Plain language summary
Regular physical activity may prevent poor outcomes due to COVID-19 in several ways such as improving immune function and reducing inflammation which may contribute to lung damage. However, lockdown measures in many countries have led to a reduction in physical activity. This observational study of 48440 patients with COVID-19 aimed to determine if regular physical activity had a protective effect for severe COVID-19 outcomes. The results showed that patients with COVID-19 who were inactive were more likely to be hospitalised, admitted to intensive care and die compared to individuals who were meeting activity guidelines set by the government in the USA and those who were doing some sort of physical activity. Interestingly individuals who were inactive were more at risk of hospitalisation, admission to intensive care and death than individuals who smoked and who had a chronic disease, indicating the role that physical activity may have in preventing poor outcomes in patients with COVID-19. It was concluded that meeting physical activity guidelines was associated with a reduced risk of severe COVID-19 outcomes. This study could be used by healthcare professionals to understand the importance of recommending activity to individuals during the COVID-19 pandemic.
Abstract
OBJECTIVES To compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines. METHODS We identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient's self-reported physical activity category (consistently inactive=0-10 min/week, some activity=11-149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes. RESULTS Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity. CONCLUSIONS Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.
Methodological quality
Jadad score
:
Not applicable
Allocation concealment
:
Not applicable
