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. 2023 Nov 17;10(12):ofad579.
doi: 10.1093/ofid/ofad579. eCollection 2023 Dec.

Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study

Stephanie A Richard  1   2 , Ann I Scher  3 , Jennifer Rusiecki  3 , Celia Byrne  3 , Catherine M Berjohn  1   3   4 , Anthony C Fries  5 , Tahaniyat Lalani  1   2   6 , Alfred G Smith  6 , Rupal M Mody  7 , Anuradha Ganesan  1   2   8 , Nikhil Huprikar  3   8 , Rhonda E Colombo  1   2   3   9 , Christopher J Colombo  3   9 , Christina Schofield  9 , David A Lindholm  3   10 , Katrin Mende  1   2   10 , Michael J Morris  10 , Milissa U Jones  11 , Ryan Flanagan  11 , Derek T Larson  3   4   12 , Evan C Ewers  3   12 , Samantha E Bazan  13 , David Saunders  3 , Ryan C Maves  14 , Jeffrey Livezey  15 , Carlos J Maldonado  16 , Margaret Sanchez Edwards  1   2 , Julia S Rozman  1   2 , Robert J O'Connell  1 , Mark P Simons  1 , David R Tribble  1 , Brian K Agan  1   2 , Timothy H Burgess  1 , Simon D Pollett  1   2 ; EPICC COVID-19 Cohort Study Group
Collaborators, Affiliations

Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study

Stephanie A Richard et al. Open Forum Infect Dis. .

Abstract

Background: The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain.

Methods: We compared survey responses in a 1-year study of US military service members with (n = 1923) and without (n = 1591) a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We fit Poisson regression models to estimate the association between history of SARS-CoV-2 infection and fitness impairment, adjusting for time since infection, demographics, and baseline health.

Results: The participants in this analysis were primarily young adults aged 18-39 years (75%), and 71.5% were male. Participants with a history of SARS-CoV-2 infection were more likely to report difficulty exercising (38.7% vs 18.4%; P < .01), difficulty performing daily activities (30.4% vs 12.7%; P < .01), and decreased fitness test (FT) scores (42.7% vs 26.2%; P < .01) than those without a history of infection. SARS-CoV-2-infected participants were at higher risk of these outcomes after adjusting for other factors (unvaccinated: exercising: adjusted risk ratio [aRR], 3.99; 95% CI, 3.36-4.73; activities: aRR, 5.02; 95% CI, 4.09-6.16; FT affected: aRR, 2.55; 95% CI, 2.19-2.98). Among SARS-CoV-2-positive participants, full vaccination before infection was associated with a lower risk of post-COVID-19 fitness impairment (fully vaccinated: exercise: aRR, 0.81; 95% CI, 0.70-0.95; activities: aRR, 0.76; 95% CI, 0.64-0.91; FT: aRR, 0.87; 95% CI, 0.76-1.00; boosted: exercise: aRR, 0.62; 95% CI, 0.51-0.74; activities: aRR, 0.52; 95% CI, 0.41-0.65; FT: aRR, 0.59; 95% CI, 0.49-0.70).

Conclusions: In this study of generally young, healthy military service members, SARS-CoV-2 infection was associated with lower self-reported fitness and exercise capacity; vaccination and boosting were associated with lower risk of self-reported fitness loss.

Keywords: COVID-19; fitness; long COVID.

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Conflict of interest statement

Potential conflicts of interest. 1045 S.D.P., T.H.B., J.S.R., and M.P.S. report that the Uniformed Services University (USU) Infectious Diseases Clinical Research Program (IDCRP), a US Department of Defense institution, and the HJF were funded under a Cooperative Research and Development Agreement to conduct an unrelated phase III COVID-19 monoclonal antibody immunoprophylaxis trial sponsored by AstraZeneca. The HJF, in support of the USU IDCRP, was funded by the Department of Defense Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense to augment the conduct of an unrelated phase III vaccine trial sponsored by AstraZeneca. Both trials were part of the US Government COVID-19 response. Neither is related to the work presented here. R.C.M. receives research support paid to his institution from Sound Pharmaceuticals for an investigational COVID-19 therapeutic unrelated to the work presented here. M.J.M. is a paid speaker for Xarelto (Janssen Pharmaceuticals). All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Responses to fitness survey questions, by time. The numbers in the bars represent the percentage of subjects who reported difficulty with exercise, daily activities (ie, walking or going up stairs), or physical fitness test score. Participants who never tested positive are included in the “never SARS-CoV-2+” group, and their answers are summarized over all surveys. Abbreviation: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Figure 2.
Figure 2.
Covariates’ association with self-reported changes in fitness. Multivariable Poisson regression models fit separately for each outcome included time since first SARS-CoV-2-positive test or time since enrollment (for SARS-CoV-2-negative participants) and random effect for the participant in addition to the listed covariates. The reference category for BMI is normal/underweight; the reference category for military service branch is Air Force; the reference category for age is 18–29 years; the reference category for SARS-CoV-2 status is uninfected. Abbreviations: BMI, body mass index; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
See this image and copyright information in PMC

References

    1. Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 2022; 28:2398–405. - PMC - PubMed
    1. Durstenfeld MS, Sun K, Tahir P, et al. Use of cardiopulmonary exercise testing to evaluate long COVID-19 symptoms in adults: a systematic review and meta-analysis. JAMA Netw Open 2022; 5:e2236057. - PMC - PubMed
    1. Rienks R, Holdsworth D, Davos CH, et al. Cardiopulmonary assessment prior to returning to high-hazard occupations post-symptomatic COVID-19 infection: a position statement of the Aviation and Occupational Cardiology Task Force of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:1724–30. - PMC - PubMed
    1. O'Sullivan O, Rienks R, et al. Vaccines and variants: an update on cardiopulmonary assessment prior to return to high-hazard occupations following COVID-19. Eur J Prev Cardiol 2022; 30:177–179. - PMC - PubMed
    1. Centers for Disease Control and Prevention . COVID Data Tracker. Available at: https://covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed December 4, 2022.