the International Society for Traumatic Stress Studies (ISTSS)
Webster, Cella, Yost, The functional assessment of chronic illness therapy (FACIT) measurement system: Properties, applications, and interpretation, Health Qual Life Outcomes,
doi:10.1186/1477-7525-1-79
Wong, Weitzer, Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-a systemic review and comparison of clinical presentation and symptomatology, Medicina,
doi:10.3390/medicina57050418
DOI record:
{
"DOI": "10.1038/s41598-022-26888-3",
"ISSN": [
"2045-2322"
],
"URL": "http://dx.doi.org/10.1038/s41598-022-26888-3",
"abstract": "<jats:title>Abstract</jats:title><jats:p>The aim of this study was to determine whether Post-acute Sequelae of SARS-CoV-2 Infection (PASC) are associated with physical inactivity in COVID-19 survivors. This is a cohort study of COVID-19 survivors discharged from a tertiary hospital in Sao Paulo, Brazil. Patients admitted as inpatients due to laboratory-confirmed COVID-19 between March and August 2020 were consecutively invited for a follow-up in-person visit 6 to 11 months after hospitalization. Ten symptoms of PASC were assessed using standardized scales. Physical activity was assessed by questionnaire and participants were classified according to WHO Guidelines. 614 patients were analyzed (age: 56 ± 13 years; 53% male). Frequency of physical inactivity in patients exhibiting none, at least 1, 1–4, and 5 or more symptoms of PASC was 51%, 62%, 58%, and 71%, respectively. Adjusted models showed that patients with one or more persistent PASC symptoms have greater odds of being physically inactive than those without any persistent symptoms (OR: 1.57 [95% CI 1.04–2.39], <jats:italic>P</jats:italic> = 0.032). Dyspnea (OR: 2.22 [1.50–3.33], <jats:italic>P</jats:italic> < 0.001), fatigue (OR: 2.01 [1.40–2.90], <jats:italic>P</jats:italic> < 0.001), insomnia (OR: 1.69 [1.16–2.49], <jats:italic>P</jats:italic> = 0.007), post-traumatic stress (OR: 1.53 [1.05–2.23], <jats:italic>P</jats:italic> = 0.028), and severe muscle/joint pain (OR: 1.53 [95% CI 1.08–2.17], <jats:italic>P</jats:italic> = 0.011) were associated with greater odds of being physically inactive. This study suggests that PASC is associated with physical inactivity, which itself may be considered as a persistent symptom among COVID-19 survivors. This may help in the early identification of patients who could benefit from additional interventions tailored to combat inactivity (even after treatment of PASC), with potential beneficial impacts on overall morbidity/mortality and health systems worldwide.</jats:p>",
"alternative-id": [
"26888"
],
"article-number": "215",
"assertion": [
{
"group": {
"label": "Article History",
"name": "ArticleHistory"
},
"label": "Received",
"name": "received",
"order": 1,
"value": "9 May 2022"
},
{
"group": {
"label": "Article History",
"name": "ArticleHistory"
},
"label": "Accepted",
"name": "accepted",
"order": 2,
"value": "21 December 2022"
},
{
"group": {
"label": "Article History",
"name": "ArticleHistory"
},
"label": "First Online",
"name": "first_online",
"order": 3,
"value": "5 January 2023"
},
{
"group": {
"label": "Competing interests",
"name": "EthicsHeading"
},
"name": "Ethics",
"order": 1,
"value": "The authors declare no competing interests."
}
],
"author": [
{
"affiliation": [],
"family": "Gil",
"given": "Saulo",
"sequence": "first"
},
{
"affiliation": [],
"family": "Gualano",
"given": "Bruno",
"sequence": "additional"
},
{
"affiliation": [],
"family": "de Araújo",
"given": "Adriana Ladeira",
"sequence": "additional"
},
{
"affiliation": [],
"family": "de Oliveira Júnior",
"given": "Gersiel Nascimento",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Damiano",
"given": "Rodolfo Furlan",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Pinna",
"given": "Fabio",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Imamura",
"given": "Marta",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Rocha",
"given": "Vanderson",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Kallas",
"given": "Esper",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Batistella",
"given": "Linamara Rizzo",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Forlenza",
"given": "Orestes V.",
"sequence": "additional"
},
{
"affiliation": [],
"family": "de Carvalho",
"given": "Carlos R. R.",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Busatto",
"given": "Geraldo Filho",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Roschel",
"given": "Hamilton",
"sequence": "additional"
},
{
"affiliation": [],
"name": "HCFMUSP COVID-19 Study Group",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Utiyama",
"given": "Edivaldo",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Segurado",
"given": "Aluisio",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Perondi",
"given": "Beatriz",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Morais",
"given": "Anna Miethke",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Montal",
"given": "Amanda",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Letaif",
"given": "Leila",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Fusco",
"given": "Solange",
"sequence": "additional"
},
{
"affiliation": [],
"family": "da Silva",
"given": "Marjorie Fregonesi Rodrigues",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Rocha",
"given": "Marcelo",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Marcilio",
"given": "Izabel",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Rios",
"given": "Izabel Cristina",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Kawano",
"given": "Fabiane Yumi Ogihara",
"sequence": "additional"
},
{
"affiliation": [],
"family": "de Jesus",
"given": "Maria Amélia",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Kallas",
"given": "Ésper Georges",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Carmo",
"given": "Carolina",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Tanaka",
"given": "Clarice",
"sequence": "additional"
},
{
"affiliation": [],
"family": "de Souza",
"given": "Heraldo Possolo",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Marchini",
"given": "Julio F. M.",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Carvalho",
"given": "Carlos",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Ferreira",
"given": "Juliana Carvalho",
"sequence": "additional"
},
{
"affiliation": [],
"family": "de Oliveira",
"given": "Maura Salaroli",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Guimarães",
"given": "Thaís",
"sequence": "additional"
},
{
"affiliation": [],
"family": "dos Santos Lázari",
"given": "Carolina",
"sequence": "additional"
},
{
"affiliation": [],
"family": "da Silva Duarte",
"given": "Alberto José",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Sabino",
"given": "Ester",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Magri",
"given": "Marcello Mihailenko Chaves",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Barros-Filho",
"given": "Tarcisio E. P.",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Francisco",
"given": "Maria Cristina Peres Braido",
"sequence": "additional"
}
],
"container-title": "Scientific Reports",
"container-title-short": "Sci Rep",
"content-domain": {
"crossmark-restriction": false,
"domain": [
"link.springer.com"
]
},
"created": {
"date-parts": [
[
2023,
1,
5
]
],
"date-time": "2023-01-05T12:04:36Z",
"timestamp": 1672920276000
},
"deposited": {
"date-parts": [
[
2023,
1,
9
]
],
"date-time": "2023-01-09T03:05:04Z",
"timestamp": 1673233504000
},
"funder": [
{
"DOI": "10.13039/501100001807",
"award": [
"2020/08091-9",
"2017/13552-2"
],
"doi-asserted-by": "publisher",
"id": [
{
"asserted-by": "publisher",
"id": "10.13039/501100001807",
"id-type": "DOI"
}
],
"name": "Fundação de Amparo à Pesquisa do Estado de São Paulo"
},
{
"DOI": "10.13039/501100003593",
"award": [
"308307/2021-6"
],
"doi-asserted-by": "publisher",
"id": [
{
"asserted-by": "publisher",
"id": "10.13039/501100003593",
"id-type": "DOI"
}
],
"name": "Conselho Nacional de Desenvolvimento Científico e Tecnológico"
}
],
"indexed": {
"date-parts": [
[
2024,
11,
19
]
],
"date-time": "2024-11-19T18:52:22Z",
"timestamp": 1732042342688
},
"is-referenced-by-count": 22,
"issue": "1",
"issued": {
"date-parts": [
[
2023,
1,
5
]
]
},
"journal-issue": {
"issue": "1",
"published-online": {
"date-parts": [
[
2023,
12
]
]
}
},
"language": "en",
"license": [
{
"URL": "https://creativecommons.org/licenses/by/4.0",
"content-version": "tdm",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2023,
1,
5
]
],
"date-time": "2023-01-05T00:00:00Z",
"timestamp": 1672876800000
}
},
{
"URL": "https://creativecommons.org/licenses/by/4.0",
"content-version": "vor",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2023,
1,
5
]
],
"date-time": "2023-01-05T00:00:00Z",
"timestamp": 1672876800000
}
}
],
"link": [
{
"URL": "https://www.nature.com/articles/s41598-022-26888-3.pdf",
"content-type": "application/pdf",
"content-version": "vor",
"intended-application": "text-mining"
},
{
"URL": "https://www.nature.com/articles/s41598-022-26888-3",
"content-type": "text/html",
"content-version": "vor",
"intended-application": "text-mining"
},
{
"URL": "https://www.nature.com/articles/s41598-022-26888-3.pdf",
"content-type": "application/pdf",
"content-version": "vor",
"intended-application": "similarity-checking"
}
],
"member": "297",
"original-title": [],
"prefix": "10.1038",
"published": {
"date-parts": [
[
2023,
1,
5
]
]
},
"published-online": {
"date-parts": [
[
2023,
1,
5
]
]
},
"publisher": "Springer Science and Business Media LLC",
"reference": [
{
"DOI": "10.1016/S1473-3099(20)30120-1",
"author": "E Dong",
"doi-asserted-by": "publisher",
"first-page": "533",
"journal-title": "Lancet Infect. Dis.",
"key": "26888_CR1",
"unstructured": "Dong, E., Du, H. & Gardner, L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect. Dis. 20, 533–534. https://doi.org/10.1016/S1473-3099(20)30120-1 (2020).",
"volume": "20",
"year": "2020"
},
{
"key": "26888_CR2",
"unstructured": "WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1."
},
{
"DOI": "10.1038/s41591-020-01177-6",
"doi-asserted-by": "publisher",
"key": "26888_CR3",
"unstructured": "Meeting the challenge of long COVID. Nat. Med. 26, 1803, https://doi.org/10.1038/s41591-020-01177-6 (2020)."
},
{
"DOI": "10.1038/s41598-021-95565-8",
"author": "S Lopez-Leon",
"doi-asserted-by": "publisher",
"first-page": "16144",
"journal-title": "Sci. Rep.",
"key": "26888_CR4",
"unstructured": "Lopez-Leon, S. et al. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. Sci. Rep. 11, 16144. https://doi.org/10.1038/s41598-021-95565-8 (2021).",
"volume": "11",
"year": "2021"
},
{
"DOI": "10.1016/S0140-6736(20)30183-5",
"author": "C Huang",
"doi-asserted-by": "publisher",
"first-page": "497",
"journal-title": "Lancet",
"key": "26888_CR5",
"unstructured": "Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395, 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5 (2020).",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1038/s41591-021-01283-z",
"author": "A Nalbandian",
"doi-asserted-by": "publisher",
"first-page": "601",
"journal-title": "Nat. Med.",
"key": "26888_CR6",
"unstructured": "Nalbandian, A. et al. Post-acute COVID-19 syndrome. Nat. Med. 27, 601–615. https://doi.org/10.1038/s41591-021-01283-z (2021).",
"volume": "27",
"year": "2021"
},
{
"DOI": "10.1016/j.genhosppsych.2022.01.002",
"author": "RF Damiano",
"doi-asserted-by": "publisher",
"first-page": "38",
"journal-title": "Gen. Hosp. Psychiatry",
"key": "26888_CR7",
"unstructured": "Damiano, R. F. et al. Post-COVID-19 psychiatric and cognitive morbidity: Preliminary findings from a Brazilian cohort study. Gen. Hosp. Psychiatry 75, 38–45. https://doi.org/10.1016/j.genhosppsych.2022.01.002 (2022).",
"volume": "75",
"year": "2022"
},
{
"DOI": "10.1186/1479-5868-7-38",
"author": "DH Paterson",
"doi-asserted-by": "publisher",
"first-page": "38",
"journal-title": "Int. J. Behav. Nutr. Phys. Act.",
"key": "26888_CR8",
"unstructured": "Paterson, D. H. & Warburton, D. E. Physical activity and functional limitations in older adults: A systematic review related to Canada’s physical activity guidelines. Int. J. Behav. Nutr. Phys. Act. 7, 38. https://doi.org/10.1186/1479-5868-7-38 (2010).",
"volume": "7",
"year": "2010"
},
{
"DOI": "10.1186/ar2154",
"author": "KC Heesch",
"doi-asserted-by": "publisher",
"first-page": "R34",
"journal-title": "Arthr. Res. Ther.",
"key": "26888_CR9",
"unstructured": "Heesch, K. C., Miller, Y. D. & Brown, W. J. Relationship between physical activity and stiff or painful joints in mid-aged women and older women: A 3-year prospective study. Arthr. Res. Ther. 9, R34. https://doi.org/10.1186/ar2154 (2007).",
"volume": "9",
"year": "2007"
},
{
"DOI": "10.1016/S2215-0366(18)30227-X",
"author": "SR Chekroud",
"doi-asserted-by": "publisher",
"first-page": "739",
"journal-title": "Lancet Psychiatry",
"key": "26888_CR10",
"unstructured": "Chekroud, S. R. et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry 5, 739–746. https://doi.org/10.1016/S2215-0366(18)30227-X (2018).",
"volume": "5",
"year": "2018"
},
{
"DOI": "10.1016/j.ypmed.2019.03.002",
"author": "M Hamer",
"doi-asserted-by": "publisher",
"first-page": "65",
"journal-title": "Prev. Med.",
"key": "26888_CR11",
"unstructured": "Hamer, M., O’Donovan, G. & Stamatakis, E. Lifestyle risk factors, obesity and infectious disease mortality in the general population: Linkage study of 97,844 adults from England and Scotland. Prev. Med. 123, 65–70. https://doi.org/10.1016/j.ypmed.2019.03.002 (2019).",
"volume": "123",
"year": "2019"
},
{
"DOI": "10.3390/ijerph18116017",
"author": "JM Delbressine",
"doi-asserted-by": "publisher",
"journal-title": "Int. J. Environ. Res. Public Health",
"key": "26888_CR12",
"unstructured": "Delbressine, J. M. et al. The impact of Post-COVID-19 Syndrome on self-reported physical activity. Int. J. Environ. Res. Public Health https://doi.org/10.3390/ijerph18116017 (2021).",
"year": "2021"
},
{
"key": "26888_CR13",
"unstructured": "IBGE. Pesquisa Nacional por Amostra de Domicílio: PNAD, https://www.ibge.gov.br/ (2021)."
},
{
"DOI": "10.1016/S0140-6736(20)32656-8",
"author": "C Huang",
"doi-asserted-by": "publisher",
"first-page": "220",
"journal-title": "Lancet",
"key": "26888_CR14",
"unstructured": "Huang, C. et al. 6-month consequences of COVID-19 in patients discharged from hospital: A cohort study. Lancet 397, 220–232. https://doi.org/10.1016/S0140-6736(20)32656-8 (2021).",
"volume": "397",
"year": "2021"
},
{
"DOI": "10.1001/jama.2021.3331",
"author": "Writing Committee for the CSG",
"doi-asserted-by": "publisher",
"first-page": "1525",
"journal-title": "JAMA",
"key": "26888_CR15",
"unstructured": "Writing Committee for the CSG. Four-month clinical status of a cohort of patients after hospitalization for COVID-19. JAMA 325, 1525–1534. https://doi.org/10.1001/jama.2021.3331 (2021).",
"volume": "325",
"year": "2021"
},
{
"DOI": "10.1001/jamanetworkopen.2021.0830",
"author": "JK Logue",
"doi-asserted-by": "publisher",
"first-page": "e210830",
"journal-title": "JAMA Netw Open",
"key": "26888_CR16",
"unstructured": "Logue, J. K. et al. Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open 4, e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830 (2021).",
"volume": "4",
"year": "2021"
},
{
"DOI": "10.1001/jama.2020.12603",
"author": "A Carfi",
"doi-asserted-by": "publisher",
"first-page": "603",
"journal-title": "JAMA",
"key": "26888_CR17",
"unstructured": "Carfi, A., Bernabei, R. & Landi, F. Gemelli against, C.-P.-A. C. S. G. persistent symptoms in patients after acute COVID-19. JAMA 324, 603–605. https://doi.org/10.1001/jama.2020.12603 (2020).",
"volume": "324",
"year": "2020"
},
{
"DOI": "10.1001/jama.2022.0040",
"author": "H Heesakkers",
"doi-asserted-by": "publisher",
"journal-title": "JAMA",
"key": "26888_CR18",
"unstructured": "Heesakkers, H. et al. Clinical outcomes among patients With 1-year survival following intensive care unit treatment for COVID-19. JAMA https://doi.org/10.1001/jama.2022.0040 (2022).",
"year": "2022"
},
{
"key": "26888_CR19",
"unstructured": "BRASIL. in vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico : estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2020 (ed Departamento de Análise em Saúde e Vigilância de Doenças não Transmissíveis) 124p (2020)."
},
{
"DOI": "10.1016/j.rmed.2015.05.007",
"author": "M Andersson",
"doi-asserted-by": "publisher",
"first-page": "1048",
"journal-title": "Respir. Med.",
"key": "26888_CR20",
"unstructured": "Andersson, M., Stridsman, C., Ronmark, E., Lindberg, A. & Emtner, M. Physical activity and fatigue in chronic obstructive pulmonary disease: A population based study. Respir. Med. 109, 1048–1057. https://doi.org/10.1016/j.rmed.2015.05.007 (2015).",
"volume": "109",
"year": "2015"
},
{
"DOI": "10.1016/j.ekir.2018.10.014",
"author": "A Sheshadri",
"doi-asserted-by": "publisher",
"first-page": "285",
"journal-title": "Kidney Int. Rep.",
"key": "26888_CR21",
"unstructured": "Sheshadri, A., Kittiskulnam, P. & Johansen, K. L. Higher physical activity is associated with less fatigue and insomnia among patients on hemodialysis. Kidney Int. Rep. 4, 285–292. https://doi.org/10.1016/j.ekir.2018.10.014 (2019).",
"volume": "4",
"year": "2019"
},
{
"DOI": "10.1038/s41591-022-01689-3",
"author": "Y Xie",
"doi-asserted-by": "publisher",
"journal-title": "Nat. Med.",
"key": "26888_CR22",
"unstructured": "Xie, Y., Xu, E., Bowe, B. & Al-Aly, Z. Long-term cardiovascular outcomes of COVID-19. Nat. Med. https://doi.org/10.1038/s41591-022-01689-3 (2022).",
"year": "2022"
},
{
"DOI": "10.3390/medicina57050418",
"author": "TL Wong",
"doi-asserted-by": "publisher",
"journal-title": "Medicina",
"key": "26888_CR23",
"unstructured": "Wong, T. L. & Weitzer, D. J. Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-a systemic review and comparison of clinical presentation and symptomatology. Medicina https://doi.org/10.3390/medicina57050418 (2021).",
"year": "2021"
},
{
"DOI": "10.1016/j.phrs.2019.104450",
"author": "G Morris",
"doi-asserted-by": "publisher",
"first-page": "104450",
"journal-title": "Pharmacol. Res.",
"key": "26888_CR24",
"unstructured": "Morris, G. et al. Myalgic encephalomyelitis/chronic fatigue syndrome: From pathophysiological insights to novel therapeutic opportunities. Pharmacol. Res. 148, 104450. https://doi.org/10.1016/j.phrs.2019.104450 (2019).",
"volume": "148",
"year": "2019"
},
{
"DOI": "10.1016/S0140-6736(12)61031-9",
"author": "IM Lee",
"doi-asserted-by": "publisher",
"first-page": "219",
"journal-title": "Lancet",
"key": "26888_CR25",
"unstructured": "Lee, I. M. et al. Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet 380, 219–229. https://doi.org/10.1016/S0140-6736(12)61031-9 (2012).",
"volume": "380",
"year": "2012"
},
{
"DOI": "10.1378/chest.129.3.536",
"author": "F Pitta",
"doi-asserted-by": "publisher",
"first-page": "536",
"journal-title": "Chest",
"key": "26888_CR26",
"unstructured": "Pitta, F. et al. Physical activity and hospitalization for exacerbation of COPD. Chest 129, 536–544. https://doi.org/10.1378/chest.129.3.536 (2006).",
"volume": "129",
"year": "2006"
},
{
"DOI": "10.1097/01.hjr.0000201513.13343.97",
"author": "RD Reid",
"doi-asserted-by": "publisher",
"first-page": "529",
"journal-title": "Eur. J. Cardiovasc. Prev. Rehabilit.: Off. J. Eur. Soc. Cardiol. Work Groups Epidemiol. Prev. Card. Rehabilit. Exerc. Physiol.",
"key": "26888_CR27",
"unstructured": "Reid, R. D. et al. Determinants of physical activity after hospitalization for coronary artery disease: The tracking exercise after cardiac hospitalization (TEACH) study. Eur. J. Cardiovasc. Prev. Rehabilit.: Off. J. Eur. Soc. Cardiol. Work Groups Epidemiol. Prev. Card. Rehabilit. Exerc. Physiol. 13, 529–537. https://doi.org/10.1097/01.hjr.0000201513.13343.97 (2006).",
"volume": "13",
"year": "2006"
},
{
"DOI": "10.1136/bmjopen-2021-051706",
"author": "GF Busatto",
"doi-asserted-by": "publisher",
"first-page": "e051706",
"journal-title": "BMJ Open",
"key": "26888_CR28",
"unstructured": "Busatto, G. F. et al. Post-acute sequelae of SARS-CoV-2 infection (PASC): A protocol for a multidisciplinary prospective observational evaluation of a cohort of patients surviving hospitalisation in Sao Paulo, Brazil. BMJ Open 11, e051706. https://doi.org/10.1136/bmjopen-2021-051706 (2021).",
"volume": "11",
"year": "2021"
},
{
"DOI": "10.1016/j.jbi.2008.08.010",
"author": "PA Harris",
"doi-asserted-by": "publisher",
"first-page": "377",
"journal-title": "J. Biomed. Inform.",
"key": "26888_CR29",
"unstructured": "Harris, P. A. et al. Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inform. 42, 377–381. https://doi.org/10.1016/j.jbi.2008.08.010 (2009).",
"volume": "42",
"year": "2009"
},
{
"DOI": "10.1001/jamanetworkopen.2021.11417",
"author": "T Nasserie",
"doi-asserted-by": "publisher",
"first-page": "e2111417",
"journal-title": "JAMA Netw. Open",
"key": "26888_CR30",
"unstructured": "Nasserie, T., Hittle, M. & Goodman, S. N. Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: A systematic review. JAMA Netw. Open 4, e2111417. https://doi.org/10.1001/jamanetworkopen.2021.11417 (2021).",
"volume": "4",
"year": "2021"
},
{
"key": "26888_CR31",
"unstructured": "Weathers, F., Litz, B. & Herman, D. in Proceedings of the 9th Annual Meeting of the International Society for Traumatic Stress Studies (ISTSS)."
},
{
"DOI": "10.1111/j.1600-0447.1983.tb09716.x",
"author": "AS Zigmond",
"doi-asserted-by": "publisher",
"first-page": "361",
"journal-title": "Acta Psychiatr. Scand",
"key": "26888_CR32",
"unstructured": "Zigmond, A. S. & Snaith, R. P. The hospital anxiety and depression scale. Acta Psychiatr. Scand 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x (1983).",
"volume": "67",
"year": "1983"
},
{
"DOI": "10.1016/s1389-9457(00)00065-4",
"author": "CH Bastien",
"doi-asserted-by": "publisher",
"first-page": "297",
"journal-title": "Sleep Med.",
"key": "26888_CR33",
"unstructured": "Bastien, C. H., Vallières, A. & Morin, C. M. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2, 297–307. https://doi.org/10.1016/s1389-9457(00)00065-4 (2001).",
"volume": "2",
"year": "2001"
},
{
"DOI": "10.1590/S1980-57642012DN06040004",
"author": "FAC Vale",
"doi-asserted-by": "publisher",
"first-page": "212",
"journal-title": "Dement. Neuropsychol.",
"key": "26888_CR34",
"unstructured": "Vale, F. A. C., Balieiro, A. P. Jr. & Silva-Filho, J. H. Memory complaint scale (MCS). Proposed tool for active systematic search. Dement. Neuropsychol. 6, 212–218. https://doi.org/10.1590/S1980-57642012DN06040004 (2012).",
"volume": "6",
"year": "2012"
},
{
"DOI": "10.1016/j.pain.2014.09.014",
"author": "AM Boonstra",
"doi-asserted-by": "publisher",
"first-page": "2545",
"journal-title": "Pain",
"key": "26888_CR35",
"unstructured": "Boonstra, A. M., Schiphorst Preuper, H. R., Balk, G. A. & Stewart, R. E. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain 155, 2545–2550. https://doi.org/10.1016/j.pain.2014.09.014 (2014).",
"volume": "155",
"year": "2014"
},
{
"DOI": "10.1186/1477-7525-1-79",
"author": "K Webster",
"doi-asserted-by": "publisher",
"first-page": "79",
"journal-title": "Health Qual Life Outcomes",
"key": "26888_CR36",
"unstructured": "Webster, K., Cella, D. & Yost, K. The functional assessment of chronic illness therapy (FACIT) measurement system: Properties, applications, and interpretation. Health Qual Life Outcomes 1, 79. https://doi.org/10.1186/1477-7525-1-79 (2003).",
"volume": "1",
"year": "2003"
},
{
"DOI": "10.1371/journal.pone.0254347",
"author": "ML Bell",
"doi-asserted-by": "publisher",
"first-page": "e0254347",
"journal-title": "PLoS One",
"key": "26888_CR37",
"unstructured": "Bell, M. L. et al. Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT. PLoS One 16, e0254347. https://doi.org/10.1371/journal.pone.0254347 (2021).",
"volume": "16",
"year": "2021"
},
{
"DOI": "10.1186/1742-7622-9-1",
"author": "M Joffe",
"doi-asserted-by": "publisher",
"first-page": "1",
"journal-title": "Emerg. Themes Epidemiol.",
"key": "26888_CR38",
"unstructured": "Joffe, M., Gambhir, M., Chadeau-Hyam, M. & Vineis, P. Causal diagrams in systems epidemiology. Emerg. Themes Epidemiol. 9, 1. https://doi.org/10.1186/1742-7622-9-1 (2012).",
"volume": "9",
"year": "2012"
},
{
"DOI": "10.1097/00001648-200105000-00011",
"author": "JM Robins",
"doi-asserted-by": "publisher",
"first-page": "313",
"journal-title": "Epidemiology",
"key": "26888_CR39",
"unstructured": "Robins, J. M. Data, design, and background knowledge in etiologic inference. Epidemiology 12, 313–320. https://doi.org/10.1097/00001648-200105000-00011 (2001).",
"volume": "12",
"year": "2001"
}
],
"reference-count": 39,
"references-count": 39,
"relation": {
"has-preprint": [
{
"asserted-by": "object",
"id": "10.21203/rs.3.rs-1638885/v1",
"id-type": "doi"
}
]
},
"resource": {
"primary": {
"URL": "https://www.nature.com/articles/s41598-022-26888-3"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [],
"subtitle": [],
"title": "Post-acute sequelae of SARS-CoV-2 associates with physical inactivity in a cohort of COVID-19 survivors",
"type": "journal-article",
"update-policy": "http://dx.doi.org/10.1007/springer_crossmark_policy",
"volume": "13"
}