Physically inactive people at higher risk for severe COVID-19

People who are physically active are less likely to progress to severe COVID-19 if diagnosed with the disease as opposed to their physically inactive counterparts, suggests a recent study.

“Specifically, when compared with those who reported being consistently inactive, those who were consistently meeting physical activity (PA) guidelines had lower odds of being hospitalized, requiring intensive care unit (ICU) admission, and dying from COVID-19,” the researchers said.

“Even activity levels that did not meet the PA guidelines were significantly associated with reduced odds of hospitalization and death,” they added.

Overall, 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, were included. The researchers 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 hospitalization, ICU admission, and death after COVID-19 diagnosis.

Multivariable logistic regression, controlling for demographics and known risk factors, was conducted to determine whether inactivity correlated with COVID-19 outcomes.

COVID-19 patients who were consistently inactive were at greater risk of hospitalization (odds ratio [OR], 2.26, 95 percent confidence interval [CI], 1.81–2.83), admission to ICU (OR, 1.73, 95 percent CI, 1.18–2.55), and death (OR, 2.49, 95 percent CI, 1.33–4.67) than those who were consistently meeting PA guidelines. [Br J Sports Med 2021;doi:10.1136/bjsports-2021-104080]

Physically inactive patients were also at higher risk of hospitalization (OR, 1.20, 95 percent CI, 1.10–1.32), admission to ICU (OR, 1.10, 95 percent CI, 0.93–1.29), and death (OR, 1.32, 95 percent CI, 1.09–1.60) than those were doing some physical activity.

“It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by [the US Centers for Disease Control and Prevention], except for age and a history of organ transplant,” the researchers said. [https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html]

“In fact, physical inactivity was the strongest risk factor across all outcomes, compared with the commonly cited modifiable risk factors, including smoking, obesity, diabetes, hypertension, cardiovascular disease, and cancer,” they added.

The US Physical Activity Guidelines recommend all adults to engage in at least 150 min/week of moderate to vigorous PA, such as brisk walking, to maximize health benefits. This amount can be accumulated in small units, making it achievable for nearly everyone. [JAMA 2018;320:2020-2028]

An earlier study showed that Americans, on average, spend 4–5 hours of leisure time daily, most of which is devoted to sedentary activities, such as electronic media. [Prev Chronic Dis 2019;16:E133]

“The findings here provide additional rationale and motivation for individuals to be more physically active, as well as for communities to design environments that are more conducive to routine PA, especially amid the COVID-19 pandemic,” the researchers said. [Circulation 2012;125:729-737; Circulation 2020;142:e167-183]