Influence of lifestyle factors on susceptibility, disease course and recovery from post COVID-19 syndrome: a scoping review

Background: A healthy lifestyle is crucial for preventing illnesses and aiding recovery. Many individuals suffer long-term effects from SARS-CoV-2 infection, known as post COVID-19 syndrome (PCS). However, there is a lack of comprehensive understanding of how lifestyle factors influence development and recovery of PCS. Methods: A scoping review was conducted to explore the impact of various lifestyle factors-exercise, smoking, alcohol, diet, mental health, sleep and overall lifestyle-on PCS susceptibility, progression and recovery. Systematic reviews, clinical studies and additional literature from PubMed (MEDLINE), Scopus and the Cochrane Library (January 2022 to December 2024) were included. Findings: Out of 4665 unique articles, 82 met the inclusion criteria. The evidence indicates that smoking and poor mental health increase the risk of developing PCS, while adequate sleep and maintaining multiple healthy lifestyle factors reduce susceptibility to PCS. Dosed exercise-based rehabilitation and cognitive behavioural therapy are effective in relieving PCS symptoms. Specific food-derived components, mind-body therapies and combined healthy lifestyle factors may be beneficial in PCS course/recovery. However, the evidence remains insufficient or inconsistent regarding the effects of exercise, alcohol consumption and habitual diets on PCS susceptibility. Likewise, evidence is lacking on the effectiveness of smoking or alcohol cessation, sleep or combined lifestyle interventions in aiding PCS recovery. Most studies focus on hospitalised adults, leaving gaps for paediatric and outpatient populations. Conclusions: The evidence shows that certain lifestyle factors can reduce PCS susceptibility and improve symptom relief and quality of life in PCS. However, substantial knowledge gaps remain. Further research is needed to understand how lifestyle factors interact with PCS, so that new knowledge can contribute to the development of treatment strategies.