The Effect Of Long Covid On The Relationship Between Physical Activity And Perceived Health

PURPOSE: Physical activity (PA) is prescribed routinely in the prevention and treatment of many chronic health conditions but some patient populations like chronic fatigue syndrome report worsening of health with PA. Long COVID is a condition that shares attributes with chronic fatigue syndrome, yet it is unclear how long COVID influences PA and health. Therefore, this study examined whether long COVID affects the relationship between PA and self-reported physical and mental health in adults. METHODS: Participants were 4316 adults reporting long COVID status, PA participation, and perceived physical and mental health (PROMIS-GH). Aerobic PA was categorized as inactive (reference group), insufficiently active, active, and highly active based on the PA guidelines. Analyses controlled for sociodemographic characteristics and health behaviors. Linear regression models stratified by long COVID status were used to determine the association between levels of PA and physical and mental health. RESULTS: Individuals with long COVID reported significantly worse physical (T = 39.67) and mental (T = 41.40) health than those without long COVID (Ts = 49.47, 48.96, respectively). In addition, those with long COVID were significantly more likely to report being inactive, as well as significantly less likely to report being highly active compared to those without long COVID. Among those without long COVID, each increase in PA level (insufficiently active, active, highly active) was associated with greater physical and mental health compared to those who were inactive (ps < 0.001). However, among those with long COVID, only the active and highly active categories reported better physical health, and only the insufficiently active and active categories reported better mental health than the inactive group (ps < 0.05). CONCLUSION: Those with long COVID reported worse physical and mental health than those without, and they were more likely to inactive while less likely to be highly active. While those with long COVID generally showed improved physical and mental health with increasing levels of PA, not all levels of increased PA were associated with improved physical and mental health when compared to those who were inactive, a deviation from the no long COVID group.