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This study aimed to assess 2-year trajectories of device-assessed physical and sleep behaviors post-hospitalization, comparing ICU- and non-ICU-treated patients, and to assess their association with HRQoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>7-day wrist-worn accelerometer assessment at 3\u20136, 12, and 24 months post-hospitalization. Physical behavior: physical activity volume, time spent in light (LIPA) and moderate-to-vigorous (MVPA) physical activity, and inactivity; sleep behavior: sleep duration, efficiency, and sleep regularity index (SRI); HRQoL: EQ-5D-5L questionnaire. Multivariable generalized estimating equations models were used to assess trajectories, and associations of physical activity (LIPA, MVPA) and sleep duration with HRQoL adjusted for covariables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      358 patients (mean age 59.7\u2009\u00b1\u200910.5 years, 246 [69%] males, 137 [38%] ICU-treated) were included. In the total cohort, estimated mean physical activity volume was 23.5 mg\/day (SE 0.40), with 153.2 min (SE 2.6) LIPA, 32.7 min (SE 1.4) MVPA, and 10.8 h (SE 0.07) inactive at 3\u20136 months. The estimated mean sleep duration was 6.9 (SE 0.05) hours\/night, efficiency 71.1% (SE 0.41), and SRI 52.7% (SE 0.72). ICU-treated patients showed significantly lower physical activity volume (22.6 [SE 0.55] vs. 24.2 [SE 0.54],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) and SRI (50.3 [SE 1.2] vs. 53.2 [SE 0.95],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) compared to non-ICU-treated patients. Over time, physical and sleep outcomes remained stable in the total cohort. However, ICU-treated patients showed greater improvements in physical activity between 3\u20136 months and 1 year compared to non-ICU-treated patients (e.g., mean difference in change in MVPA\u2009=\u20096.9 min [95% CI 2.0 to 11.8],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Trajectories did not differ significantly between groups thereafter. MVPA, but not LIPA and sleep duration, was significantly associated with HRQoL, independent of covariables (\u03b2\n                      <jats:sub>adjusted<\/jats:sub>\n                      0.06 [95% CI 0.02 to 0.10],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Device-assessed physical and sleep behaviors seemed generally sufficient and remained stable up to 2 years post-hospitalization. However, ICU-treated patients initially showed less physical activity, reaching the levels of non-ICU-treated from the 1-year visit onwards, likely reflecting recovery from critical illness. Less time spent in MVPA was associated with poorer HRQoL; however, physical activity support should be personalized and cautiously considered in COVID-19 aftercare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This study has been prospectively registered in the International Clinical Trial Registry Platform (NL8710).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11136-025-04095-7","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T13:15:08Z","timestamp":1764335708000},"page":"3191-3204","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of device-assessed physical activity and sleep in ICU- and non-ICU-treated patients up to 2 years after hospitalization for COVID-19, and their association with health-related quality of life"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4640-9947","authenticated-orcid":false,"given":"J. 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