Exploring the Impact of COVID-19 on Physical Activity One Month after Infection and Its Potential Determinants: Re-Infections, Pre-Illness Vaccination Profiles/Types, and Beyond

Abstract

This study investigated changes in physical activity (PA) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection while considering age, PA level, underlying medical conditions (UMCs), vaccination profiles/types, re-infections, disease severity, and treatment. Data were collected from 5829 respondents by using a validated web-based questionnaire. The findings showed that there was a significant overall decrease in PA (-16.2%), including in daily occupation (-11.9%), transportation (-13.5%), leisure-time (-16.4%), and sporting (-27.6%) activities. Age, PA level, UMCs, vaccination profiles/types, disease severity, and treatment played a role in determining PA in individuals' post-acute SARS-CoV-2 infections. Re-infections did not impact the decline in PA. Unvaccinated individuals experienced a significant decline in PA (-13.7%). Younger (-22.4%) and older adults (-22.5%), those with higher PA levels (-20.6%), those with 2-5 UMCs (-23.1%), those who were vaccinated (-16.9%) or partially vaccinated (-19.1%), those with mRNA-type vaccines only (-17.1%), those with recurrent (-19.4%)-to-persistent (-54.2%) symptoms, and those that required hospital (-51.8%) or intensive care unit (-67.0%) admission during their infections had more pronounced declines in PA. These findings emphasize the complex relationship between post-acute SARS-CoV-2 infection and PA and highlight the need for targeted interventions, further research, and multidisciplinary care to promote PA resumption and mitigate long-term effects on global public health.

Keywords: Long COVID; cross sectional; exercise; mRNA; performance; post-COVID-19 conditions (PCCs); post-acute Sequelae of SARS-CoV-2 infection (PASC); public health; retrospective; viral vector.

Figure 1

Study design. Abbreviation: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Figure 2

Change in overall PA (%, from the PRE to the POST conditions) on a weekly basis in all participants and in the subgroups according to respondent sex at birth, age, body mass index, PA level, smoking status, region of residence, education level, number of underlying medical conditions, pre-illness vaccination profile, pre-illness vaccine type(s) received, incidence of SARS-CoV-2 re-infections, disease severity, and illness treatment. Error bars present the lower bounds of the 95% confidence intervals. Abbreviations: ICU, intensive care unit; MET, metabolic equivalent task (1 MET = 3.5 mL O₂·kg⁻¹·min⁻¹); mRNA, messenger ribonucleic acid; n, sample size; N, subgroup’s sample size; PA, physical activity; POST, one month post-SARS-CoV-2 infection; PRE, 1–2 wk pre-SARS-CoV-2 infection; PS, protein subunit; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; VV, viral vector.

Figure 3

Change in daily occupation, transportation (to and from daily occupation), leisure-time, and regular sporting activities (%, from the PRE to POST conditions) on a weekly basis in all participants and in the subgroups according to respondent pre-illness vaccination profile, pre-illness vaccine type(s) received, and incidence of SARS-CoV-2 re-infections. Error bars present the lower bounds of the 95% confidence intervals. Abbreviations: MET, metabolic equivalent task (1 MET = 3.5 mL O₂·kg⁻¹·min⁻¹); mRNA, messenger ribonucleic acid; n, sample size; N, subgroup’s sample size; PA, physical activity; POST, one month post-SARS-CoV-2 infection; PRE, 1–2 wk pre-SARS-CoV-2 infection; PS, protein subunit; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; VV, viral vector.