COVID-19 pandemic tied to significant reduction in physical activity including daily step counts: JAMA

The researchers found a statistically significant reduction in daily step counts that remained even after the relaxation of most COVID-19–related restrictions, suggesting that COVID-19 affected long-term behavioural choices.

The outbreak of COVID-19 had a global impact on social, mental, and physical health. Data collected in the early pandemic suggested a general decline in step counts worldwide, but factors contributing to reduced activity remained unknown. So, Stacy Desine, Vanderbilt University Medical Center, Nashville, Tennessee, and colleagues aimed to determine if COVID-19 was linked with daily activity among All of Us (AOU) research program participants.

They hypothesized that a reduction in activity across the US would persist even after the relaxation of most social distancing recommendations and that mental health status and socioeconomic factors would continue to affect reduced activity.

The cohort study included participants with a digital device tracking physical activity (Fitbit Inc) for at least ten days each month. Daily steps were examined over four years, from 2018 through 2021. Differences in observed and estimated post–COVID-19 daily steps were discussed. Postpandemic steps were calculated using counterfactual analysis based on two years of activity data preceding COVID-19.

During enrollment, surveys assessed mental health, sociodemographic factors, deprivation index, and location. Associations of COVID-19 vaccine, sociodemographics, comorbidities, and mental health factors were examined with differences in observed and estimated post–COVID-19 daily steps.

The authors reported the following findings:

• Data from 5443 participants with valid Fitbit data for at least six months pre- and post–COVID-19 were analyzed.
• Median observed daily step counts pre–COVID-19 (from January 1, 2018, to January 31, 2020) and post–COVID-19 (from June 1, 2020, to December 31, 2021) were 7808 steps and 7089 steps, respectively.
• The counterfactual model estimated that participants walked 575 fewer steps per day post–COVID-19 than observed daily steps.
• The difference between observed and estimated post–COVID-19 steps was significantly explained by younger age (β = −243 per 10-year decrease), Northeast region compared with other areas (Northeast vs others, β = −288), and higher deprivation index (β = −477 per 0.1 increments).
• Post–COVID-19 step counts were also explained by COVID-19 vaccination status (vaccinated vs unvaccinated: β = 48), depression (β = −36 per 1 score increment), and psychological stress (β = −13 per 1 score increment).
• No association was observed between reduced step counts and sex or comorbidities such as obesity, diabetes, coronary artery disease, hypertension or cancer.

"Our findings suggest a widespread, consistent, and significant decline in activity following COVID-19 onset in the US," the researchers wrote. "Vulnerable populations, including people at a lower socioeconomic status and those with worse mental health in the early period of COVID-19, were at the highest risk of reduced activity."

To conclude, COVID-19 is associated with decreased physical activity, which may have implications for future cardiometabolic risk and potentially exacerbate health disparities related to socioeconomic status and mental health.

Reference:

Desine S, Master H, Annis J, et al. Daily Step Counts Before and After the COVID-19 Pandemic Among All of Us Research Participants. JAMA Netw Open. 2023;6(3):e233526. doi:10.1001/jamanetworkopen.2023.3526