The Effects of COVID-19 on Physical Activity, Physical Function, and Psychological Health

Coronavirus (COVID-19) is caused by the SARS-CoV-2 virus. Long COVID is secondary to an acute COVID-19 infection and is characterized by chronic symptoms that persist for >3 months after initial infection with minimal information about the mechanisms and who is most vulnerable. Further, the protective effects of physical activity (PA) on the acute symptoms of COVID-19 and persistent symptoms of Long COVID are not known. The purpose of this dissertation was to determine (1) PA levels before, and after COVID-19 infection, and the persistent effects of COVID-19 on (2) physical function and (3) psychological health in non-hospitalized COVID-19 survivors. We hypothesized that higher PA prior to infection would lessen the acute and persistent symptoms affiliated with Long COVID in people who had not been hospitalized for their acute COVID-19 infection. Aim one demonstrated that PA (self-reported) declined in COVID-19 survivors from pre-COVID-19 to an average of 8.5 months following infection and rebounded to levels similar to pre-COVID on average 4.25 years later. PA declined the most among participants who reported Long COVID symptoms after initial infection. Furthermore, both COVID-19 survivors and age- and sex- matched controls (non-COVID) experienced reduced PA, highlighting the broader impact of the pandemic on activity levels. Aim two demonstrated that persistent symptoms in COVID-19 survivors had a negative impact on muscular and cardiopulmonary function, potentially influencing exercise tolerance even 8.5 months after infection. However, higher levels of PA prior to COVID-19 infection appeared to help preserve maximal handgrip and lower-extremity muscle strength, maximal oxygen utilization (predicted V̇O2), and pulmonary function in people who experienced Long COVID symptoms. Aim three demonstrated greater self-reported fatigue, depression, anxiety and stress in COVID-19 survivors compared with matched controls. These attributes of psychological health were worse in COVID-19 survivors who reported the most symptoms acutely and in people with Long COVID symptoms. These dissertation findings highlight the critical role of PA in mitigating some of the long-term effects of COVID-19 on physical and psychological health. These results emphasize the importance of promoting PA to support recovery, maintain functional and performance abilities, and maintain the overall well-being in COVID-19 survivors.