Physical activity, acute severity and long-term consequences of COVID-19: an 18-month follow-up survey based on a Swedish national cohort

Abstract

ObjectiveTo investigate how changes in levels of physical activity (PA) in regard to acute disease severity relate to perceived difficulties in performing daily life activities 18 months after COVID-19 infection.DesignAn observational study with an 18-month follow-up survey based on registry data from a national cohort.Participants5464 responders to the 18-month follow-up survey of a Swedish national cohort of 11 955 individuals on sick leave due to COVID-19 during the first wave of the pandemic.OutcomesThe follow-up survey included questions on daily life activities, as well as present and retrospective level of PA. Changes in PA level from before COVID-19 to follow-up were assessed by the Saltin-Grimby PA Level Scale and analysed by the Wilcoxon signed-rank test. Comparisons of groups were analysed by the Student’s t-test, Mann-Whitney U test and χ2. Multiple binary logistic regression was performed to assess the association of changes in PA with perceived difficulties in performing daily life activities.ResultsAmong the 5464 responders (45% of national cohort), the PA level decreased. Hospitalised individuals had a lower PA level both prior to COVID-19 (p=0.035) and at the 18-month follow-up (p=0.008) compared with non-hospitalised responders. However, the level of PA decreased in both groups. A decrease in PA level increased the odds (OR 5.58, 95% CI 4.90 to 6.34) of having difficulties performing daily life activities.ConclusionsPA levels were reduced 18 months after COVID-19 infection. A decrease in PA over that time was associated with perceived difficulties performing daily life activities 18 months after COVID-19. As PA is important in maintaining health and deconditioning takes time to reverse, this decline may have long-term implications for PA and health.