Physical functioning post-COVID-19 and the recovery process: a mixed methods study

Figures & data

Figure 1. Explanation of mixed methods analysis using a sequential explanatory strategy [12].

Description of workflow in explanatory mixed methods sequential design. Initial quantitative data collection phase, followed by quantitative data analysis, drafting of the interview protocol, qualitative data collection phase, qualitative data analysis and lastly interpretation of the entire analysis.

Figure 2. Patient inclusion flowchart.

Flowchart over patient inclusion. One hundred and forty-nine are eligible to participate. A total of one-hundred and nine declined or withdrew, leaving forty who gave consent to participate. One patient was excluded due to the inability to fully participate. Thirty-nine patients performed the physical tests and were later asked to participate in interviews. Nine patients were unreachable or declined, leaving thirty patients who participated in the interviews.

Table 1. General characteristics of participants.

	All participants
	(n = 39)
Sex, n (%)
Male	26 (67)
Female	13 (33)
Age in years, M (SD)	59 (12)
Highest academic qualification, n (%)
Primary education	5 (13)
Secondary education	17 (44)
Post-secondary education (<3 yrs)	7 (18)
Post-secondary education (≥3 yrs)	10 (26)
Occupational status, n (%)
Employed	26 (67)
Retired	9 (23)
Unemployed	4 (10)
Marital status, n (%)
Single	10 (26)
Married/cohabitation	29 (74)
Previous comorbidities, n (%)
Hypertension	14 (36)
Diabetes mellitus (types 1 and 2)	8 (21)
Cardiovascular diseases (excluding hypertension)	7 (18)
BMI, kg/m^2, median (IQR)	30 (8,2)
Smoking status six months post hospitalisation, n (%)
Never	18 (46)
Former	17 (44)
Active	4 (10)
Hospital stay, days, median (IQR)	10 (14)
Mechanical ventilation, n (%)	10 (26)
NHF, n (%)	38 (97)

BMI: Body mass index; IQR: Interquartile range; M: Mean; NHF: Nasal high-flow oxygen therapy; SD: Standard deviation.

Table 2. Tests measuring physical functioning six months after hospitalisation due to COVID-19.

	All participants
	(n = 39)
6MWT
Walking distance, m, median (IQR)	542 (160)
Number of participants with a subnormal result	19
Borg scale score after test, M (SD)^b	4.8 (1.8)
Heart Rate after test, M (SD)^c	112 (16)
SpO2 after test, %, median (IQR)^a	93 (4)
SpO2 lowest value, %, median (IQR)^a	92 (3)
Chair stand test
Number of stands 30s, M (SD)^a	15 (4.4)
Number of stands 60s, M (SD)^a	28 (8.7)
Borg scale score after test, M (SD)	6 (1.9)
SpO2 after test, %, median (IQR)^d	95 (3)
Number of participants with a subnormal result	31
Grip strength, kg, M (SD)
Right hand	36 (14)
Number of participants with a subnormal result	14
Left hand^b	34 (14)
Number of participants with a subnormal result	18
Spirometry, M (SD)
FEV1, percent of predicted value^b	90 (16)
PEF	476 (134)
MIP, cmH2O, median (IQR)	69 (51)
Number of participants with a subnormal result	29
MEP, cmH2O, M (SD)	97 (31)
PA-level, CPM
Age <65 years	325
Age ≥65 years	235
Number of participants with a subnormal result	24
EQ-5D-5L, median (IQR)
Value set	0.83 (0.28)
HQ VAS	80 (15)

6MWT: 6-min walk test; CPM: Counts per minute; FEV1: Forced expiratory volume 1s; FVC: Forced vital capacity; HQ: Health quality. IQR: Interquartile range; M: Mean. MEP: Maximal expiratory pressure; MIP: Maximal inspiratory pressure; PA: Physical activity; PEF: peak expiratory flow; SD: Standard deviation; SpO₂: Peripheral oxygen saturation; VAS: Visual analogue scale.

^an = 37.

^bn = 38.

^cn = 36.

^dn = 35.

Table 3. The questionnaires mMRC, PSFS and DRI, measuring physical functioning six months after hospitalisation due to COVID-19.

	All participants (n = 39)
	median (IQR)
mMRC scale	1 (2)
PSFS
Leisure activity^a	7 (5)
Work^b	7 (6)
PA	6 (6)
DRI total score	284 (361)

DRI: Disability rating index; IQR: Interquartile range; mMRC: Modified medical research council; PA: Physical activity; PSFS: Patient-specific functional scale.

^an = 35.

^bn = 38.

Figure 3. Displaying the overarching theme, three categories, and the sub-categories identified from semi-structured interviews exploring individuals’ experiences of COVID-19 and their perceived impact on physical activity.

Displaying the overarching theme of The rough road after COVID-nineteen. The theme is supported by three categories, first Physical impairment and deteriorated health, second The recovery process and third Clinical support. Each category is supported by two or three sub-categories.

Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 2nd ed. Thousand Oaks, CA: SAGE Publications; 2011.

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Data availability statement

The datasets generated and analysed during the current study are not publicly available, as they contain information that could compromise the integrity of research participants. However, they are available from the corresponding author upon reasonable request.