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Post-acute sequelae of SARS-CoV-2 associates with physical inactivity in a cohort of COVID-19 survivors

Gil et al., Scientific Reports, doi:10.1038/s41598-022-26888-3
Jan 2023  
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Cohort study of 614 COVID-19 survivors discharged from a hospital in Brazil showing an association between post-acute sequelae of SARS-CoV-2 (PASC) and physical inactivity 6-11 months after hospitalization. Patients with one or more persistent PASC symptoms had 57% greater odds of being physically inactive compared to those without symptoms. Dyspnea, fatigue, insomnia, posttraumatic stress, and severe muscle/joint pain were each associated with higher odds of physical inactivity. Authors note that PASC may predispose COVID-19 survivors to physical inactivity.
Gil et al., 5 Jan 2023, Brazil, peer-reviewed, 43 authors, study period March 2020 - August 2020. Contact: hars@usp.br.
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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.
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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> &lt; 0.001), fatigue (OR: 2.01 [1.40–2.90], <jats:italic>P</jats:italic> &lt; 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. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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