More exercise linked to lower likelihood of severe COVID-19: study

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Add one more potential benefit to getting the recommended amount of physical activity each week: People who exercised regularly and then tested positive for SARS-CoV-2 were less likely to have more severe COVID-19 results, a new study shows.

Importantly, even people who could not realistically exercise for 150 minutes or more per week still experienced significant benefits compared to people who said they exercised for 10 minutes or less.

Compared to the most active people in the study – those who exercised for 150 minutes or more each week – patients with COVID-19 who were ‘consistently inactive’ were 226% more likely to be hospitalized, 173% more likely to to be admitted to an intensive care unit (ICU), and 149% more likely to die in the study.

“We strongly believe that the results of this study represent a clear and useful guideline that can be used by populations around the world to reduce the risk of serious COVID-19 outcomes, including death,” said study author Deborah. Rohm Young, PhD. Medscape Medical News.

The study was published online April 13 in the British Journal of Sports Medicine.

A little practice goes a long way

A more realistic strategy could have a greater overall impact, Ross Arena, PhD, PT, who was not affiliated with the study, said. Medscape Medical News when asked to comment. “How many sedentary people can watch that jump to 150 minutes or more of physical activity per week?” A more effective message could be “something is better than nothing, and more is better,” he said.

“Walking your dog is being physically active,” added Arena, professor and chief of the physiotherapy department at the University of Illinois at the Chicago College of Applied Health Sciences.

“You don’t have to run a marathon or go to a gym and run on a treadmill for 60 minutes a day. Although that’s great,” he said; it is also good to move more and sit less.

For example, youth and colleagues found that compared to people who reported exercising for 11 to 149 minutes per week, the inactive group was 120% more likely to be hospitalized, 110% more likely to be admitted to intensive care, and 132% more likely to be admitted to hospital. die.

Classifying physical activity between 11 minutes and 149 minutes per week is “a pretty broad range and there’s probably a way to leverage that out more,” Arena said.

“We hope the message that a small exercise can go a long way will be heard and followed up,” added Young, a researcher at the Kaiser Permanente Southern California Department of Research and Evaluation in Pasadena.

The merits of moving

So what’s the connection? For example, regular exercise can improve immune function. “We have long known that immune function improves with regular physical activity, and those who are regularly active have a lower incidence, intensity of symptoms, and death from viral infections,” said Young.

Additional benefits include increased lung capacity and improved cardiovascular and muscle function “which may serve to reduce the negative effects of COVID-19,” she said.

“To put it simply, exercise is medicine. If you have better heart and lung function – as you would expect from someone who meets physical activity guidelines – then it makes sense that you are more resistant to the stress factor of physical activity. COVID-19 affecting many bodily systems, ”said Monica Verduzco-Gutierrez, MD, chair of the Department of Rehabilitation Medicine at the Long School of Medicine at UT Health San Antonio in Texas. Medscape Medical News.

To find out more, Young, lead author Robert Sallis, and their colleagues evaluated 48,440 adults in the Kaiser Permanente system. They all had a positive COVID-19 test or diagnosis between January 1 and October 21, 2020. Their mean age was 47 years and 62% were women.

The researchers also required patients to complete at least three outpatient visits with exercise assessments between March 19, 2018 and March 19, 2020. The majority of the participants were in the ‘some physical activity’ category, with only 6.4% meeting the US recommended physical activity. levels and an additional 14.4% consistently inactive.

Higher chance of bad results

Compared to the most active group who met the guidelines, those with COVID-19 who reported 10 minutes or less of physical activity per week had a greater risk of hospitalization (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.81 – 2.83). They were also more likely to be admitted to the ICU (OR 1.73; 95% CI 1.18 – 2.55) and to die (OR 2.49; 95% CI 1.33 – 4.67) due to COVID -19.

In addition, patients who were consistently inactive had a greater risk of hospitalization (OR, 1.20; 95% CI, 1.10-1.32), compared to the group with ‘some physical activity’, admission to the ICU (OR , 1.10, 95% CI). 0.93 – 1.29) and death (OR 1.32; 95% CI 1.09 – 1.60) due to COVID-19.

“I did not expect the odds ratios to be as strong as we found, especially after controlling for known risk factors for COVID-19, particularly obesity status,” said Young. She and colleagues also adjusted for other underlying conditions, age, gender, race, and smoking status.

“It’s a great study,” said Arena. “It builds on this scientific foundation that is growing rapidly in the COVID pandemic era, where lifestyle is hugely important. Leading a healthy lifestyle protects you from chronic illness as well as complications from viral infection.”

Previous research has indicated similar benefits between physical activity and COVID-19 results. A study first published as a prepress in May 2020 evaluated how lifestyle and other factors may affect infection risk. The British Biobank study included 387,109 adults in the United Kingdom. These researchers also found that physical activity was a very strong predictor of less serious complications with COVID-19.

Another study group showed in a January 2021 study that greater exercise capacity, estimated from incline and speed on a treadmill, was also a significant predictor of a lower risk of COVID complications.

A lockdown on physical activity?

Education about the benefits of physical activity and advice to maintain or increase physical activity during the pandemic in the United States was “essentially absent,” the researchers note.

Young said, “The potential for regular physical activity to reduce the severity of COVID-19 disease should be promoted by the medical community and public health agencies.”

“People move even less now,” said Arena. “The big concern is whether this will become the new norm after we get out of the pandemic?” He and his colleagues published a “Tale of Two Pandemics” commentary earlier this year examining the interplay between COVID-19 and global trends in inactivity and sedentary behavior.

“The magnitude of risk for all outcomes associated with consistently inactivity exceeded the probability of smoking and virtually all of the chronic diseases studied in this analysis,” add the researchers. This finding could indicate that “physical inactivity may play a critical role as a risk factor for severe COVID-19 outcomes.”

Challenging or not, still a modifiable risk factor

“This study found that physical inactivity was one of the strongest risk factors for severe COVID-19 outcomes. Physical inactivity was the third highest risk factor – only after advanced age and history of organ transplantation – for patients with COVID-19 who were admitted to hospital. admitted to the ICU, or dying, ”said Verduzco-Gutierrez

“You can’t change your risk factor of advanced age, unfortunately, but you can increase your physical activity and reduce your risk of severe COVID,” added Verduzco-Gutierrez, who is also a member of the American Academy of Physical Medicine and Rehabilitation Inclusion and Engagement Committee and as Director of the Post-COVID Recovery Clinic at the University of Texas Health Science Center in San Antonio and at University Health.

“The next step would be to see if physical inactivity is related to patients suffering from lung COVID,” she said.

Young, Arena and Verduzco-Gutierrez have not disclosed any relevant financial relationships. Partial support for the study came from Kaiser Permanente Community Benefit Fund.

Damian McNamara is a personnel journalist based in Miami. It covers a wide variety of medical specialties, including infectious diseases, gastroenterology and intensive care. Follow Damian on Twitter: @MedReporter.

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