Worldwide physical activity trends since COVID-19 onset

Worldwide physical activity trends since COVID-19 onset The COVID-19 pandemic has disrupted nearly all aspects of daily life worldwide. Public health interventions necessary to curb disease spread could have unintended consequences that adversely influence long-term health outcomes beyond near-term mortality. 1 For example, step counts-a proxy for physical activity 2 -were markedly lower early in the COVID-19 pandemic than pre-pandemic. 3 As the global pandemic persists despite vaccines, understanding its long-term ramifications on physical activity-an important determinant of health 4is crucial, and might help to inform public health and regional policy decisions. We examined worldwide trends in physical activity, measured by step counts, 2 years since the onset of the COVID-19 pandemic. We hypothesised that worldwide physical activity remains lower than pre-COVID-19. We used deidentified individual-level data from Jan 1, 2019, to Feb 17, 2022, collected from the freely available Azumio Argus smartphone app, a popular health-wellness app. Daily step counts are determined using smartphone accelerometers and Apple or Android algorithms for step counting. 5 User location was determined by smartphone IP address. Pre-pandemic baseline mean steps were calculated per region using data from Jan 1, 2019, to Dec 31, 2019. COVID-19 regional case counts were obtained from publicly available sources. Significant differences in mean step counts for various time windows were examined using the Kruskal-Wallis and Conover's tests with Bonferroni correction at p<0•001. This study was reviewed and exempted by the University of California, San Francisco Institutional Review Board (20-30 539). A total of 140 424 429 daily step count measurements were provided by 1 255 811 unique users from more than 200 countries and territories during the study period; 92% of smartphones were iOS, 8% were Android. Worldwide, physical activity has somewhat recovered but remains depressed compared with the pre-pandemic baseline of 5323 steps per day during the 2019 calendar year (figure). The mean step count in the 90 days preceding the end of the study period (November 2021-February 2022) was significantly lower for all continents compared with the same 90-day, 2019-2020 prepandemic period (p<0•001). The same 2020-2021 midpandemic 90-day period was also significantly lower