Impact of risk for severe COVID-19 illness on physical activity during the pandemic
Analysis of 640 adults in the USA, showing that adults at high risk of severe COVID-19 were disproportionately more likely to be physically inactive and had lower activity levels during the early months of the pandemic.
Wierenga et al., 8 May 2023, USA, peer-reviewed, survey, mean age 42.7, 9 authors.
Abstract: Heart & Lung 61 (2023) 84 91
Contents lists available at ScienceDirect
Heart & Lung
journal homepage: www.heartandlung.com
Impact of risk for severe COVID-19 illness on physical activity during the
Kelly L. Wierenga, PhD, RNa,*, Susan M. Perkins, PhDb, Anna K. Forster, PhD, RNa,
Jennifer Alwine, BSN, RNa, Susan Ofner, MSb,
Malissa A. Mulkey, PhD, APRN, CCNS, CCRN, CNRNc,
Eileen Danaher Hacker, PhD, APRN, AOCN, FAANd, Susan J. Pressler, PhD, RN, FAANa,
Scott Emory Moore, PhD, APRN, AGPCNP-BC, FAANe
Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA
Indiana University School of Medicine, Department of Biostatistics and Health Data Science, 410W 10th St, Suite 3000, Indianapolis, IN 46202, USA
University of South Carolina College of Nursing, 1601 Greene Street, WMBB323, Columbia, SC 29208, USA
University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, FC2.2046, Houston, TX 77030, USA
Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-7343, USA
A R T I C L E
I N F O
Received 10 February 2023
Revised 1 May 2023
Accepted 4 May 2023
Available online 8 May 2023
Metabolic equivalent of task
A B S T R A C T
Background: Precautions to mitigate spread of COVID-19 such as the closing of exercise facilities impacted
physical activity behaviors. Varied risks for severe COVID-19 may have inﬂuenced participation in regular
physical activity to maintain precautions.
Objective: Describe differences in the amount and intensity of physical activity between adults at high versus
low risk for severe COVID-19 illness during the pandemic. We hypothesized that over 13 months, 1) highrisk adults would have greater odds of inactivity than low-risk adults, and 2) when active, high-risk adults
would have lower metabolic equivalent of task minutes (MET-min) than low-risk adults.
Methods: This longitudinal observational cohort study surveyed U.S. adults’ demographics, health history,
and physical activity beginning March 2020 using REDCap. Using self-report, health history was assessed
with a modiﬁed Charlson Comorbidity Index and physical activity with the International Physical Activity
Questionnaire. Repeated physical activity measurements were conducted in June, July, October, and December of 2020, and in April of 2021. Two models, a logistic model evaluating physical inactivity (hypothesis 1)
and a gamma model evaluating total MET-min for physically active individuals (hypothesis 2), were used.
Models were controlled for age, gender, and race.
Results: The ﬁnal sample consisted of 640 participants (mean age 42.7 § 15.7, 78% women, 90% white), with
n = 175 categorized as high-risk and n = 465 as low-risk. The odds of inactivity for the high-risk adults were
2.8 to 4.1 times as high than for low-risk adults at baseline and 13 months. Active high-risk adults had lower
MET-min levels than low-risk adults in March (28%, p = 0.001), June (29%, p = 0.002), and July of 2020 (30%,
p = 0.005) only.
Conclusions: Adults at high risk of severe COVID-19 illness were disproportionately more likely to be physically inactive and exhibit lower MET-min levels than adults at low risk during the early months of the
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