@article{4cdcaed09a784a38a38f336a7c7f1f9e,
title = "Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study",
abstract = "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.",
keywords = "Accelerometry/methods, Aftercare, Aged, COVID-19, Diabetes Mellitus, Type 2/therapy, Exercise, Female, Hospitalization, Hospitals, Humans, Male, Patient Discharge, Sleep",
author = "{Writing group (on behalf of the PHOSP-COVID Collaborative Group)} and Tatiana Plekhanova and Rowlands, {Alex V} and Evans, {Rachael A} and Edwardson, {Charlotte L} and Bishop, {Nicolette C} and Bolton, {Charlotte E} and Chalmers, {James D} and Davies, {Melanie J} and Enya Daynes and Dempsey, {Paddy C} and Docherty, {Annemarie B} and Omer Elneima and Greening, {Neil J} and Greenwood, {Sharlene A} and Hall, {Andrew P} and Harris, {Victoria C} and Harrison, {Ewen M} and Joseph Henson and Ling-Pei Ho and Alex Horsley and Linzy Houchen-Wolloff and Kamlesh Khunti and Leavy, {Olivia C} and Lone, {Nazir I} and Michael Marks and Ben Maylor and McAuley, {Hamish J C} and Nolan, {Claire M} and Krisnah Poinasamy and Quint, {Jennifer K} and Betty Raman and Matthew Richardson and Sargeant, {Jack A} and Saunders, {Ruth M} and Marco Sereno and Aarti Shikotra and Amisha Singapuri and Michael Steiner and Stensel, {David J} and Wain, {Louise V} and Julie Whitney and Wootton, {Dan G} and Brightling, {Christopher E} and Man, {William D-C} and Singh, {Sally J} and Tom Yates",
note = "Funding Information: This study would not be possible without all the participants who have given their time and support. We thank all the participants and their families. We thank the many research administrators, health-care and social-care professionals who contributed to setting up and delivering the study at all of the 65 NHS trusts/Health boards and 25 research institutions across the UK, as well as all the supporting staff at the NIHR Clinical Research Network, Health Research Authority, Research Ethics Committee, Department of Health and Social Care, Public Health Scotland, and Public Health England, and support from the ISARIC Coronavirus Clinical Characterisation Consortium. We thank Kate Holmes at the NIHR Office for Clinical Research Infrastructure (NOCRI) for her support in coordinating the charities group. The PHOSP-COVID industry framework was formed to provide advice and support in commercial discussions, and we thank the Association of the British Pharmaceutical Industry as well as Ivana Poparic and Peter Sargent at NOCRI for coordinating this. We are very grateful to all the charities that have provided insight to the study: Action Pulmonary Fibrosis, Alzheimer{\textquoteright}s Research UK, Asthma UK/British Lung Foundation, British Heart Foundation, Diabetes UK, Cystic Fibrosis Trust, Kidney Research UK, MQ Mental Health, Muscular Dystrophy UK, Stroke Association Blood Cancer UK, McPin Foundations, and Versus Arthritis. We thank the NIHR Leicester Biomedical Research Centre patient and public involvement group and the Long Covid Support Group. Details of the PHOSP-COVID Collaborative Group membership is provided as a supplementary file. Funding Information: CEBo reports grants from NUH Trust R&I / NIHR Nottingham BRC and Nottingham Hospital Charity, outside of the submitted work. SAG reports grants from NIHR clinical lectureship and Kidney Beam Trial funded by Kidney Research UK and being a member of global steering committee of the MFIT trial (Australia) and President UK Kidney Association, Joint Chair UK Kidney Research Consortium, outside of the submitted work. WD-CM reports grants from National Institute for Health Research and British Lung Foundation, personal fees from Mundipharma, Novartis, and European Conference and Incentive Services DMC, and being an advisory board member for Jazz Pharmaceuticals, outside of the submitted work. CMN reports being Co-chair of British Thoracic Society Pulmonary Rehabilitation Group, outside of the submitted work. JW reports grants from NIHR Programme Development Grant 2021—Digital and Remote Enhancements for the Assessment and Management of older people living with frailty, and King{\textquoteright}s College Hospital Charity 2020—COVID-19 rehabilitation scoping work, outside of the submitted work. LHW reports grants from NIHR RfPB and ARC East Midlands, outside of the submitted work. JDC reports grants from Astrazeneca, Boehringer Ingelheim, Novartis, Gilead Sciences, Insmed, Glaxosmithkline, and fees for consultancy from Astrazeneca, Boehringer Ingelheim, Novartis, Zambon, Gilead Sciences, Insmed, Glaxosmithkline, Chiesi, outside of the submitted work. LPH reports grants from UKRI for UKILD study, MRC UK Regenerative Medicine Platform, Celgene (Immune mechanisms in fibrosis), British Lung Foundation (Immune drivers in Sarcoidosis), Boehnringer Ingleheim (IPF study), reports being on advisory board for CATALYST, phase 2 COVID platform trial and Chair of Respiratory Translational Research Collaboration, outside of the submitted work. AH reports grants from NIHR Manchester Biomedical Research Centre, during the conduct of the study and reports being Deputy Chair NIHR Translational Research Collaboration, outside of the submitted work. BR reports grants from British Heart Foundation Oxford Centre of Research Excellence, NIHR Oxford BRC and UKRI MRC during the conduct of the study, and fees for consultancy from Axcella Therapeutics, and payment from Axcella Therapeutics, outside of the submitted work. LVW reports grants from GSK and Orion Pharma, fees for consultancy from Galapagos, personal fees from Genentech, and being on advisory board for Galapagos, outside of the submitted work. RAE reports grants from NIHR, personal fees from Boehringer and Chiesi, and being European Respiratory Society Assembly 01.02 Pulmonary Rehabilitation secretary, outside of the submitted work. MJD is co-funded by the NIHR Leicester Biomedical Research Centre. TY reports grants from NIHR Leicester BRC during the conduct of the study, and grants from UKRI (MRC)-DHSC (NIHR) COVID19 Rapid Response Rolling Call (MR/V020536/1) and from HDR-UK (HDRUK2020.138), outside of the submitted work. KK reports being Chair of the Ethnicity Subgroup of the UK Scientific Advisory Group for Emergencies (SAGE). DGW is supported by an NIHR Advanced Fellowship. CEB reports grants from Grants from GSK, AZ, Sanofi, BI, Chiesi, Novartis, Roche, Genentech, Mologic, 4DPharma, fees to institution for consultancy GSK, AZ, Sanofi, BI, Chiesi, Novartis, Roche, Genentech, Mologic, 4DPharma, TEVA. All other authors declare no competing interests. Funding Information: Jointly funded by UK Research and Innovation and National Institute of Health Research (grant references: MR/V027859/1 and COV0319). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = jul,
day = "28",
doi = "10.1186/s12966-022-01333-w",
language = "English",
volume = "19",
pages = "94",
journal = "International Journal of Behavioral Nutrition and Physical Activity",
issn = "1479-5868",
publisher = "BioMed Central",
number = "1",
}