ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2025
Trajectories of device-assessed physical activity and sleep in ICU- and non-ICU-treated patients up to 2 years after hospitalization for COVID-19, and their association with health-related quality of life.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSevere COVID-19 may have lasting effects on physical and sleep behaviors, which could affect health-related quality of life (HRQoL). This study aimed to assess 2-year trajectories of device-assessed physical and sleep behaviors post-hospitalization, comparing ICU- and non-ICU-treated patients, and to assess their association with HRQoL.
methods7-day wrist-worn accelerometer assessment at 3-6, 12, and 24 months post-hospitalization. Physical behavior: physical activity volume, time spent in light (LIPA) and moderate-to-vigorous (MVPA) physical activity, and inactivity; sleep behavior: sleep duration, efficiency, and sleep regularity index (SRI); HRQoL: EQ-5D-5L questionnaire. Multivariable generalized estimating equations models were used to assess trajectories, and associations of physical activity (LIPA, MVPA) and sleep duration with HRQoL adjusted for covariables.
results358 patients (mean age 59.7 ± 10.5 years, 246 [69%] males, 137 [38%] ICU-treated) were included. In the total cohort, estimated mean physical activity volume was 23.5 mg/day (SE 0.40), with 153.2 min (SE 2.6) LIPA, 32.7 min (SE 1.4) MVPA, and 10.8 h (SE 0.07) inactive at 3-6 months. The estimated mean sleep duration was 6.9 (SE 0.05) hours/night, efficiency 71.1% (SE 0.41), and SRI 52.7% (SE 0.72). ICU-treated patients showed significantly lower physical activity volume (22.6 [SE 0.55] vs. 24.2 [SE 0.54], p = 0.05) and SRI (50.3 [SE 1.2] vs. 53.2 [SE 0.95], p = 0.04) compared to non-ICU-treated patients. Over time, physical and sleep outcomes remained stable in the total cohort. However, ICU-treated patients showed greater improvements in physical activity between 3-6 months and 1 year compared to non-ICU-treated patients (e.g., mean difference in change in MVPA = 6.9 min [95% CI 2.0 to 11.8], p = 0.006). Trajectories did not differ significantly between groups thereafter. MVPA, but not LIPA and sleep duration, was significantly associated with HRQoL, independent of covariables (β
conclusionDevice-assessed physical and sleep behaviors seemed generally sufficient and remained stable up to 2 years post-hospitalization. However, ICU-treated patients initially showed less physical activity, reaching the levels of non-ICU-treated from the 1-year visit onwards, likely reflecting recovery from critical illness. Less time spent in MVPA was associated with poorer HRQoL; however, physical activity support should be personalized and cautiously considered in COVID-19 aftercare.
trial registrationThis study has been prospectively registered in the International Clinical Trial Registry Platform (NL8710).
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