Recovery Of Physical Activity During 2.5 Years Following COVID-19: My Get-up-and-go Got Up And Went

PURPOSE: Previously (ACSM, 2023), we documented no protective effect of pre-diagnosis (pre-dx) physical activity (PA) against long COVID (LC) nine months following infection. Additionally, we found that greater pre-dx PA predicted difficulty recovering an original high level of activity, with fatigue and shortness of breath during acute illness and ongoing reports of fatigue associated with poor recovery of PA. In this abstract, we seek to document longer-term changes in PA over 30 months after COVID-19, and further examine difficulty in recovering higher levels of PA. METHODS: Invitations were emailed to 21,933 adults who were SARS-CoV-2 positive in the Northwell Health system between March, 2020 and February, 2021. Participants (n = 503 submitting at least one follow-up) completed a medical history and a Physical Activity History (PAH) survey for the 3-months pre-diagnosis. Monthly thereafter they were emailed links to the PAH.Both raw PA score and recovery of PA to pre-dx level (current PA/pre-dx PA) were examined, with subjects stratified into tertiles based on their pre-dx PA. PA scores and recovery were analyzed using three-way ANOVA, with the factors being activity tertile, time and the presence of COVID-related symptoms. RESULTS: Data are reported for 9-30 months after COVID-19 infection: 503 participants 9 months following infection, with 122 still reporting at 30 months. Pre-dx PA was not different between those who reported continuing symptoms vs those who did not (p = 0.292). Those with symptoms had lower PA scores and worse recovery (both p < 0.001). For PA score, an interaction of activity tertile x presence of symptoms (p < 0.001) indicated that symptomatic subjects with greater pre-dx PA had larger deficits in PA. Similarly, subjects in the lowest PA tertile showed complete recovery of PA, whereas those in the higher tertiles showed incomplete recovery (64% and 56% in second and third tertiles, respectively; p < 0.001 compared to first tertile). CONCLUSIONS: Clinicians should be aware of this difficulty in returning to PA following COVID-19, with those having high pre-dx PA levels reporting difficulty returning to their active lifestyle; this may persist for years following infection. Those still experiencing COVID-related symptoms show lower PA, an effect exacerbated for those with greater pre-dx PA.