More exercise related to lower chance of severe COVID-19: study

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Add another 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 experience more severe COVID-like results. 19, shows a new study.

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

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

“We strongly believe that the results of this study are a clear and concrete guide that can be used by populations around the world to reduce the risk of severe COVID-19 outcomes, including death,” said study author Deborah Rohm Young, Ph.D. Medscape medical news.

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

A little exercise goes a long way

A more realistic strategy could have a greater overall impact, said Ross Arena, Ph.D., who was not affiliated with the study. Medscape medical news when asked to comment. “How many sedentary individuals can be seen doing this jump to 150 or more minutes 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 physically active,” added Arena, a professor and head of the physical therapy department at the University of Illinois at Chicago College of Applied Health Sciences.

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

Young people and colleagues found, for example, that compared to people who reported exercise between 11 and 149 minutes each week, the inactive group was 120% more likely to be hospitalized, 110% more likely to need care. critical and 132% more likely to die.

Classifying physical activity between 11 minutes and 149 minutes a week is “a fairly wide range and there’s probably a way to tease it more,” Arena said.

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

The merits of the movement

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

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

“To put it simply, exercise is medicine. If you have better basic heart and lung function – as you would expect from someone who follows physical activity guidelines – then it is reasonable that you can better withstand the stress factor of COVID-19 that impacts many body systems. said Monica Verduzco-Gutierrez, MD, president of the Department of Rehabilitation Medicine at Long School of Medicine at UT Health San Antonio, Texas. Medscape medical news.

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

The researchers also required that patients have at least three outpatient visits with exercise assessments between March 19, 2018 and March 19, 2020. Most participants were in the “certain physical activity” category, with only 6.4% meeting US physical activity recommended levels and another 14.4% consistently idle.

Higher odds of poor results

Compared to the most active group that meets the guidelines, people with COVID-19 who reported 10 minutes or less of physical activity per week had a higher risk of hospitalization (odds ratio). [OR], 2.25; 95% confidence interval [CI], 1.81 – 2.83). They were also more likely to apply for admission to the ICU (OR, 1.73; 95% CI, 1.18 – 2.55) and die (OR, 2.49; 95% CI, 1.33 – 4). , 67) because of COVID-19.

Moreover, compared to the “certain physical activity” group, patients who were constantly inactive also had a higher risk of hospitalization (OR, 1.20; 95% CI, 1.10 – 1.32), admission to the ICU (OR, 1.10; 95% CI, 0.93 – 1.29) and death (OR, 1.32; 95% CI, 1.09 – 1.60) from cause COVID-19.

“I didn’t expect quota rates to be as high as I found, especially after checking for known risk factors for COVID-19, especially obesity,” Young said. She and her colleagues also adapted to other basic conditions, age, sex, race and smoking status.

“It’s a wonderful study,” Arena said. It is based on this rapidly growing evidence base in the era of the COVID pandemic, in which lifestyle is extremely important. Leading a healthy lifestyle protects you from chronic diseases, but also from complications with viral infection.

Previous research has shown similar benefits between physical activity and COVID-19 results. A study first published as a prepress in May 2020 assessed how lifestyle and other factors could affect the risk of infection. 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 severe complications with COVID-19.

Another research group demonstrated in a January 2021 study that higher effort capacity, estimated in degree and speed on a treadmill, was also a significant predictor of lower risk of COVID complications.

A physical activity block?

Education about the benefits of physical activity and tips for maintaining or increasing physical activity during the pandemic in the United States were “essentially absent,” the researchers note.

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

“People are moving even less now,” Arena said. “The big concern is that this will become the new norm after we get out of the pandemic?” He and colleagues published a commentary on the “story of two pandemics” earlier this year, examining the interaction between COVID-19 and global trends in inactivity and sedentary behavior.

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

Provocative or not, another 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 largest risk factor – only behind old age and a history of organ transplantation – for COVID-19 patients who ended up in hospital. , admitted to the ICU, or dying, “said Verduzco-Gutierrez.

“You can’t change your risk factor for old 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 Inclusion in Rehabilitation and Commitment 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 look at whether physical inactivity is related to patients with long-term COVID,” she said.

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

Damian McNamara is a Miami-based journalist. It covers a wide range of medical specialties, including infectious diseases, gastroenterology and critical care. Follow Damian on Twitter: @MedReporter.

For more news, follow Medscape on Facebook, Twitter, Instagram and YouTube.