The impact of Covid-19 on physical activity one year after hospital discharge

Introduction: The long-term impact of severe COVID-19 on the physical activity (PA) of patients is unknown. Method(s): Forty-nine patients (63% male, 47% ICU stay, mean+/-SD 61+/-10 y, BMI 29.6+/-4.5 kg/m2) were assessed 1 year after hospital discharge for severe COVID-19. PA was objectively measured with the Dynaport Movemonitor for 1 week. Pulmonary function (FEV1, diffusion capacity (DL,co)), physical functioning (6 minute walking distance (6MWD), quadriceps force (QF)) and symptoms of dyspnea were assessed. Pearson correlations were used, to explore the association between PA (mean step count) and these outcomes. Low PA levels was defined as a mean step count of <7500 steps/day. Result(s): Patients had a mean daily total walking time of mean+/-SD 80+/-41 min/day and a mean movement intensity of 1.99+/-0.35 m/s2. They performed 6817+/-3567 steps/day. One year after discharge 65% of patients retained low PA levels. PA was not different between patients who had an ICU stay and those who did not (6667+/-4650 steps/day vs. 6943+/-2408 steps/day, p=0.80;71% vs 64% with low PA levels, p=0.29). 20% of patients reported mMRC dyspnea scale scores >1;90% of them had low PA levels. PA was associated with 6MWD, but not with QF, FEV1 and DL,co (figure 1). Conclusion(s): A significant proportion of patients was inactive 1 year after severe COVID-19 with no difference between patients with or without ICU stay. PA was positively associated with exercise capacity.

Improved peak exercise performance after 12 weeks of pulmonary rehabilitation in patients post COVID-19

Background: Pulmonary Rehabilitation (PR) is recommended for patients that suffered from severe COVID19. The exercise and training response as well as predictors of response are not yet well studied. Aim(s): To study the response to an incremental exercise test performed before and after 12 weeks of outpatient PR. Method(s): An exercise test was conducted in 37 of 70 patients that completed PR after COVID19, (age 52+/-9, BMI 29+/-6, 20 male, FEV1 89+/-21%pre, 31 hospitalized). Result(s): Before starting PR, exercise tolerance was reduced. A cardiac, ventilatory, gas exchange and muscular limitation was observed in 24%, 22%, 37% and 45% of patients respectively. Physiologic limitations were inconclusive in 19% of patients. After completing PR, significant desaturation was still seen in 30% of patients. Rehabilitation increased Wmax by 58+/-55% and VO2max by 40+/-38% of baseline values with significant improvements in O2pulse (see table1). Multiple regression revealed that improvement in VO2peak was associated with gender (+386ml/min in male p=0.01 Partial R2=0.14), and Hospital anxiety and depression scale -21ml/min per baseline point in total score (partial R2 0.18 p=0.03). Quadriceps force did not significantly enter the model (p=0.1). Conclusion(s): Peak exercise tolerance increased rapidly upon initiation of PR in patients after COVID19. In patients with psychologic morbidity at baseline, this response seems somewhat blunted.

Late Breaking Abstract - Physical activity in lung transplant recipients during Belgian COVID-19 lockdown

Introduction: SARS-CoV-2 caused a pandemic in 2020 with a 'lockdown' resulting in reduced mobility. Activity tracker companies noticed reduced physical activity (PA) in the general population. If observed in patients, this may add to the devastating consequences of physical inactivity. Aim: To investigate PA levels of lung transplant (LTX) recipients before and during the Belgian soft lockdown measures of COVID-19. A decline in daily step count during lockdown measures was hypothesized. Methods: 16 LTX recipients (56% male, mean±SD age 61±6.7 years, 30.2±12.7 months post LTX) involved in an RCT (NCT04122768) were included in the present sub-analysis. Daily step counts were collected by activity trackers, >4 weeks prior to (phase 1) and 4 weeks during the Belgian lockdown (phase 2). The differences in PA between both phases were compared with paired t-tests. Results: Daily number of steps was low in phase 1 (mean±SD 6910±4225 steps/day) but did not change during phase 2 (7016±5665 steps/day), p=0.89, see figure 1. Conclusions: The Belgian COVID-19 lockdown measures did not significantly affect the PA levels of LTX recipients compared to the preceding period.