The COVID-19 Pandemic and Daily Steps in the General Population: Meta-analysis of Observational Studies

Abstract

Background The COVID-19 pandemic has the potential to accelerate another pandemic: physical inactivity. Daily steps, a proxy of physical activity, are closely related to health. Recent studies indicate that over 7000 steps per day is the critical physical activity standard for minimizing the risk of all-cause mortality. Moreover, the risk of cardiovascular events has been found to increase by 8% for every 2000 steps per day decrement. Objective To quantify the impact of the COVID-19 pandemic on daily steps in the general adult population. Methods This study follows the guidelines of the MOOSE (Meta-analysis Of Observational Studies in Epidemiology) checklist. PubMed, EMBASE, and Web of Science were searched from inception to February 11, 2023. Eligible studies were observational studies reporting monitor-assessed daily steps before and during the confinement period of the COVID-19 pandemic in the general adult population. Two reviewers performed study selection and data extraction independently. The modified Newcastle-Ottawa Scale was used to assess the study quality. A random effects meta-analysis was conducted. The primary outcome of interest was the number of daily steps before (ie, January 2019 to February 2020) and during (ie, after January 2020) the confinement period of COVID-19. Publication bias was assessed with a funnel plot and further evaluated with the Egger test. Sensitivity analyses were performed by excluding studies with low methodological quality or small sample sizes to test the robustness of the findings. Other outcomes included subgroup analyses by geographic location and gender. Results A total of 20 studies (19,253 participants) were included. The proportion of studies with subjects with optimal daily steps (ie, ≥7000 steps/day) declined from 70% before the pandemic to 25% during the confinement period. The change in daily steps between the 2 periods ranged from –5771 to –683 across studies, and the pooled mean difference was –2012 (95% CI –2805 to –1218). The asymmetry in the funnel plot and Egger test results did not indicate any significant publication bias. Results remained stable in sensitivity analyses, suggesting that the observed differences were robust. Subgroup analyses revealed that the decline in daily steps clearly varied by region worldwide but that there was no apparent difference between men and women. Conclusions Our findings indicate that daily steps declined substantially during the confinement period of the COVID-19 pandemic. The pandemic further exacerbated the ever-increasing prevalence of low levels of physical activity, emphasizing the necessity of adopting appropriate measures to reverse this trend. Further research is required to monitor the consequence of long-term physical inactivity. Trial Registration PROSPERO CRD42021291684; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=291684

Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life

“…Compared with normative values the VO2max/kg was reduced by 8.6±5.8 ml/min/kg (27.7%), the 6MWT by 71±96 m (11.9%), the health-related quality of life physical component score by 15.0±9.0 points (29.9%) and the mental component score by 10.6±12.8 points (20.6%). Subdivided into mild fatigue (FAS score [22][23][24][25][26][27][28][29][30][31][32][33][34] and severe fatigue (FAS score �35), patients with severe fatigue showed a significant reduction of the 6-minute walk test by 64±165 m (p<0.01) and the health-related quality of life physical component score by 5.8±17.2 points (p = 0.01). In multiple regression analysis age (β = -0.24, p = 0.02), sex (β = 0.22, p = 0.03), mental (β = -0.51, p<0.01) and physical (β = -0.44, p<0.01) health-related quality of life and by trend the 6-minute walk test (β = -0.22, p = 0.07) were associated with the FAS.…”

“…The performance in percentage was more limited in the maximal ranges than in the submaximal range, although the FAS correlated significantly only with the 6MWT performance, a finding also observed in other studies [ 6 ], and tended to correlate with VO2 max . Possible causes of impaired cardiopulmonary fitness can be, in addition to reduced fitness even before the onset of the disease, a further reduction due to inactivity and a sedentary lifestyle because of COVID-19 related symptoms [ 29 ] or government-ordered measures of quarantine [ 30 , 31 ]. Further reasons might include COVID-19-induced physical impairments, side effects of drug treatment or a combination of these factors [ 32 ].…”

Mental Health and Physical Activity during and after the COVID-19 Pandemic: A Review

“…The trial was a randomized controlled trial that compared low versus high-intensity aerobic training with resistance training (Nambi et al, 2022). Lastly, Wu et al's meta-analysis revealed a substantial decrease in daily steps throughout the quarantine period of the pandemic, underscoring the exacerbation of low levels of physical activity due to COVID-19 (Wu et al, 2023). Research indicates that engaging in regular physical activity is essential for reducing the impact of the COVID-19 pandemic on a number of health issues.…”

Relationship Between Rhabdomyolysis and SARS-CoV-2 Disease Severity

“…With over 750 million cases of SARS-CoV-2 infection confirmed globally, the COVID-19 pandemic continues to be a focus of research due to many unknown features of the virus and long-term patient outcomes [1][2][3]. Symptoms can range from mild illness to severe deterioration requiring ICU-level care.…”