Physical function differences by COVID-19 status: A cross-sectional analysis from the RECOVER adult cohort
Kulik (née Ditzenberger), GL; Zheng, T; Jolley, SE; et al., Physical Therapy
Published
April 2025
Journal
Physical Therapy
Abstract
Importance: Many adults with prior SARS-CoV-2 infection have persistent limitations, but few studies have examined objective physical function impairment that persist longer than 3 months after infection. Objective: The objective was to characterize physical function impairment among adults with and without SARS-CoV-2 infection. Design: This study was a retrospective, cross-sectional analysis. Setting: Researching COVID to Enhance Recovery (RECOVER) initiative, a multi-site observational study in the United States (ClinicalTrials.gov: NCT05172024). Participants: Participants were adults ≥18 years old with and without SARS-CoV-2 infection. Exposures: Groups were defined based on COVID-19 status at enrollment: never diagnosed (control), diagnosed with COVID-19 ≤ 12 weeks (recent COVID-19), or > 12 weeks prior to enrollment (remote COVID-19). The RECOVER-Adult Long COVID Index was used to further characterize by Index ≥12 versus 0. Main outcomes/measures: Physical function (main outcome) was assessed by number of repetitions on a 30-second sit-to-stand test (30STS). Results: 30STS assessments at enrollment were available from 11,578 participants. 30STS repetitions were lowest in the remote COVID-19 group (n = 4942) with 11.5 (SD = 4.2) repetitions compared to 12.5 (SD = 4.7) repetitions among controls (n = 1887) or 12.2 (SD = 4.5) in recent COVID-19 (n = 4698). Remote COVID-19, but not recent COVID-19, was associated with lower physical function in the adjusted model (-0.61 repetitions; SD = 0.21). Those with RECOVER Long COVID Research Index ≥12 performed 1.6 (SD = 0.2) fewer repetitions than those with an Index equal 0. Conclusions: Physical function impairment did not show clinically meaningful group differences between RECOVER Adult Cohort participants by COVID-19 status, or by Long COVID Index. Individual responses over time or in response to an intervention may be more clinically relevant. Relevance: In the RECOVER adult cohort, overall physical function differences by time since COVID-19 or by Long COVID Index were small. Individualized assessments are needed to determine functional impairment following COVID-19 diagnosis and subsequent steps for rehabilitation interventions.
Authors
Grace L Kulik (née Ditzenberger), Tianyu Zheng, Sarah E Jolley, Hassan Ashktorab, Hassan Brim, Elen M Feuerriegel, John W Hafner, Rachel Hess, Benjamin D Horne, Mady Hornig, Brandon Johnson, C Kim, Adeyinka O Laiyemo, Grace A McComsey, Janko Ž Nikolich, Kayleigh Reid, John Scherry, Zaki A Sherif, Huong G Tran, Monica Verduzco-Gutierrez, Shelby West, Kristine M Erlandson; RECOVER Adult Cohort Consortium
Keywords
Covid-19; Long covid; Pasc; Physical function
Short Summary
This RECOVER study looked at how COVID-19 can impact people’s physical abilities. Researchers looked at 3 groups of adults in the RECOVER study: people who never had COVID-19, people who had COVID-19 in the last 3 months, and people who had COVID-19 more than 3 months ago. They wanted to know if people who had COVID-19 were more likely to have trouble with daily activities like walking, climbing stairs, or getting in and out of a chair compared to those who never had COVID-19. To measure physical ability, participants were asked to sit in a chair and stand up as many times as they could in 30 seconds. This study didn't find big differences in physical abilities between the groups, but those who had severe COVID-19 and long-lasting symptoms faced more challenges. This study is important because the findings show that COVID-19 may have long-term impacts on physical function.