Regular exercise associated with reduced COVID-19 severity: BMJ

Spain: A systemic review and meta-analysis have related regular physical activity with reduced unfavorable COVID-19 outcomes, including infectivity, hospitalization, severity, and mortality.

Regular physical activity offers a multitude of health benefits, including protection against complications of respiratory infections. The personal characteristics identified as risk factors accountable for disease severity in COVID-19 are age, sex, race, diabetes, obesity, hypertension, respiratory illness, etc.

Physical activity may reduce the aforementioned risk factors related to COVID-19 outcomes. The link between COVID-19 outcomes and regular physical activity remains unclear. No attempt has been made to evaluate systematically and meta-analyze this unknown link.

Researchers from the University of Valencia, Spain, have highlighted the potential benefits of regular physical exercise in reducing the severity of COVID-19.

The study is published in the British Journal of Sports Medicine, BMJ.

Yasmin Ezzatvar and Antonio Garcia-Hermoso independently searched three databases through March 2022, PubMed, Web of Science, and SportDiscus. The terms used for search are 'physical activity, 'COVID-19', 'SARS-CoV-2', 'mortality', 'hospitalization OR 'hospitalisation', 'infection', 'severe COVID-19'. A random-effects inverse variance model extracted and pooled Risk estimates, including Relative Risk (RR).

The key points of the study are:

• A total of Sixteen studies were included.

• There were 1,853,610 adults included in the study.

• Adults with regular physical activity were compared to those who were inactive.

• Physically active adults had a lowered risk of SARS-CoV-2 infection with a Relative risk (RR) of 0.89 and a p-value of 0.014. The Relative risk for hospitalization was 0.64 with p<0.001. Severe COVID-19 illness had an RR of 0.66 and p<0.001, and death due to COVID-19 had an RR of 0.57 with p=0.001

• A non-linear dose-response relationship exists between physical activity presented in metabolic equivalent of task (MET)-min per week and severe COVID-19 illness and death.

• The dose-response curve is flattened at around 500 MET-min per week.

Robinson Ramirez-Velez added, "We found an evidential association between regular physical activity and an 11% lower risk of COVID-19 infection.". The best possible explanation is physically active people will have less severe symptoms, shorter recovery times, and are less likely to infect others they come into contact with.

Yamin Ezzatvar wrote, "Our results support the findings of other studies in this area linking physical activity with infectious diseases. A recent review reported that regularly engaging in moderate-to-vigorous physical activity is associated with 31% lower prospective risk of infectious disease and 37% lower risk of infectious disease-related mortality."

The most significant benefit is achieved at least 500-MET min/week of physical activity, equivalent to 150 min of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week. The researchers confirmed this public target range.

Observational designs, subjective tools assessing physical activity, and publication bias are some of the study's limitations while interpreting the results. More studies with standardized methodology are warranted to report the outcomes more precisely and accurately.

The study's findings may prove beneficial for physicians and healthcare policymakers in recommending the degree of physical activity that can help reduce the risk and complications of COVID-19, especially in high-risk patients.

Further Reading:

Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, et alPhysical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose-response meta-analysis of data from 1 853 610 adults British Journal of Sports Medicine Published Online First: 22 August 2022