COVID-19 pandemic restrictions continuously impact on physical activity in adults with cystic fibrosis

Abstract

Background We have recently reported reduced physical activity (PA) in people with cystic fibrosis (pwCF) with and without lung transplantation (LTX) during a 6-week stringent lockdown in Switzerland. This follow-up study explores the impact of coronavirus-2019 disease (COVID-19) related pandemic restrictions on individuals’ therapy regimens and health-related aspects in pwCF. Methods We conducted a cross-sectional web-based national survey in Spring 2021. The survey included questions on daily PA, airway clearance and inhalation therapy, questions on COVID-19-compatible symptoms, diagnostic tests and vaccination status, and enquired health-related aspects covering the pandemic period between March 2020 to April 2021. Results 193 individuals with CF (53% female; 25% LTX recipients) participated. Among pwCF, 10 reported COVID-19 (n = 2 LTX recipients), two subjects were hospitalized, no invasive ventilation required, no deaths. The clinical course was generally mild. Overall, 46% reported less PA during the pandemic, mostly due to closed fitness facilities (85%), lack of motivation (34%), and changes in daily structures (21%). In contrast, 32/193 (17%) pwCF were able to increase their PA levels: 12 (38%) and 11 (34%) reported undertaking home-based training and outdoor activities more frequently; 6 (19%) reported an increase in routine PA, and another 3 (9%) started new activities. Among pwCF without LTX, 5% and 4% reported to undertake less airway clearance and inhalation therapy, respectively. Conclusions Our study reveals unfavorable consequences of COVID-19 pandemic restrictions on PA of pwCF with unknown long-term consequences for their overall physical fitness and lung health. Strategies to overcome this undesirable situation are needed; increased uptake of telehealth PA programs and virtual exercise classes to promote PA participation might be one promising approach along with vaccination of pwCF and their close contacts.

Pet ownership and lifestyle behaviours of immunosuppressed individuals and their relatives in the context of COVID-19 pandemic

“…When comparing changes in lifestyle behaviours from before to during the COVID-19 pandemic, our results show, based on the effect sizes, a small but significant decrease in VPA and a large increase in SED. These results are consistent with other studies suggesting a decrease in MPA and VPA in the general population ( Lesser and Nienhuis, 2020 , Wunsch et al, 2022 ) and in immunosuppressed populations with lupus, rheumatoid arthritis, or cystic fibrosis ( Ammitzbøll et al, 2021 , Radtke et al, 2021 ) during the COVID-19 pandemic. In two studies among immunosuppressed individuals, 45–46% of participants reported being less active since the start of the pandemic ( Ammitzbøll et al, 2021 , Radtke et al, 2021 ).…”

“…It is unclear how immunosuppressed individuals’ lifestyle behaviours are affected by stressful life events such as COVID-19 pandemic and its related PSD measures. Immunosuppressed individuals were given strict instructions regarding self-isolation and avoidance of social contact given their increased risk of severe complications due to COVID-19 ( Banerjee et al, 2020 , Bhoori et al, 2020 ), which represented additional barriers to maintain healthy lifestyle behaviours during the pandemic ( Ammitzbøll et al, 2021 , Lupi et al, 2020 , Radtke et al, 2021 , Radtke et al, 2020 ). These behaviours likely extend to close relatives of immunosuppressed individuals as they might adopt stricter PSD measures to protect their loved ones ( Chan et al, 2020 ).…”

COVID-19 Lockdown Impacts Among Patients with Cystic Fibrosis: An Italian Regional Reference Centre Experience

“…We think that during lockdown, despite the fact that most of our population reported an unchanged diet, patients had greater adherence to therapy, assuming that they took their pancreatic enzymes more regularly and did not skip meals. In addition, although the population similarly stated reduced physical activity in another study, most patients reported better adherence to respiratory physical therapy [15].…”

Clinical outcomes of adults and children with cystic fibrosis during the COVID-19 pandemic

“…Pulmonary exacerbations are associated with increased energy expenditure [ 21 ], therefore, reduced incidence of pulmonary exacerbations in the post-index period may have positively influenced BMI. Another potential explanation for increased BMI is reduced levels of physical activity during the pandemic [ 22 ] and other pandemic related behaviours such as increased snacking on energy dense foods [ 23 ]. An alternative measure such as fat free mass index would be helpful in elucidating the impact of the pandemic on nutritional status, however, fat free mass index is not a routinely collected clinical measure.…”