Long-term impact of the COVID-19 pandemic on physical activity and estimated cardiorespiratory fitness in south American adults: a multi-country cross-sectional online survey

Abstract

Background: Restriction measures during the COVID-19 pandemic may have reduced opportunities to engage in physical activity. This study explored the changes in self-reported physical activity level (PAL), risk factors, and estimated cardiorespiratory fitness (eCRF) among south American adults by comparing data reflecting the pre-pandemic period to data collected during the survey.

Methods: We conducted a cross-sectional online survey between July 2021 through March 2022 using validated questionnaires (e.g., GPAQ and WHO-STEPS) on a convenience sample of 1,934 adults (68.7% women) from Argentina (n = 484), Brazil (n = 405), Chile (n = 279), Colombia (n = 343) and Uruguay (n = 423). We compared self-reported PAL, risk factors, and eCRF before the pandemic period and at the time of the survey (mean 842 days from the first reported case in each country). Data were presented as medians (interquartile range [IQR]) or means (95% confidence interval [CI]) for continuous variables and percentages for categorical ones. Paired data analyses were conducted using paired t-tests, Wilcoxon Signed Rank test, and McNamar's tests, as applicable.

Results: We observed a decrease in PAL at work (median, 0 METs/min/week and interquartile range, [0-240] vs. 0 METs/min/week [0-30]; p = 0.032) and active transportation domains (0 METs/min/week [0-693] vs. 0 METs/min/week [0-594]; p = 0.008). In addition, the median sedentary time on weekdays increased by 60 min/day (360 [240-540] vs 420 [240-600]; p < 0.001). We also observed an increase in the proportion of participants with hypertension (12.9 vs. 16.5%), diabetes (6.8 vs. 9.8%), dyslipidemia (18.9 to 24%), depression symptoms (14.4 to 15.4%) and obesity (15.4 to 18.2%) compared with pre-pandemic levels (all p-values < 0.05). The eCRF was significantly lower at the survey time compared with pre-pandemic levels (mean difference, -1.17 mL/min/kg (or 3.34%): 95% CI, -1.03 to -1.30) even after adjusting for age (-0.50 mL/min/kg (or 1.45%): 95% CI -0.37 to -0.64).

Conclusions: Across five countries in South America, social restriction policies to control the COVID-19 pandemic may have reduced physical activity and estimated cardiorespiratory fitness with no recovery until the survey time.

Keywords: V ˙ O2max; Cardiovascular risk; Coronavirus; Exercise; SARS-Cov-2.

Fig. 1

Flowchart of the present study. *We considered inconsistent information in case of missing values, mistyped data, as well as spurious (out of range) numbers

Fig. 2

Self-reported prevalence of cardiovascular risk factors and depression symptoms before the pandemic and at the time of the survey. PAFIT online survey was conducted between June 2021 and January 2023. ‡p < 0.05

Fig. 3

Self-reported prevalence of cardiovascular risk factors and depression symptoms before the pandemic and at the time of the survey. PAFIT online survey was conducted between June 2021 and January 2023. ‡ p < 0.05. A Proportion of physically active participants (≥ 600 METs/min/week). B The proportion of participants with ow age-adjusted estimated cardiorespiratory fitness (≤ 8 metabolic equivalents (28 mLO₂•kg⁻¹•min.⁻¹))

Fig. 4

Mean absolute change in estimated cardiorespiratory fitness from “Before” the pandemic up to the time of the survey response. Estimated cardiorespiratory fitness and 95% confidence intervals expressed in mLO₂•kg⁻¹•min⁻¹. A Unadjusted. B Adjusted for age