Long COVID refers to individuals who begin symptoms months after they recovered from the initial COVID-19 infection. These symptoms may be from fatigue, breathlessness, and body aches to more serious health issues such as heart and lung damage.
Researchers claim that fatigue, breathlessness, and other signs that might last for months following the infection can both encourage a sedentary lifestyle and become more frequent as a result of inactivity.
The correlation between physical inactivity and COVID-19's persistent symptoms is becoming more evident. Researchers at the University of So Paulo in Brazil conducted a survey that was published in Scientific Reports. It found that individuals who have survived COVID-19 but still have at least one persistent symptom are 57% more likely to live a sedentary lifestyle.
The findings suggest that discussion and encouragement of physical activity should be conducted throughout the epidemic, even during the last author of the study and one of the coordinators of USP's Applied Physiology and Nutrition Research Group.
The research, funded by FAPESP, is the first to assess the effect of physical activity on the condition known as long COVID. Long COVID is characterized by symptoms that last for at least two months following the resolution of the coronavirus infection and cannot be linked to any other health difficulties.
Early data suggested that around three out of every four patients admitted to hospital because of COVID-19 had at least one persistent symptom six months after their discharge, according to a December 2020 issue in Nature Medicine.
The researchers examined data collected by the HCFMUSP COVID-19 study group at the Hospital das Clnicas (HC), the hospital complex managed by USP's Medical School (FM-USP). A total of 614 survivors of laboratory-confirmed COVID-19 with an average age of 56 were included in the investigation.
Patients were hospitalized between March and August 2020, and a follow-up protocol was implemented between October 2020 and April 2021 (6-11 months after discharge). They were also asked to describe ten symptoms related to long COVID, such as fatigue, breathlessness, severe muscle pain, and memory impairment.
According to World Health Organization (WHO) guidelines, participants were classified as physically inactive if they did not perform at least 150 minutes of moderately intense exercise per week. “In our case, exercise included housework and walking, as well as sports," Roschel said.
Researchers performed a number of statistical investigations to examine whether or not long-term COVID might be linked to physical inactivity.
In a nationwide survey conducted in 2020, sixty percent of respondents were found to be physically inactive.
“These are risk factors for severe COVID-19, which were expected to be frequent in the study because all of the participants had been hospitalized,” Roschel said, adding that 55% had required intensive care and 37% had been intubated.
The presence of at least one persistent symptom was associated with a 57% increased likelihood of physical inactivity, according to Roschel. When five or more symptoms were reported, the odds of physical activity increased by 138%.
According to the adjusted statistical models, certain sequelae linked to long COVID correlated very closely with physical inactivity. The highest correlations were found with breathlessness (132%) and fatigue (101%).
"It makes sense to assume that people with this condition will have greater difficulty maintaining an active routine," he said. "It's also plausible that people with a sedentary lifestyle may be more susceptible to these long-term symptoms after recovering from an acute infection. Our research does not allow us to infer causality."
Physical inactivity, according to the authors, may be a persistent symptom among COVID-19 survivors, according to a Dutch paper. Two39 recovering patients reported walking significantly less six months after the onset of symptoms than before they contracted the illness.
According to previous research, sedentarism might theoretically reduce the likelihood of long COVID. A research conducted in 2021 and also led by Roschel discovered that hospitalized COVID-19 patients with greater muscle strength and mass (hence likely less sedentary) tended to stay longer in the hospital.
The same authors conducted a separate investigation to discover that COVID-19-infected individuals were more likely to develop persistent symptoms, while also implying that higher post-acute COVID healthcare expenses were connected.
In a 2020 retrospective experiment conducted in the United States, 48,440 COVID-19 patients were evaluated and found that the risk of hospitalization, hospitalization, and death was higher among those who were consistently inactive.
"Our most recent investigation provided additional information by describing specific correlations between physical inactivity and persistent COVID-19 symptoms. Future research should investigate this relationship in order to understand the cause," Roschel said.
The connection might be a two-way street, where sedentarism favors long COVID, and those with long COVID prefer exercise.
Roschel noted that physical activity is clearly demonstrated in a situation like this. Sedentarism is responsible for 9% of all-cause deaths worldwide.
Reference: "Post-acute sequelae of SARS-CoV-2 associates with physical inactivity in a cohort of COVID-19 survivors," by Saulo Gil, Bruno Gualano, Rodolfo Furlan Damiano, Esper Kallas, Linamara Rizzo Batistella, Geraldo Filho Busatto, Hamilton Roschel and HCFMUSP COVID-19 Study Group, 5 January 2023
The So Paulo Research Foundation provided the study.