Adapted Physical Activity Protocol Improves Health-Related Quality of Life and Psychological Outcomes in Long COVID: A Prospective Longitudinal Study

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Background: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has resulted in persistent symptoms in some individuals-referred to as long COVID or post-acute sequelae of SARS-CoV-2 infection (PASC). Common symptoms such as fatigue, dyspnea, anxiety, and depression can markedly impair health-related quality of life (HRQOL). Conventional rehabilitation may be insufficient, raising interest in Adapted Physical Activity (APA) as a non-pharmacological strategy to improve physical and psychological outcome. Thus, this study aimed to evaluate the short- and medium-term effects of an APA protocol on HRQOL and psychological outcomes in patients with long COVID. Methods: Fifty non-hospitalized patients with long COVID (mean age 52.0 ± 15.3 years; 44% female) participated in in a prospective, longitudinal observational study. Each patient underwent a 6-week APA program consisting of two 30-minute individualized cardiorespiratory sessions per week. HRQOL (SF-12), anxiety, and depression (HADS) were evaluated at baseline (E1), immediately post-intervention (E2), and at 5-7 months follow-up (E3). Results: Significant improvements were found in both physical and mental SF-12 scores across time points (p < 0.001). The proportion of patients with normal physical HRQOL rose from 16% at baseline to 90% at E2 and remained higher than baseline at E3 (66%). Symptoms of anxiety and depression were significantly reduced (p < 0.001). Dyspnea prevalence decreased substantially from baseline to follow-ups. Strong negative correlations were observed between HRQOL and HADS scores (p < 0.001). Conclusion: The APA protocol showed significant short- and medium-term improvements in HRQOL and psychological outcomes in long COVID patients. Benefits were more pronounced for physical symptoms and anxiety than for depression. These findings suggest that structured physical activity may offer a feasible, non-pharmacological strategy to enhance recovery and quality of life. Incorporating APA into routine care may help meet the diverse functional and psychological needs of this population.

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