High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation

Abstract

Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with patient characteristics, disease severity and cardiac dysfunction. We objectively assessed PA, sedentary behaviour and sleep duration for 24 h/day during 8 days at 3-6 months after COVID-19 hospitalisation. PA and sedentary time were compared across pre-defined subgroups based on patient and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram at 3-6 months post-hospitalisation and persistence of symptoms post-discharge. PA and sedentary behaviour were assessed in 37 patients (60 ± 10 years old; 78% male). Patients spent 4.2 [3.2; 5.3] h/day light-intensity PA and 1.0 [0.8; 1.4] h/day moderate-to-vigorous intensity PA. Time spent sitting was 9.8 [8.7; 11.2] h/day, which was accumulated in 6 [5; 7] prolonged sitting bouts (≥30 min) and 41 [32; 48] short sitting bouts (<30 min). No differences in PA and sedentary behaviour were found across subgroups, but sleep duration was higher in patients with versus without persistent symptoms (9.1 vs. 8.3 h/day, p = 0.02). Taken together, high levels of sedentary time are common at 3–6 months after COVID-19 hospitalisation, whilst PA and sedentary behaviour are not impacted by patient or disease characteristics.

Device-assessed physical activity and sleep quality of post-COVID patients undergoing a rehabilitation program

“…As this observation is not statistically signi cant further research with a longer follow-up-interval is needed to con rm this result. Regarding the age of the participants, the current results are consistent with the results of van Bakel, et al (30). Younger post-COVID patients (<55 years) tend to spend less time inactive and achieved a signi cantly higher amount of vigorous PA before rehabilitation compared to older patients (≥55 years).…”

“…Plekhanova, et al (29) reported a lower amount of MVPA with mean (M) = 14.9 minutes/day of female and M = 21.1 minutes/day of male post-COVID patients, which is below the recommended PA level. The female and male patients spend M = 12.1 to 12.6 hours/day in an inactive state, which is in line with ndings by van Bakel, et al (30). The authors of the mentioned studies compared their results with these of healthy population studies and stated, that post-COVID patients are less physical active, and thus, PA should be promoted within this patient cluster.…”

“…Compared with other studies including post-COVID patients, the assessed inactivity time is higher. (30) which revealed, that the level of MVPA of post-COVID patients is not reaching the WHO recommendations. Considering the diverse and complex symptoms of post-COVID patients and the heterogeneity of the study results, nevertheless, it should be critically questioned whether the general WHO's activity recommendations are suitable for such a speci c sample, rather personalised concepts are needed.…”

“…Device based measurements of sleep characteristics of post-COVID patients such as the usage of accelerometers are rare. Plekhanova, et al (29) and van Bakel, et al (30) assessed with accelerometers the PA and sleep behaviour of post-COVID patients admitted to the hospital during the acute phase of infection. Patients with a better recovery process had better sleep parameters and the sleep duration per day was higher.…”

Effect of Thromboprophylaxis on Clinical Outcomes After COVID-19 Hospitalization

“…In addition, during autopsies of patients who died with COVID-19, a high burden of microvascular thrombosis was found as well as macrovascular thromboembolic events that were clinically unsuspected before death ( 17 , 18 ). Many patients hospitalized with COVID-19 also had additional risk factors for VTE and were likely to be more sedentary after hospital discharge ( 19 ). On the basis of these observations, we estimated the primary end point rate would be 4% in the placebo-treated participants by day 30 after hospital discharge.…”