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Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study

Plekhanova, Tatiana; Rowlands, Alex V; Evans, Rachael A; Edwardson, Charlotte L; Bishop, Nicolette C; Bolton, Charlotte E.; Chalmers, James D; Davies, Melanie J; Daynes, Enya; Dempsey, Paddy C; Docherty, Annemarie B; Elneima, Omer; Greening, Neil J; Greenwood, Sharlene A; Hall, Andrew P; Harris, Victoria C; Harrison, Ewen M; Henson, Joseph; Ho, Ling Pei; Horsley, Alex; Houchen-Wolloff, Linzy; Khunti, Kamlesh; Leavy, Olivia C; Lone, Nazir I; Marks, Michael; Maylor, Ben; McAuley, Hamish J C; Nolan, Claire M; Poinasamy, Krisnah; Quint, Jennifer K; Raman, Betty; Richardson, Matthew; Sargeant, Jack A; Saunders, Ruth M; Sereno, Marco; Shikotra, Aarti; Singapuri, Amisha; Steiner, Michael; Stensel, David J; Wain, Louise V; Whitney, Julie; Wootton, Dan G; Brightling, Christopher E; Man, William D-C; Singh, Sally J; Yates, Tom; PHOSP-COVID Collaborative Group

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Tatiana Plekhanova

Alex V Rowlands

Rachael A Evans

Charlotte L Edwardson

Nicolette C Bishop

James D Chalmers

Melanie J Davies

Enya Daynes

Paddy C Dempsey

Annemarie B Docherty

Omer Elneima

Neil J Greening

Sharlene A Greenwood

Andrew P Hall

Victoria C Harris

Ewen M Harrison

Joseph Henson

Ling Pei Ho

Alex Horsley

Linzy Houchen-Wolloff

Kamlesh Khunti

Olivia C Leavy

Nazir I Lone

Michael Marks

Ben Maylor

Hamish J C McAuley

Claire M Nolan

Krisnah Poinasamy

Jennifer K Quint

Betty Raman

Matthew Richardson

Jack A Sargeant

Ruth M Saunders

Marco Sereno

Aarti Shikotra

Amisha Singapuri

Michael Steiner

David J Stensel

Louise V Wain

Julie Whitney

Dan G Wootton

Christopher E Brightling

William D-C Man

Sally J Singh

Tom Yates

PHOSP-COVID Collaborative Group


Background: The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms. Methods: One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators. Results: Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7h/day spent inactive and 7.2 ± 1.1h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7h /day and 6.9 ± 1.1h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Conclusions: Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of sleep several months after discharge. Our comparative cohorts indicate that the long-term impact of COVID-19 on physical behaviours is significant.


Plekhanova, T., Rowlands, A. V., Evans, R. A., Edwardson, C. L., Bishop, N. C., Bolton, C. E., …PHOSP-COVID Collaborative Group. (2022). Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study. International Journal of Behavioral Nutrition and Physical Activity, 19(1), Article 94.

Journal Article Type Article
Acceptance Date Jul 6, 2022
Online Publication Date Jul 28, 2022
Publication Date Dec 1, 2022
Deposit Date Oct 5, 2022
Publicly Available Date Oct 5, 2022
Journal International Journal of Behavioral Nutrition and Physical Activity
Electronic ISSN 1479-5868
Peer Reviewed Peer Reviewed
Volume 19
Issue 1
Article Number 94
Keywords Nutrition and Dietetics; Physical Therapy, Sports Therapy and Rehabilitation; Medicine (miscellaneous)
Public URL
Publisher URL
Additional Information Authors on behalf of the PHOSP-COVID Collaborative Group


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