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Background: Many patients hospitalized for COVID-19 experience prolonged symptoms months after discharge. Little is known abou t patients' personal experiences recovering from COVID-19 in the United States (US), where medically underserved populations are at particular risk of adverse outcomes., Objective: To explore patients' perspectives on the impact of COVID-19 hospitalization and barriers to and facilitators of recovery 1 year after hospital discharge in a predominantly Black American study population with high neighborhood-level socioeconomic disadvantage., Design: Qualitative study utilizing individual, semi-structured interviews., Participants: Adult patients hospitalized for COVID-19 approximately 1 year after discharge home who were engaged in a COVID-19 longitudinal cohort study., Approach: The interview guide was developed and piloted by a multidisciplinary team. Interviews were audio-recorded and transcribed. Data were coded and organized into discrete themes using qualitative content analysis with constant comparison techniques., Key Results: Of 24 participants, 17 (71%) self-identified as Black, and 13 (54%) resided in neighborhoods with the most severe neighborhood-level socioeconomic disadvantage. One year after discharge, participants described persistent deficits in physical, cognitive, or psychological health that impacted their current lives. Repercussions included financial suffering and a loss of identity. Participants reported that clinicians often focused on physical health over cognitive and psychological health, an emphasis that posed a barrier to recovering holistically. Facilitators of recovery included robust financial or social support systems and personal agency in health maintenance. Spirituality and gratitude were common coping mechanisms., Conclusions: Persistent health deficits after COVID-19 resulted in downstream consequences in participants' lives. Though participants received adequate care to address physical needs, many described persistent unmet cognitive and psychological needs. A more comprehensive understanding of barriers and facilitators for COVID-19 recovery, contextualized by specific healthcare and socioeconomic needs related to socioeconomic disadvantage, is needed to better inform intervention delivery to patients that experience long-term sequelae of COVID-19 hospitalization., (© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.)

Background: Older adults are encouraged to walk ≥100 steps∙minute(-1) for moderate-intensity physical activity (i.e., brisk walking). It is unknown if the ability to walk ≥100 steps∙minute(-1) predicts mortality., Objective: To determine if the ability to walk ≥100 steps∙minute(-1) predicts mortality among older adults., Design, Setting, and Patients: A population-based cohort study among 5,000 older adults from the Third National Health and Nutrition Survey (NHANES III; 1988-1994). Vital status and cause of death were collected through December 31, 2006. Median follow-up was 13.4 years. Average participant age was 70.6 years., Measurements: Walking cadence (steps∙minute(-1)) was calculated using a timed 2.4-m walk. Walking cadence was dichotomized at 100 steps∙minute(-1) (≥100 steps∙minute(-1) versus <100 steps∙minute(-1)) to demarcate the lower threshold of absolutely defined moderate-intensity physical activity. Walking cadence was also analyzed as a continuous variable. Predicted survival was compared between walking cadence and gait speed. The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular-specific and cancer-specific mortality and mortality from other causes., Results: Among 5,000 participants, 3,039 (61 %) walked ≥100 steps∙minute(-1). During follow-up, 3,171 subjects died. In multivariable-adjusted analysis, ability to walk ≥100 steps∙minute(-1) predicted a 21 % reduction in all-cause mortality (hazard ratio [HR], 0.79; 95 % confidence interval [95 % CI], 0.71-0.89, p < 0.001). Each ten-step increase in walking cadence predicted a 4 % reduction in all-cause mortality (HR, 0.96, [0.94-0.98], p < 0.001). In secondary analyses, ability to walk ≥100 steps∙minute(-1) predicted reductions in cardiovascular-specific mortality (HR, 0.79 [0.67-0.92], p = 0.002), cancer-specific mortality (HR, 0.76 [0.58-0.99], p = 0.050), and mortality from other causes (HR, 0.82 [0.68-0.97], p = 0.025). Predicted survival, adjusted for age and sex, was not different using walking cadence versus gait speed., Limitations: Walking cadence was a cross-sectional measurement., Conclusions: The ability to walk ≥100 steps∙minute(-1) predicts a reduction in mortality among a sample of community-dwelling older adults.