Post-acute sequelae of SARS-CoV-2 associates with physical inactivity in a cohort of COVID-19 survivors 2023 Gil et al

Abstract


The aim of this study was to determine whether Post-acute Sequelae of SARS-CoV-2 Infection (PASC) are associated with physical inactivity in COVID-19 survivors. This is a cohort study of COVID-19 survivors discharged from a tertiary hospital in Sao Paulo, Brazil. Patients admitted as inpatients due to laboratory-confirmed COVID-19 between March and August 2020 were consecutively invited for a follow-up in-person visit 6 to 11 months after hospitalization.

Ten symptoms of PASC were assessed using standardized scales. Physical activity was assessed by questionnaire and participants were classified according to WHO Guidelines. 614 patients were analyzed (age: 56 ± 13 years; 53% male). Frequency of physical inactivity in patients exhibiting none, at least 1, 1–4, and 5 or more symptoms of PASC was 51%, 62%, 58%, and 71%, respectively.

Adjusted models showed that patients with one or more persistent PASC symptoms have greater odds of being physically inactive than those without any persistent symptoms (OR: 1.57 [95% CI 1.04–2.39], P = 0.032). Dyspnea (OR: 2.22 [1.50–3.33], P < 0.001), fatigue (OR: 2.01 [1.40–2.90], P < 0.001), insomnia (OR: 1.69 [1.16–2.49], P = 0.007), post-traumatic stress (OR: 1.53 [1.05–2.23], P = 0.028), and severe muscle/joint pain (OR: 1.53 [95% CI 1.08–2.17], P = 0.011) were associated with greater odds of being physically inactive.

This study suggests that PASC is associated with physical inactivity, which itself may be considered as a persistent symptom among COVID-19 survivors. This may help in the early identification of patients who could benefit from additional interventions tailored to combat inactivity (even after treatment of PASC), with potential beneficial impacts on overall morbidity/mortality and health systems worldwide.

https://www.nature.com/articles/s41598-022-26888-3

 

Death can be associated with physical inactivity, which if left untreated may become a persistent symptom.

 

Illness? Boy, I don't know.

Physicians baffled by the concept of illness and unable to pay attention to what their patients are saying is just about the most baffling thing in the modern world. You can train people as much as you want, if you train them wrong a lot of that training really amounts to nothing in some areas.

 

Have you noticed that people who interact with the police and the criminal justice system are often involved in crime? Let’s abolish the police, the courts and prison, then crime will disappear over night.

The majority of people who die from illness either in hospital or at home do so lying in bed. Let’s get rid of all beds to stop people dying from illnesses.

Do any courses teaching medical research methodology point out that association is not the same as causality and that even if there is a causal relationship the association alone tells us nothing about the direction of causality?

 

I'm going to die alone, destitute, and in squalor after decades of intense and unremitting suffering because scientists research this instead of treatments.

 

Physical activity is great and whatnot but we can't claim it's a cure-all. Lifestyle interventions difficult to stick to, and only provide some benefit so need to be combined with medicine.

We know PEM is a common long Covid symptom and one of the few medical reasons not to exercise. Presumably, some fraction of this cohort had PEM and thus wisely limited their activity level. (My gut says PEM is less common in LC from severe Covid compared to mild, but still enough to be a major factor) Unfortunately, the authors completely ignored PEM when drafting this study. They didn't bother to ask about it, they didn't even mention it. So we don't know how many had it.