Lockdown to Long COVID: Sedentary Behaviour, Physical Activity, and their Vascular and Mental Health Consequences

Abstract

The COVID-19 pandemic has resulted in 700 million infections and 7 million deaths worldwide since 2019. However, beyond these statistics, millions are experiencing the long-term consequences of infection. Approximately 2 million people in the UK have symptoms of Long COVID (LC), a condition that causes persistent symptoms and functional impairment, commonly experienced for months or even years, with no clear end in sight. This thesis aimed to assess behavioural changes, including physical activity (PA) and daily life disruptions, following the COVID-19 pandemic, with a specific focus on individuals with LC and, the impact of COVID-19 and LC on arterial stiffness and vascular health. A quantitative survey explores how movement restrictions introduced in the UK to curb the spread of the virus caused significant reductions in PA in the general population (Chapter 3). A cohort of individuals, specifically those with LC were identified at high risk of PA changes (Chapter 3). Qualitative analysis demonstrates that early in the pandemic, individuals with LC faced challenges accessing appropriate healthcare due to diagnostic uncertainty and a lack of specialist knowledge (Chapter 4). Consequently, many have had to make significant alterations to their daily lives to manage their condition, leading to reductions in PA and an increase in sedentary behaviour (SB) (Chapter 4). A systematic review revealed that infection with COVID-19 causes a prolonged impairment in vascular health, with greater long-term susceptibility observed in individuals with LC (Chapter 6). An experimental laboratory study established that acute bouts of SB increase blood pressure (BP), a key indicator of cardiovascular disease risk; however, interrupting sitting with light activity has not shown a protective effect (Chapter 6). Due to the highly sedentary (Chapter 4; Chapter 6) and episodic nature of the condition, general PA guidelines may not be appropriate due to symptom exacerbation and limited functional capacity. Future work, proposed in Chapter 7, should identify whether longer periods of SB, representative of habitual behaviour, exacerbates acute BP changes and leads to functional changes to the arteries. This will enhance understanding of how LC and SB jointly influence vascular health.

Date of Award	17 Mar 2026
Original language	English
Awarding Institution	University of Winchester
Supervisor	James Faulkner (Supervisor), Scott Hannah (Supervisor) & Margaret Husted (Supervisor)