Nicholas Institute of Sports Medicine and Athletic Trauma, Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA -
Nicholas Institute of Sports Medicine and Athletic Trauma, Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
J Sports Med Phys Fitness. 2024 Jul;64(7):685-693. doi: 10.23736/S0022-4707.24.15516-8.
Physical activity (PA) is known to decrease COVID-19 risk factors and can attenuate symptoms of viral infections. However, difficulty exercising and fatigue are common complaints after COVID-19. It is unknown whether prior habitual PA will improve outcomes and what the time course is until full recovery of PA after COVID-19.
Invitations were emailed to 21,933 adults who were SARS-CoV-2 positive between March 2020 and February 2021. Participants completed intake surveys and the Physical Activity History (PAH) questionnaire regarding PA during the 3-month prior to infection. Monthly thereafter, for up to 23 months, participants were emailed surveys. Scores were computed for moderate and heavy PA. Long COVID (LC) was defined as having recurring/persistent symptoms 9 months after diagnosis.
Overall, 993 patients completed the intake survey (age 50.7±15.8 years, BMI 27.3±9.2, 58% women); 28% had been hospitalized. One-third had recovered to their pre-infection level of PA at 9 months post-infection; this increased to 65% at one year, and 90% at two years. Higher pre-diagnosis PA reduced odds of hospitalization (P<0.05) but not of LC. Factors predictive of poor PA recovery were higher pre-diagnosis PA, shortness of breath and fatigue during acute illness, and fatigue chronically. Participants who reported ongoing symptoms had consistently poorer recovery of habitual PA compared to those not reporting chronic symptoms.
Habitual PA reduced odds of hospitalization but not of LC. Thirty-five percent had not returned to pre-COVID-19 levels of PA one year after infection, representing a major public health threat.
体力活动（PA）已知可降低 COVID-19 的风险因素，并可减轻病毒感染的症状。然而，在 COVID-19 后，锻炼困难和疲劳是常见的抱怨。目前尚不清楚先前习惯性的 PA 是否会改善预后，以及在 COVID-19 后恢复 PA 的时间过程是什么。
向 21933 名在 2020 年 3 月至 2021 年 2 月期间 SARS-CoV-2 阳性的成年人发送电子邮件邀请。参与者完成了关于感染前 3 个月内 PA 的入组调查和体力活动史（PAH）问卷。此后每月，最多 23 个月，参与者都会收到电子邮件调查。中度和剧烈 PA 的分数被计算出来。长新冠（LC）被定义为在诊断后 9 个月出现反复发作/持续症状。
总体而言，993 名患者完成了入组调查（年龄 50.7±15.8 岁，BMI 27.3±9.2，58%为女性）；28%的患者曾住院治疗。三分之一的患者在感染后 9 个月恢复到感染前的 PA 水平；这一比例在 1 年后增加到 65%，在 2 年后增加到 90%。较高的发病前 PA 降低了住院的几率（P<0.05），但对 LC 没有影响。预测 PA 恢复不良的因素包括较高的发病前 PA、急性疾病期间的呼吸急促和疲劳以及慢性疲劳。报告持续症状的参与者与未报告慢性症状的参与者相比，习惯性 PA 的恢复情况一直较差。
习惯性 PA 降低了住院的几率，但不能降低 LC 的几率。在感染后一年，35%的患者尚未恢复到 COVID-19 前的 PA 水平，这是一个主要的公共卫生威胁。
