Factors associated with changes in sedentary behavior after ICU hospitalization in COVID-19 patients
Sedentary behavior after COVID-19
Keywords:
Health Risk Behaviors, Quality of Life, Hospitalization, Intensive Care Units, COVID-19Abstract
Introduction: Elevated levels of sedentary behavior are associated with health risks. Patients hospitalized due to COVID-19 complications experienced sequelae that affected their quality of life and lifestyle, leading to significant changes in sedentary behavior. Objective: This study aimed to analyze factors associated with changes in different types of sedentary behavior (SB) after intensive care unit (ICU) hospitalization due to COVID-19. Methods: This cross-sectional study included patients hospitalized in ICUs in southern Brazil. Outcomes were self-reported changes in various SB indicators (TV watching, computer use, cell phone use, sitting time during commuting, and work), categorized as maintained, increased, or decreased after hospitalization. Multinomial logistic regression was used, with results expressed as odds ratio (OR) and 95% confidence intervals (95% CI). Results: Among 148 participants, 50% were male, with a mean age of 50.1 ± 13.2 years. The perception of increased television viewing time after hospitalization was associated with female sex (OR: 2.45; 95% CI: 1.08; 5.54) and physical inactivity during commuting (OR: 0.17; 95% CI: 0.04; 0.77). Higher education level was associated with the perception of increased computer use (OR: 1.47; 95% CI: 1.12; 1.92) and cell phone use (OR: 1.21; 95% CI: 1.06; 1.37), while the consumption of ultra-processed foods was associated with a lower chance of perceiving a reduction in computer use (OR: 0.59; 95% CI: 0.36; 0.97). Conclusion: After ICU hospitalization, sociodemographic, health, and lifestyle factors were associated with changes in sedentary behavior. Particularly, education level and age were strong predictors of changes in different SB types.
Downloads
References
Liang ZD, Zhang M, Wang CZ, Yuan Y, Liang JH. Association between sedentary behavior, physical activity, and cardiovascular disease-related outcomes in adults-A meta-analysis and systematic review. Front Public Health. 2022; 10:1018460. DOI: 10.3389/fpubh.2022.1018460.
Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015; 162(2):123-32. DOI: 10.7326/m14-1651.
Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, et al. Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act. 2017; 14(1):75. DOI: 10.1186/s12966-017-0525-8.
Chaput JP, Carson V, Gray CE, Tremblay MS. Importance of all movement behaviors in a 24 hour period for overall health. Int J Environ Res Public Health. 2014; 11(12):12575-81. DOI: 10.3390/ijerph111212575.
Pate RR, O'Neill JR, Lobelo F. The evolving definition of "sedentary". Exerc Sport Sci Rev. 2008; 36(4):173-78. DOI: 10.1097/JES.0b013e3181877d1a.
Runacres A, Mackintosh KA, Knight RL, Sheeran L, Thatcher R, Shelley J, et al. Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021; 18(21):11286. DOI:10.3390/ijerph182111286.
World Health Organization. Coronavirus disease (COVID-19) pandemic. World Health Organization [Internet]. 2020 [cited 2023 Aug. 25]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
Malik P, Patel K, Pinto C, Jaiswal R, Tirupathi R, Pillai S, et al. Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)-A systematic review and meta-analysis. J Med Virol. 2022; 94(1):253-62. DOI: 10.1002/jmv.27309.
Zheng C, Huang WY, Sun FH, Wong MC, Siu PM, Chen XK, et al. Association of Sedentary Lifestyle with Risk of Acute and Post-Acute COVID-19 Sequelae: A Retrospective Cohort Study. Am J Med. 2023; S0002-9343(23)00757-X. DOI: 10.1016/j.amjmed.2023.12.002.
van Bakel BMA, van den Heuvel FMA, Vos JL, Rotbi H, Bakker EA, Nijveldt R, et al. High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation. J Clin Med. 2022; 11(4):1110. DOI: 10.3390/jcm11041110.
Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re'em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 2021; 38:101019. DOI: 10.1016/j.eclinm.2021.101019.
Jang DK, Park M, Kim YH. Sociodemographic, Behavioural, and Health Factors Associated with Sedentary Behaviour in Community-Dwelling Older Adults: A Nationwide Cross-Sectional Study. Journal of Clinical Medicine. 2023; 12(15):5005. DOI: 10.3390/jcm12155005.
Heredia-Ciuró A, Gámiz-Molina AB, Raya-Benítez J, Valenza-Peña G, Granados-Santiago M, López-López L, et al. Sedentary Behavior Is Related to Clinical Profile, Disability and Quality of Life in Community-Acquired Pneumonia Patients at Hospitalization and Follow-Up. Applied Sciences. 2025; 15(6):3074. DOI: 10.3390/app15063074.
Wang Y, Su B, Alcalde-Herraiz M, Barclay NL, Tian Y, Li C, et al. Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalization, and death. Nat Commun. 2024 Jul 29; 15(1):6363. DOI: 10.1038/s41467-024-50495-7.
Baldwin CE, Rowlands AV, Fraysse F, Johnston KN. The sedentary behaviour and physical activity patterns of survivors of a critical illness over their acute hospitalisation: An observational study. Aust Crit Care. 2020; 33(3):272-80. DOI: 10.1016/j.aucc.2019.10.006.
Chrisman M, Chesnut SR, Thompson M, Hopper A, Lasiter S. Physical activity and sedentary behavior in middle-aged intensive care unit survivors discharged home: A systematic review. Intensive Crit Care Nurs. 2024; 81:103608. DOI: 10.1016/j.iccn.2023.103608.
von Elm E, Altman DG, Egger M, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344-9. DOI: 10.1016/j.jclinepi.2007.11.008.
Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36) [Internet]. Rev Bras Reumatol. 1999 [cited 2023 Aug. 22]; 39(3):143-50. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/lil-296502.
Fiocruz. Convid Pesquisa de Comportamentos [Internet] [cited 2021 Nov. 29]. Available from: https://convid.fiocruz.br/arquivos/QuestionarioConVidPesquisaDeComportamentos.pdf.
Mielke GI, Crochemore M da Silva I, Gomersall SR, Owen N, Hallal PC. Reliability of a multi-domain sedentary behaviour questionnaire and comparability to an overall sitting time estimate. J Sports Sci. 2020; 38(3):351-56. DOI: 10.1080/02640414.2019.1701794.
Ministério da Saúde (BR). Vigitel Brasil 2021: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico [Internet]. Brasília: Ministério da Saúde; 2022 [cited 2024 Jun. 19]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2021.pdf.
Szumilas M. Explaining odds ratios [Internet]. J Can Acad Child Adolesc Psychiatry. 2010 [cited 2023 Jul. 08]; 19(3):227-9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2938757/pdf/ccap19_3p227.pdf.
Costa BGG, Chaput JP, Silva KS. The two sides of sedentary behavior. J Phys Educ. 2022; 33(1):e-3312. DOI: 10.4025/jphyseduc.v33i1.3312.
Villanti AC, Johnson AL, Ilakkuvan V, Jacobs MA, Graham AL, Rath JM. Social Media Use and Access to Digital Technology in US Young Adults in 2016. J Med Internet Res. 2017; 19(6):e196. DOI: 10.2196/jmir.7303.
van Sleeuwen D, van de Laar FA, Simons KS, van Bommel D, Burgers-Bonthuis D, Koeter J, et al. Associations Between Social Economic Determinants and Long-Term Outcomes of Critically Ill Patients. Crit Care Med. 2025; 53(4):e783-e793. DOI: 10.1097/CCM.0000000000006587.
Ministério da Saúde (BR). Vigitel Brasil 2023: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico [Internet]. Brasília: Ministério da Saúde; 2023 [cited 2024 Jun. 22]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2023.pdf.
Wildenbos GA, Peute LW, Jaspers MW. A framework for evaluating mHealth tools for Older Patients on Usability [Internet]. Stud Health Technol Inform. 2015 [cited 2023 Aug. 19]; 210:783-87. Available from: https://pubmed.ncbi.nlm.nih.gov/25991261/.
Fang X, Ming C, Cen Y, Lin H, Zhang K, Yang S, et al. Post-sequelae one year after hospital discharge among older COVID-19 patients: A multi-center prospective cohort study. J Infect. 2022; 84(2):179-86. DOI: 10.1016/j.jinf.2021.12.005.
Lu P, Kong D, Shelley M. Risk Perception, Preventive Behavior, and Medical Care Avoidance among American Older Adults During the COVID-19 Pandemic. J Aging Health. 2021; 33(7-8):577-84. DOI: 10.1177/08982643211002084.
Madeira MC, Siqueira FCV, Facchini LA, Silveira DS, Tomasi E, Thumé E, et al. Physical activity during commuting by adults and elderly in Brazil: prevalence and associated factors. Cad Saúde Pública. 2013; 29(1):165-74. DOI: 10.1590/s0102-311x2013000100019.
Balhes S. Elas: Comportamentos e barreiras [Internet]. Nielsen Measurement, 2022 [cited 2023 Aug. 21]. Available from: https://www.linkedin.com/smart-links/AQHdhIDS5omSRQ/3cf2641e-fa6e-42b7-b7db-5422aaf355f1.
Maglietta G, Diodati F, Puntoni M, Lazzarelli S, Marcomini B, Patrizi L, et al. Prognostic Factors for Post-COVID-19 Syndrome: A Systematic Review and Meta-Analysis. J Clin Med. 2022; 11(6):1541. DOI: 10.3390/jcm11061541.
Malta DC, Szwarcwald CL, Barros MBA, Gomes CS, Machado IE, Souza Júnior PRB, et al. A pandemia da COVID-19 e as mudanças no estilo de vida dos brasileiros adultos: um estudo transversal, 2020. Epidemiol Serv Saúde. 2020; 29(4):e2020407. DOI: 10.1590/S1679-49742020000400026.
Korupolu R, Francisco GE, Levin H, Needham DM. Rehabilitation of critically ill COVID-19 survivors. J Int Soc Phys Rehabil Med. 2020; 3(2):45-52. DOI: 10.4103/jisprm.jisprm_8_20.
Reinecke L, Hartmann T, Eden A. The guilty couch potato: the role of ego depletion in reducing recovery through media use. J Commun. 2014; 64(4):569-89. DOI: 10.1111/jcom.12107.
Pereira MG, Assumpção D, Barros MBA, Zangirolani LTO. Consumo de alimentos ultraprocessados e fatores associados em adultos: evidências do Inquérito ISACamp 2008-2009. Ciênc saúde coletiva. 2021; 26:3815-24. DOI: 10.1590/1413-81232021269.2.31062019.
Hiles SA, Lamers F, Milaneschi Y, Penninx BWJH. Sit, step, sweat: longitudinal associations between physical activity patterns, anxiety and depression. Psychol Med. 2017; 47(8):1466-77. DOI: 10.1017/S0033291716003548.
Vartanian K, Fish D, Kenton N, Gronowski B, Wright B, Robicsek A. Integrating patient-reported physical, mental, and social impacts to classify long COVID experiences. Sci Rep. 2023; 13(1):16288. DOI: 10.1038/s41598-023-43615-8.
Silva PSC, Boing AF. Fatores associados à prática de atividade física no lazer: análise dos brasileiros com doenças crônicas. Ciênc saúde coletiva. 2021; 26(11):5727-38. DOI: 10.1590/1413-812320212611.32432020.
Fadul AAI, Mohamed AAO, Mohammed Ahmed AASM, Elmobark S, Hammour ASM, Elsiad NMNEK, et al. Post-coronavirus Disease 2019 (COVID-19) Cardiovascular Manifestations: A Systematic Review of Long-Term Risks and Outcomes. Cureus. 2025; 17(4):e83083. DOI: 10.7759/cureus.83083.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Edú Fiorin Schopf, Jucemar Benedet, Cecília Bertuol, Deborah Kazimoto Alves, Caroline Soares da Silva , Patrine Vargas , Giovani Firpo Del Duca
This work is licensed under a Creative Commons Attribution 4.0 International License.
Cessão de Primeira Publicação à HU Revista
Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.
![](<p style="text-align:center;"> <a href="https://www.instagram.com/hurevista/" target="_blank"> <img src="https://periodicos.ufjf.br/public/site/images/hurevista/instagram.png" alt="Instagram da HU Revista" width="80"> </a> </p>)
