Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study
Plekhanova T., Rowlands AV., Evans RA., Edwardson CL., Bishop NC., Bolton CE., Chalmers JD., Davies MJ., Daynes E., Dempsey PC., Docherty AB., Elneima O., Greening NJ., Greenwood SA., Hall AP., Harris VC., Harrison EM., Henson J., Ho LP., Horsley A., Houchen-Wolloff L., Khunti K., Leavy OC., Lone NI., Marks M., Maylor B., McAuley HJC., Nolan CM., Poinasamy K., Quint JK., Raman B., Richardson M., Sargeant JA., Saunders RM., Sereno M., Shikotra A., Singapuri A., Steiner M., Stensel DJ., Wain LV., Whitney J., Wootton DG., Brightling CE., Man WDC., Singh SJ., Yates T.
Background: The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms. Methods: One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators. Results: Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7 min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7 h/day spent inactive and 7.2 ± 1.1 h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7 h /day and 6.9 ± 1.1 h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2 h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Conclusions: Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of sleep several months after discharge. Our comparative cohorts indicate that the long-term impact of COVID-19 on physical behaviours is significant.