Physical activity, heart rate and sleep before and during the COVID-19 pandemic in 34 countries (Preprint)

Abstract

BACKGROUND The COVID-19 pandemic disrupted behavior within populations, affecting physical activity (PA), heart rate (HR) and sleep characteristics in particular. OBJECTIVE We analyzed the associations between the features of the COVID pandemic worldwide and PA, HR & sleep parameters, using data collected from wearable sensors over a three-year period. METHODS We performed a retrospective analysis of data obtained from the Withings Steel HR activity trackers of 208,818 individuals from 34 countries, from 2019 to 2022. Key metrics analyzed included daily step counts, average heart rate and sleep duration. The statistical methods used included descriptive analyses, time-trend analysis and mixed models evaluating the impact of restriction measures, controlling for potential confounders such as sex, age and seasonal variations. RESULTS We detected a significant decrease in physical activity, with a 12.3% reduction of daily step count over the three years. A 1.50% decrease in HR occurred during lockdowns, associated with the decrease in activity levels. In 2022, the global population had not returned to pre-pandemic physical activity levels, with a noticeable persistence of inactivity. Particularly, the proportion of sedentary individuals remained elevated compared to 2019, indicating that the impact of the pandemic on reducing physical activity has had lasting effects on populations worldwide. Sleep duration increased during restrictions, particularly in the countries with the most severe lockdowns. CONCLUSIONS The sustained decrease in physical activity and its physiological consequences highlight the need for public health strategies to mitigate the long-term effects of the measures taken during the pandemic. Despite the gradual lifting of restrictions, physical activity levels have not fully recovered, with lasting implications for global health. If similar circumstances arise in the future, priority should be given to measures for effectively increasing physical activity to counter the increase in sedentary behavior, mitigate health risks and prevent the rise of chronic diseases.