Physical Activity

Exercise Capacity 6 Months After COVID-19 Pneumonia Relates to Severity of Disease

In patients who recover from COVID-19 pneumonia, impaired exercise capacity and quality of life persist 6 months after illness onset, according to study findings presented at CHEST 2021.

Those with mild or moderate disease showed improved exercise capacity (p < 0.01) 6 months after illness onset compared with 3 months after illness onset.

To determine the effect of surviving COVID-19 on exercise capacity and quality of life in health care workers at the Philippine Heart Center in Quezon City, the researchers evaluated the performance of participants in a prospective cohort study on the 6‑minute walk test and the results of administering the Medical Outcomes Study 36‑item Short-Form General Health Survey, or SF-36, to participants 3 and 6 months after illness onset. The study included health care workers who were at least age 19 years and had been discharged from the center after recovering from COVID‑19 pneumonia from September 2020 to January 2021.

Researchers used the one-way ANOVA, Kruskal-Wallis test, and Fisher’s exact test to determine the differences in mean, rank, and frequency for 3 different severities of COVID-19 and the paired sample T-test or Wilcoxon sign rank test to determine the difference of mean or rank from the third to the sixth month. Null hypotheses were rejected at the 0.05 α-level of significance.

After 3 months from illness onset, compared with the general population, COVID-19 survivors had a lower average 6‑minute walking distance, and this distance was proportional to the severity of the disease. Unlike survivors of severe disease, those who had mild or moderate disease had significant improvement (p < 0.01) in 6‑minute walking distance 6 months from illness onset. Although, the distance walked was still less than that of the general population, and the researchers considered the improvement not clinically relevant. 

Moreover, most of the scores on domains of the SF-36 were lower for participants than for the general population, and participants gave the lowest scores to physical functioning, social functioning, role limitations because of physical problems, and general health.

The researchers concluded that their exercise capacity finding “underscores the need for large-scale follow up and early intervention to improve residual impairments in patients who had COVID-19.”

—Ellen Kurek


Ross J, Limpin ME, Ong-Dela Cruz B. Exercise capacity and health-related quality of life in survivors of COVID-19 pneumonia. Paper presented at: CHEST 2021 Annual Meeting; October 17-20, 2021; Virtual.