Determinants of 5 Year Progression of Muscle Dysfunction and Inactivity in COPDGene Participants Diversity Supplement

ABSTRACT COVID-19 disease is a highly transmittable viral infection caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2. Rapid human-to-human transmission has forced countries to implement restrictions to reduce the rate and impact of community spread. Advice for social restrictions was especially directed to the elderly and individuals with pre-existing chronic conditions, who are at greater risk of developing severe COVID-19 disease. These restrictions led to many individuals sheltering in their homes, in solitary or household isolation, for weeks or more at a time, affecting their social interactions and increasing poor health behaviors such as binge eating and physical inactivity. Reduced daily physical activity underlies many detrimental facets to health, including but not limited to poor glucose and lipid control, cardiovascular disease, cancer and a pro-inflammatory state. The CDC has identified physical inactivity as an "actual cause" of chronic disease, which contributes to the pathology and progression of many diseases including chronic obstructive pulmonary disease (COPD). COPD is a progressive lung disease that causes breathing difficulties, and, until COVID-19, was the 4th leading cause of death in the USA. In COPD, physical inactivity is associated with muscle dysfunction (e.g., loss of muscle mass, low oxidative capacity and increased oxidative stress) and exercise intolerance. Physical activity and exercise capacity are the strongest predictors of early mortality in COPD, rather than the severity of pulmonary function impairment. Many COPD patients report that the social restrictions imposed to mitigate COVID-19 exacerbated physical inactivity, increased depression and reduced quality-of-life. This study will assess the effect of COVID-19 restrictions on physical activity, symptoms, depression and quality-of-life. Fifty individuals who had these assessments made prior to COVID-19 restrictions in the parent Muscle Health Study (R01HL151452), will repeat these assessments now, after COVID-19 restrictions were implemented. In the past twelve months several studies were published elucidating the characteristics, pathogenesis and acute complications of COVID-19 disease, however the longer-term consequences are still unknown. Future impacts are especially relevant for patients with lung conditions such as COPD who are at greater risk of persistent consequences for at least 6 months after infection (e.g., dyspnea, fatigue, poor mental health, sleep problems). This proposal will provide evidence to support and promote efforts to re-tool pulmonary rehabilitation programs to impart impactful benefits in the COPD patients using virtual formats. Furthermore, this study would pave a career path for Mr. Baez, a Master's Student at the University of Rhode Island, to pursue his training in respiratory therapy for chronic lung disease patients.