Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study
Author:
Richard Stephanie A12ORCID, Scher Ann I3, Rusiecki Jennifer3, Byrne Celia3, Berjohn Catherine M134, Fries Anthony C5, Lalani Tahaniyat126ORCID, Smith Alfred G6, Mody Rupal M7, Ganesan Anuradha128, Huprikar Nikhil38, Colombo Rhonda E1239, Colombo Christopher J39, Schofield Christina9, Lindholm David A310, Mende Katrin1210, Morris Michael J10, Jones Milissa U11, Flanagan Ryan11, Larson Derek T3412, Ewers Evan C312, Bazan Samantha E13, Saunders David3, Maves Ryan C14, Livezey Jeffrey15, Maldonado Carlos J16, Edwards Margaret Sanchez12, Rozman Julia S12, O’Connell Robert J1, Simons Mark P1, Tribble David R1, Agan Brian K12ORCID, Burgess Timothy H1, Pollett Simon D12, Cowden Col J, Darling LTC M, DeLeon S, Lindholm Maj D, Markelz LTC A, Mende K, Merritt S, Merritt T, Turner LTC N, Wellington CPT T, R Carl, Bazan LTC S, Love P K, T Alexander, Dimascio-Johnson N, Elnahas N, Ewers MAJ E, Gallagher LCDR K, Glinn C, Jarral U, Jennings D, Larson LCDR D, Reterstoff K, Rutt A, Silva A, West C, M Henry, Blair P, Chenoweth J, Clark D, Bowman J, Chambers S, Colombo LTC C, Colombo R, Conlon CPT C, Everson CPT K, Faestel COL P, Ferguson COL T, Gordon MAJ L, Grogan LTC S, Lis CPT S, Martin M, Mount COL C, Musfeldt LTC D, Odineal CPT D, Perreault LTC M, Robb-McGrath W, Sainato MAJ R, Schofield C, Skinner COL C, Stein M, Switzer MAJ M, Timlin MAJ M, Wood MAJ S, Banks S, Carpenter R, Kim L, Kronmann CAPT K, Lalani T, Lee LCDR T, Smith LCDR A, Smith R, Tant R, Warkentien CDR T, Berjohn CDR C, Cammarata S, Kirkland N, Libraty D, Maves R, Utz G, Bradley C, Chi S, Flanagan LTC R, Fuentes A, Jones MAJ M, Leslie N, Lucas C, Madar C, Miyasato K, Uyehara C, Adams H, Agan B, Andronescu L, Austin A, Broder C, Burgess CAPT T, Byrne C, Chung K, Davies J, English C, Epsi N, Fox C, Fritschlanski M, Hadley A, Hickey COL P, Laing E, Lanteri LTC C, Livezey LTC J, Malloy A, Mohammed R, Morales C, Nwachukwu P, Olsen C, Parmelee E, Pollett S, Richard S, Rozman J, Rusiecki J, Saunders COL D, Samuels E, Sanchez M, Scher A, Simons CDR M, Snow A, Telu K, Tribble D, Tso M, Ulomi L, Wayman M, Hockenbury N, Chao TSgt T, Chapleau R, Christian M, Fries A, Harrington C, Hogan V, Huntsberger S, Lanter K, Macias E, Meyer J, Purves S, Reynolds K, Rodriguez J, Starr C, Iskander CAPT J, Kamara CDR I, Barton B, Hostler LTC D, Hostler LTC J, Lago MAJ K, Maldonado C, Mehrer J, Hunter MAJ T, Mejia J, Mody R, Montes J, Resendez R, Sandoval P, Barahona I, Baya A, Ganesan A, Huprikar MAJ N, Johnson B, Peel S,
Affiliation:
1. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA 2. Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, Maryland , USA 3. Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA 4. Naval Medical Center San Diego , San Diego, California , USA 5. US Air Force School of Aerospace Medicine , Wright-Patterson, Ohio , USA 6. Naval Medical Center Portsmouth , Portsmouth, Virginia , USA 7. William Beaumont Army Medical Center , El Paso, Texas , USA 8. Walter Reed National Military Medical Center , Bethesda, Maryland , USA 9. Madigan Army Medical Center , Joint Base Lewis McChord, Washington , USA 10. Brooke Army Medical Center , Joint Base San Antonio-Fort Sam Houston, Texas , USA 11. Department of Pediatrics, Translational Medicine Unit, Uniformed Services University , Bethesda, Maryland , USA 12. Alexander T. Augusta Military Medical Center , Fort Belvoir, Virginia , USA 13. Carl R. Darnall Army Medical Center , Fort Cavazos, Texas , USA 14. Wake Forest University School of Medicine , Winston-Salem, North Carolina , USA 15. Department of Pediatrics, Clinical Pharmacology and Medical Toxicology, Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA 16. Womack Army Medical Center , Fort Liberty, North Carolina , USA
Abstract
Abstract
Background
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.
Methods
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.
Results
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%; P < .01), difficulty performing daily activities (30.4% vs 12.7%; P < .01), and decreased fitness test (FT) scores (42.7% vs 26.2%; P < .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).
Conclusions
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.
Funder
Defense Health Program National Institute of Allergy and Infectious Disease Infectious Disease Clinical Research Program Department of Defense Uniformed Services University of the Health Sciences Henry M. Jackson Foundation National Institutes of Health
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
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