Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study

• Published in: Open forum infectious diseases Vol. 10; no. 12; p. ofad579
• Main Authors: Richard, Stephanie A, Scher, Ann I, Rusiecki, Jennifer, Byrne, Celia, Berjohn, Catherine M, Fries, Anthony C, Lalani, Tahaniyat, Smith, Alfred G, Mody, Rupal M, Ganesan, Anuradha, Huprikar, Nikhil, Colombo, Rhonda E, Colombo, Christopher J, Schofield, Christina, Lindholm, David A, Mende, Katrin, Morris, Michael J, Jones, Milissa U, Flanagan, Ryan, Larson, Derek T, Ewers, Evan C, Bazan, Samantha E, Saunders, David, Maves, Ryan C, Livezey, Jeffrey, Maldonado, Carlos J, Edwards, Margaret Sanchez, Rozman, Julia S, O'Connell, Robert J, Simons, Mark P, Tribble, David R, Agan, Brian K, Burgess, Timothy H, Pollett, Simon D
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.12.2023
• Subjects: Major; COVID-19; fitness; long COVID
• ISSN: 2328-8957; 2328-8957
• DOI: 10.1093/ofid/ofad579

The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain. We compared survey responses in a 1-year study of US military service members with (n = 1923) and without (n = 1591) a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We fit Poisson regression models to estimate the association between history of SARS-CoV-2 infection and fitness impairment, adjusting for time since infection, demographics, and baseline health. The participants in this analysis were primarily young adults aged 18-39 years (75%), and 71.5% were male. Participants with a history of SARS-CoV-2 infection were more likely to report difficulty exercising (38.7% vs 18.4%; < .01), difficulty performing daily activities (30.4% vs 12.7%; < .01), and decreased fitness test (FT) scores (42.7% vs 26.2%; < .01) than those without a history of infection. SARS-CoV-2-infected participants were at higher risk of these outcomes after adjusting for other factors (unvaccinated: exercising: adjusted risk ratio [aRR], 3.99; 95% CI, 3.36-4.73; activities: aRR, 5.02; 95% CI, 4.09-6.16; FT affected: aRR, 2.55; 95% CI, 2.19-2.98). Among SARS-CoV-2-positive participants, full vaccination before infection was associated with a lower risk of post-COVID-19 fitness impairment (fully vaccinated: exercise: aRR, 0.81; 95% CI, 0.70-0.95; activities: aRR, 0.76; 95% CI, 0.64-0.91; FT: aRR, 0.87; 95% CI, 0.76-1.00; boosted: exercise: aRR, 0.62; 95% CI, 0.51-0.74; activities: aRR, 0.52; 95% CI, 0.41-0.65; FT: aRR, 0.59; 95% CI, 0.49-0.70). In this study of generally young, healthy military service members, SARS-CoV-2 infection was associated with lower self-reported fitness and exercise capacity; vaccination and boosting were associated with lower risk of self-reported fitness loss.