Impact of COVID-19 restrictions on physical activity in adults with severe asthma: a preliminary two-year retrospective analysis

Abstract

<b>Background:</b> Physical inactivity and sedentary behaviour is associated with worse clinical and inflammatory outcomes and impaired quality of life in people with severe asthma (pwSA) (Cordova-Rivera et al. JACI:IP 2018;6(3):814-22). Since March 2020, national lockdowns have been periodically implemented in the UK to reduce the transmission of COVID-19, however, the impact of these restrictions on physical activity in pwSA has yet to be evaluated. <b>Aims:</b> To compare physical activity levels prior to and during COVID-19 lockdown in pwSA. <b>Method:</b> A preliminary retrospective analysis of physical activity (step count objectively assessed via an in-built smartphone pedometer (Reilly et al. J Asthma 2021:1-9)) between March-June 2019 (usual daily living) versus March-June 2020 (first UK lockdown) in adults attending a specialist asthma service. <b>Results:</b> Twelve adults with severe asthma receiving biological therapies (male: n = 4) (age: 52 ± 16; FEV₁ % predicted: 64 ± 16) were recruited. A significant and clinically meaningful reduction in daily step count was observed between 2019 and 2020 for all months: March (-25%) (P=0.02); April (-40%) (P=0.02); May (-33%) (P = 0.04); June (-38%) (P = 0.001). Total absolute reduction in daily step-count: 4627 ± 1833 versus 3054 ± 1967 (-34%) (P&lt;0.001). <b>Conclusions:</b> COVID-19 restrictions reduced step-based physical activity by approximately one-third in pwSA. These findings underline the importance of monitoring and promoting physical activity during routine asthma review given the potential adverse impact on health and disease-related outcomes.