PHYSICAL IMPAIRMENTS IN PEOPLE SUFFERING FROM LONG COVID: A LONGITUDINAL STUDY

J.-S. Roy^1,2, F. Desmeules^3,4, K. Perreault^1,2, A. Campeau-Lecours^2,5, K. Best^2,1, S. Beaulieu-Bonneau^2,6, J.-S. Paquette^7,8, S. Deslauriers⁷, G. Drouin², I. Zahouani⁴, I. Salmam², J. Tittley²

¹Université Laval, Department of Rehabilitation, Quebec City, Canada, ²Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada, ³Université de Montréal, School of Rehabilitation, Montréal, Canada, ⁴Hôpital Maisonneuve-Rosemont Research Center, Montreal, Canada, ⁵Université Laval, Department of Mechanical Engineering, Quebec City, Canada, ⁶Université Laval, School of Psychology, Quebec City, Canada, ⁷VITAM – Research Centre on Sustainable Health, Quebec City, Canada, ⁸Université Laval, Département de Médecine Familiale et de Médecine d’Urgence, Quebec City, Canada

Background: A third of people infected with COVID-19 report persistent symptoms 12 weeks after their primary infection (i.e., long COVID), including physical symptoms such as fatigue, shortness of breath and muscle weakness. Although available data regarding the clinical presentation of COVID-19 have been increasing over the past few months, the evolution of physical symptoms experienced over time by people with long COVID is still not well understood. Studies to date have been primarily based on self-reported symptom checklists and questionnaires and on retrospective data from hospital medical records. Although self-reported measures are of great value in understanding symptoms experienced, current evidence does not provide enough objectively measured prospective data on the physical symptoms experienced by people with long COVID. A better understanding of the evolution of physical symptoms would help better define health care needs and guide the development of appropriate interventions.

Purpose: The objectives of this study are to describe the physical symptoms experienced by people with long COVID using objective clinical measures, and to explore how these symptoms change over time by comparing people with long COVID to people who have not contracted COVID-19.

Methods: Seventy-four adults with long COVID (long COVID Group; at least one self-reported physical symptom more than 12 weeks following the infection), and 51 age-matched adults who did not contract COVID-19 (Control Group) took part in this longitudinal cohort study that included two in-lab evaluation sessions over 3 months (baseline, 3-month). During each of the in-lab evaluations, clinical tests were performed to obtain physical function variables: grip strength (handgrip dynamometer), Short Performance Physical Battery (SPPB; lower extremity function: static standing balance, gait speed, getting in and out of a chair; 12-point scale), 6-minute walk test (6MWT; maximal distance covered in 6 minutes) and perceived exertion level during 6MWT (Borg Scale; 10-point scale). Repeated measures ANOVAs were performed to compare the longitudinal performance variations across groups (2 Groups x 2 Times).

Results: Group effects (p<.004) were obtained for all four variables as the long COVID group had reduced physical performance at baseline and at 3 months compared to the control group. Mean between-group differences at baseline and 3 months were, respectively, 9.4±2.6kg and 8.7±3.4kg for prehension, 1.0±0.2 and 0.9±0.2 for SPPB, 94.2±13.8m and 99.8±17.5m for 6MWT, and 1.6±0.2 and 1.4±0.3 for the level of exertion during the 6MWT. Time effects were also observed for SPPB (p=.038; mean change: 0.4+/-1.9) and 6MWT (p=.046; mean change: 13.0+/-66.3) as both groups significantly improved their performance from baseline to 3 months. There were no group x time interactions.

Conclusions: People with long COVID show lower physical performance compared to people who have not contracted COVID-19, and this lower performance seems to persist for at least three months after the initial evaluation. Although there were some improvements over time, these improvements were small and similar to the changes seen in the participants not infected with COVID.

Implications: This study provides a better understanding of physical impairments through objective measures, which will help define better care for these individuals.

Funding acknowledgements: This study was funded by the Canadian Institutes of Health Research (CIHR, Grant #466876)

Keywords:
Long COVID
Physical impairments
Functional limitations

Topics:
COVID-19
Disability & rehabilitation
Cardiorespiratory

Did this work require ethics approval? Yes

Institution: CIUSSS de la Capitale-Nationale

Committee: Sectorial Rehabilitation and Social Integration Research Ethics Committee

Ethics number: MP-13-2022-2328