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Xia W, Zheng D, Chen X, Yu L, Jiang X, Fan M, Zou H, Li C, Liu M, Zhao Y, Kang J. The association between healthy walking and COVID-19 symptom severity: A cross-sectional study on the first peak following China's prevention policy change. BMC Public Health 2025; 25:1497. [PMID: 40269852 PMCID: PMC12016432 DOI: 10.1186/s12889-025-22748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 04/10/2025] [Indexed: 04/25/2025] Open
Abstract
BACKGROUND Healthy walking is a moderate aerobic exercise with a step frequency of more than 100 steps per minute. This study aims to assess the impact of Healthy Walking, a novel form of physical activity, on the severity and course of COVID-19 among patients aged from 18 to 65 years old. METHODS This cross-sectional study included 1,128 adult participants who completed the questionnaire after recovering from the first wave of COVID-19 infections following China`s modification of its prevention policy. The survey questions included their health status when suffering from COVID-19, basic sociodemographic data, and medical history concerning chronic conditions and lifestyle. A multiple logistic regression model and linear regression model were used to evaluate the dependent variable that reflects the severity of COVID-19 infection. RESULTS Among the 1,128 adult participants, the mean age was 39.93 ± 10.18 (IQR: 31.75-48), and 407 (36.08%) were male. Participants who walked up to 300 min per week had a negative association with COVID-19 (OR: 0.562, 95% CI: 0.41-0.863). Receiving three vaccine doses was negatively associated with severe COVID-19 (OR: 0.289, 95% CI:0.092-0.742) compared with receiving only one dose. Females (OR: 1.935, 95% CI:1.475-2.540) had a positive association with severe COVID-19, also a high incidence of co-habitatants was also positively associated (OR: 2.741, 95% CI:1.284-5.881) In the linear model assessing risk factor affecting the course of COVID-19, habitual Healthy Walking ([Formula: see text] =-0.433, [Formula: see text]=0.004) was linked to a reduced disease duration after adjusting all significant risk factors. CONCLUSIONS Regular Healthy Walking may help alleviate symptoms and speed up recovery. Therefore, incorporating walking into other physical exercise may reduce COVID-19 symptom severity and speed up COVID-19 recovery.
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Affiliation(s)
- Wanyuan Xia
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Daikun Zheng
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Xiaomin Chen
- Chaling Center for Disease Prevention and Control, Zhuzhou City, 412400, Hunan Province, China
| | - Liliang Yu
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Xiujuan Jiang
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Mingyue Fan
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Haifang Zou
- Zhiping Central Hospital, Jiangjin District, Chongqing, 402260, China
| | - ChangFeng Li
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Min Liu
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China
| | - Yan Zhao
- Ministry of Public Infrastructure, Chongqing Three Gorges Medical College, Chongqing, 404120, China
| | - Jiming Kang
- School of Public Health and Management, Chongqing Three Gorges Medical College, Chongqing, 404120, P. R. China.
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McNeill R, Marshall R, Fernando SA, Harrison O, Machado L. COVID-19 may Enduringly Impact Cognitive Performance and Brain Haemodynamics in Undergraduate Students. Brain Behav Immun 2025; 125:58-67. [PMID: 39709062 DOI: 10.1016/j.bbi.2024.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 11/19/2024] [Accepted: 12/09/2024] [Indexed: 12/23/2024] Open
Abstract
To date, 770 million people worldwide have contracted COVID-19, with many reporting long-term "brain fog". Concerningly, young adults are both overrepresented in COVID-19 infection rates and may be especially vulnerable to prolonged cognitive impairments following infection. This calls for focused research on this population to better understand the mechanisms underlying cognitive impairment post-COVID-19. Addressing gaps in the literature, the current study investigated differences in neuropsychological performance and cerebral haemodynamic activity following COVID-19 infection in undergraduate students. 94 undergraduates (age in years: M = 20.58, SD = 3.33, range = 18 to 46; 89 % female) at the University of Otago reported their COVID-19 infection history before completing a neuropsychological battery while wearing a multichannel near-infrared spectroscopy (NIRS) device to record prefrontal haemodynamics. We observed that 40 % retrospectively self-reported cognitive impairment (brain fog) due to COVID-19 and 37 % exhibited objective evidence of cognitive impairment (assessed via computerised testing), with some suggestion that executive functioning may have been particularly affected; however, group-level analyses indicated preserved cognitive performance post COVID-19, which may in part reflect varying compensatory abilities. The NIRS data revealed novel evidence that previously infected students exhibited distinct prefrontal haemodynamic patterns during cognitive engagement, reminiscent of those observed in adults four decades older, and this appeared to be especially true if they reported experiencing brain fog due to COVID-19. These results provide new insights into the potential neuropathogenic mechanisms influencing cognitive impairment following COVID-19.
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Affiliation(s)
- Ronan McNeill
- Department of Psychology, and Brain Health Research Centre, University of Otago, William James Building, 275 Leith Walk, Dunedin 9054, New Zealand
| | - Rebekah Marshall
- Department of Psychology, and Brain Health Research Centre, University of Otago, William James Building, 275 Leith Walk, Dunedin 9054, New Zealand
| | - Shenelle Anne Fernando
- Department of Psychology, and Brain Health Research Centre, University of Otago, William James Building, 275 Leith Walk, Dunedin 9054, New Zealand
| | - Olivia Harrison
- Department of Psychology, and Brain Health Research Centre, University of Otago, William James Building, 275 Leith Walk, Dunedin 9054, New Zealand; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Translational Neuromodeling Unit, University of Zurich and ETHZ Zurich, Zurich, Switzerland
| | - Liana Machado
- Department of Psychology, and Brain Health Research Centre, University of Otago, William James Building, 275 Leith Walk, Dunedin 9054, New Zealand.
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Du M, Liu M, Wang Y, Qin C, Liu J. Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods. SSM Popul Health 2024; 25:101588. [PMID: 38225953 PMCID: PMC10788304 DOI: 10.1016/j.ssmph.2023.101588] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024] Open
Abstract
Sleep disturbances are highly prevalent during the COVID-19 pandemic, especially among older adults. We aimed to evaluate sleep heath during COVID-19 pandemic and assess the differences among geographical regions and pandemic periods. We searched three databases (PubMed, Embase, Web of Science) to find articles up to March 12, 2023. We included observational studies that reported the prevalence of sleep disturbances among adults aged 60 years or older in any setting. Two researchers independently reviewed the literature and retrieved the data. We used Der Simonian-Laird random effects meta-analyses to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. A total of 64 studies with 181,224 older adults during the pandemic were included. The prevalence of poor sleep quality, short sleep duration, long sleep duration, and insomnia symptoms were 47.12% (95% CI: 25.97%, 68.27%), 40.81% (95% CI: 18.49%, 63.12%), 31.61% (95% CI: 24.83%, 38.38%), and 21.15% (95% CI: 15.30%, 27.00%), respectively. The prevalence of sleep problems reported by self-constructed items was 26.97% (95% CI: 20.73%, 33.22%). When compared to America (64.13%), Europe (20.23%) and the Western Pacific (21.31%) showed a lower prevalence of sleep problems (all P < 0.0001). The prevalence of worsened sleep problems was 27.88% (95% CI: 11.94%, 43.82%). Compared to 2020 (15.14%), it increased to 47.42% in 2021 (P < 0.05). Eight studies on sleep disturbances among 672 older COVID-19 patients were included. The prevalence of sleep problems and insomnia symptoms among older COVID-19 patients were 41.58% (95% CI: 21.97%, 61.20%) and 41.56% (95% CI: 28.11%, 58.02%), respectively. A significant burden related to poor sleep has been observed among older adults worldwide over the past three years, with variations across different regions and time periods. It is important to make more efforts in prevention and intervention to identify the risk factors, treatment, and rehabilitation of sleep disturbances for healthy aging.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
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Chu WM, Hsieh TH, Wei JCC. Comment on Tsai et al.'s "clinical effectiveness of oral antiviral agents in older patients with COVID-19 based on real-world data". J Med Virol 2023; 95:e29086. [PMID: 37695099 DOI: 10.1002/jmv.29086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Wei-Min Chu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsung-Hsueh Hsieh
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Quan SF, Weaver MD, Czeisler MÉ, Barger LK, Booker LA, Howard ME, Jackson ML, Lane RI, McDonald CF, Ridgers A, Robbins R, Varma P, Wiley JF, Rajaratnam SMW, Czeisler CA. Insomnia, Poor Sleep Quality and Sleep Duration, and Risk for COVID-19 Infection and Hospitalization. Am J Med 2023; 136:780-788.e5. [PMID: 37075878 PMCID: PMC10108572 DOI: 10.1016/j.amjmed.2023.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Medical comorbidities increase the risk of severe acute COVID-19 illness. Although sleep problems are common after COVID-19 infection, it is unclear whether insomnia, poor sleep quality, and extremely long or short sleep increase risk of developing COVID-19 infection or hospitalization. METHODS The study used a cross-sectional survey of a diverse sample of 19,926 US adults. RESULTS COVID-19 infection and hospitalization prevalence rates were 40.1% and 2.9%, respectively. Insomnia and poor sleep quality were reported in 19.8% and 40.1%, respectively. In logistic regression models adjusted for comorbid medical conditions and sleep duration but excluding participants who reported COVID-19-associated sleep problems, poor sleep quality, but not insomnia, was associated with COVID-19 infection (adjusted odds ratio [aOR] 1.16; 95% CI, 1.07-1.26) and COVID-19 hospitalization (aOR 1.50; 95% CI, 1.18-1.91). In comparison with habitual sleep duration of 7-8 hours, sleep durations <7 hours (aOR 1.14; 95% CI, 1.06-1.23) and sleep duration of 12 hours (aOR 1.61; 95% CI, 1.12-2.31) were associated with increased odds of COVID-19 infection. Overall, the relationship between COVID-19 infection and hours of sleep followed a quadratic (U-shaped) pattern. No association between sleep duration and COVID-19 hospitalization was observed. CONCLUSION In a general population sample, poor sleep quality and extremes of sleep duration are associated with greater odds of having had a COVID-19 infection; poor sleep quality was associated with an increased requirement of hospitalization for severe COVID-19 illness. These observations suggest that inclusion of healthy sleep practices in public health messaging may reduce the impact of the COVID-19 pandemic.
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Affiliation(s)
- Stuart F Quan
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine.
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine
| | - Mark É Czeisler
- Francis Weld Peabody Society, Harvard Medical School, Boston, Mass; School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine
| | - Lauren A Booker
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Department of Medicine, The University of Melbourne, Victoria, Australia
| | - Melinda L Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Rashon I Lane
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass
| | - Christine F McDonald
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anna Ridgers
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Joshua F Wiley
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine; School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine
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