Post-COVID-19 physical activity and symptom burden in patients with asthma and copd compared with individuals without chronic disease: A multicenter cross-sectional study

Abstract

Background/Objectives: The COVID-19 pandemic led to profound lifestyle changes and long-term functional consequences, particularly among individuals with chronic respira tory diseases. Patients with asthma and chronic obstructive pulmonary disease (COPD) maybeespecially vulnerable to reductions in physical activity and persistent post-COVID 19 symptoms. This study aimed to compare lifestyle characteristics, physical activity levels, and post-COVID-19 symptom persistence in patients with asthma and COPD with those of individuals without chronic disease in the post-pandemic period. Methods: This national, multicenter, cross-sectional study was conducted in 2022 at five pulmonary out patient clinics. Participants were categorized into three groups: asthma (n = 165), COPD (n = 82), and individuals without chronic disease (n = 431). Demographic and clinical data were collected through face-to-face structured interviews. Physical activity levels were assessed using the short form of the International Physical Activity Questionnaire and expressed as metabolic equivalent of task (MET) scores before and after the pan demic. Dyspnea severity was evaluated using the modified Medical Research Council scale. COVID-19 history, disease severity, and persistent symptoms were recorded. Results: A total of 678 participants were included. The median age was highest in the COPD group (68 (61–74) years), followed by the asthma group (54 (42–64) years) and individuals without chronic disease (38 (27–50) years). Female sex predominated among patients with asthma (77%), whereas male sex was more frequent in the COPD group (83%); sex distribution was similar among individuals without chronic disease (51% female). Across all groups, post-COVID-19 symptoms—including dyspnea, cough, fatigue, and myalgia—persisted for at least six months after infection. Physical activity levels, assessed by metabolic equivalent of task (MET) scores, declined significantly in the post-pandemic period in all groups, with the lowest levels observed in patients with COPD. COVID-19 severity and hospitaliza tion rates were higher in patients with COPD, while intensive care unit admission rate were comparable between patients with asthma and individuals without chronic disease. Conclusions: In the post-pandemic period, physical activity levels declined markedly, and lifestyle changes were negatively affected in patients with asthma and COPD. Post COVID-19 symptoms persisted longer than expected even in those without chronic disease. Therefore, individualized home-based exercise programs and psychosocial support should be considered to improve physical activity and quality of life, particularly in patients with chronic respiratory diseases, while preventive strategies should also be implemented at the population level.