Being physically inactive is linked to a higher risk of developing severe COVID-19 that requires hospitalization, as well as worse outcomes among people hospitalized, according to a new study published in the British Journal of Sports Medicine.
Researchers looked at data from 48,440 adults in the United States who received a COVID-19 diagnosis between January 1, 2020, and October 21, 2020. Each person included in the study also had self-reported physical activity in their health records, reported between March 2018 and March 2019. Participants were grouped into different categories based on their responses — consistently inactive (0 to 10 minutes of activity per week), some activity (11 to 149 minutes per week), and consistently meeting guidelines (150 or more minutes per week). These responses were compared with outcomes related to COVID-19, including whether a person was hospitalized and how they fared during their hospital stay.
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Inactivity linked to heightened risk of COVID-19 hospitalization
Compared with consistently meeting activity guidelines, being consistently inactive was linked to 2.26 times the risk of being hospitalized for COVID-19, 1.73 times the risk of being admitted to a hospital’s intensive care unit (ICU), and 2.49 times the risk of death from the viral infection. Being consistently inactive was also somewhat worse than getting some activity — compared with this group, being consistently inactive was linked to 1.20 times the risk of being hospitalized, 1.10 times the risk of being admitted to the ICU, and 1.32 times the risk of death. Overall, 8.6% of participants were hospitalized for COVID-19, 2.4% were admitted to the ICU, and 1.6% died.
The average age of study participants was 47.5 years, and 61.9% of participants were female. Overall, only 6.4% of participants consistently met physical activity guidelines, 79.2% fell in the “some activity” category, and 14.4% of participants were consistently inactive. White participants were most likely to meet physical activity guidelines (9.4% of this group), followed by Asian participants (7.3%), Hispanic participants (5.5%) and African-American participants (4.6%). The average body-mass index (BMI, a measure of weight that takes height into account) of participants was 31.2, which falls in the category of obese.
It’s unclear, based on these findings, whether physical activity was actually responsible for all or most of the lower risks associated with COVID-19 that were linked to it. It’s possible that people with the worst overall health were unable to exercise or couldn’t exercise as much, and that this accounts for at least part of the reason for the relationship found between physical activity and the outcomes of hospitalization, ICU admissions and death. Still, the link between consistent inactivity and poor COVID-19 outcomes was strong enough that getting enough exercise “may be the most important modifiable risk factor for severe COVID-19,” according to the researchers.
“Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults,” the researchers concluded. “We recommend efforts to promote physical activity be prioritized by public health agencies and incorporated into routine medical care.”
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