Changes in Physical Activity and Psychological Status in Patients with COPD Between Pre- and Post-COVID-19 Assessments: A Pilot Observational Longitudinal Cohort Study

Abstract

Background/Objectives: Physical activity is a key prognostic factor in chronic obstructive pulmonary disease (COPD), but changes in physical activity patterns during the COVID-19 pandemic remain insufficiently characterized. Methods: We conducted an observational longitudinal cohort study in patients with COPD managed in primary care in Lleida, Spain. Baseline assessment was performed between December 2018 and February 2019 (pre-COVID-19 pandemic), and follow-up assessment was conducted between March and June 2021 (post-COVID-19 pandemic). Physical activity was measured using triaxial accelerometry, and clinical, functional, and psychological variables were collected. Results: Of the 192 screened patients, 13 patients were included in the baseline pre-COVID-19 cohort, of whom 7 completed the longitudinal follow-up assessment in the post-COVID-19 period. Among the seven patients with longitudinal follow-up, at baseline, participants exhibited a predominantly sedentary profile, spending approximately 80% of their time in a sedentary mode and accumulating a mean of 6179 steps/day. In the post-COVID-19 period, sedentary time increased to 85.7% and mean steps/day decreased to 3038. Patients also showed a worse psychological profile, mainly driven by increased anxiety levels. Exploratory analyses suggested variable associations between physical activity and clinical, health-related quality of life, and psychological measures. Conclusions: In this small exploratory longitudinal cohort, lower physical activity and a less favorable psychological profile, particularly regarding anxiety, were observed at the post-COVID-19 assessment compared with the baseline. Given the small, paired sample and observational design, these findings should be considered exploratory and hypothesis-generating. Further studies with larger controlled longitudinal cohorts are warranted to confirm these observations.