Objective To quantify the association between physical activity and risk of SARS-CoV-2 infection, COVID-19-associated hospitalisation, severe illness and death due to COVID-19 in adults. Design A systematic review and meta-analysis. Data sources Three databases were systematically searched through March 2022. Eligibility criteria for selecting studies Peer-reviewed articles reporting the association between regular physical activity and at least one COVID-19 outcome in adults were included. Risk estimates (ORs, relative risk (RR) ratios or HRs) were extracted and pooled using a random-effects inverse-variance model. Results Sixteen studies were included (n=1 853 610). Overall, those who engaged in regular physical activity had a lower risk of infection (RR=0.89; 95% CI 0.84 to 0.95; I2=0%), hospitalisation (RR=0.64; 95% CI 0.54 to 0.76; I2=48.01%), severe COVID-19 illness (RR=0.66; 95% CI 0.58 to 0.77; I2=50.93%) and COVID-19-related death (RR=0.57; 95% CI 0.46 to 0.71; I2=26.63%) as compared with their inactive peers. The results indicated a non-linear dose–response relationship between physical activity presented in metabolic equivalent of task (MET)-min per week and severe COVID-19 illness and death (p for non-linearity <0.001) with a flattening of the dose–response curve at around 500 MET-min per week. Conclusions Regular physical activity seems to be related to a lower likelihood of adverse COVID-19 outcomes. Our findings highlight the protective effects of engaging in sufficient physical activity as a public health strategy, with potential benefits to reduce the risk of severe COVID-19. Given the heterogeneity and risk of publication bias, further studies with standardised methodology and outcome reporting are now needed. PROSPERO registration number CRD42022313629.

/pdf/physical-activity-and-risk-of-infection-severity-and-wc4ue84e.pdf

Physical 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

With the continued spread of COVID‐19 globally, it is crucial to identify the potential risk or protective factors associated with COVID‐19. Here, we performed genetic correlation analysis and Mendelian randomization analysis to examine genetic relationships between COVID‐19 hospitalization and 405 health conditions and lifestyle factors in 456 422 participants from the UK Biobank. The genetic correlation analysis revealed 134 positive and 65 negative correlations, including those with intakes of a variety of dietary components. The MR analysis indicates that a set of body fat‐related traits, maternal smoking around birth, basal metabolic rate, lymphocyte count, peripheral enthesopathies and allied syndromes, blood clots in the leg, and arthropathy are causal risk factors for severe COVID‐19, while higher education attainment, physical activity, asthma, and never smoking status protect against the illness. Our findings have implications for risk stratification in patients with COVID‐19 and the prevention of its severe outcomes.

A phenome‐wide investigation of risk factors for severe COVID‐19

https://doi.org/10.1016/j.jshs.2022.08.002

Physical activity lowers the risk for acute respiratory infections: Time for recognition

Purpose: This systematic review and meta-analysis investigated the association between Physical activity (PA) before Coronavirus Disease 2019 (COVID-19) infection and the severity of illness and mortality in COVID-19 patients. Methods: A comprehensive search was undertaken to identify retrospective and nonrandomized controlled trial studies comparing the severity and mortality of COVID-19 infection among COVID-19 patients who had previously reported their participation in PA with those who had not. The databases searched were PubMed, Cochrane Library, Scopus, Science Direct, EMBASE, OPENGREY.EU, and ClinicalTrials.gov. The risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model was used for determining pairwise meta-analyses. The protocol was registered with PROSPERO (CRD42021262548). Results: Eighteen studies met the inclusion criteria (5 cross-sectional, 12 cohort, and 1 case-control studies). All 1 618 680 subjects were adults. PA significantly decreased the risk of death in COVID-19 patients (odds ratio [OR] 0.34; 95% confidence interval [CI], 0.19–0.62; p < 0.001) and the risk of severe outcomes (OR 0.60; 95% CI, 0.48–0.76; p < 0.001). Subgroup analysis showed that PA for ≥150 min/wk at a moderate intensity or ≥75 min/wk at a vigorous intensity reduced the risks of severity and mortality. Vigorous PA reduced mortality risk, whereas moderate to vigorous PA reduced the risks of severity and mortality. Conclusion: PA before infection might reduce severity and mortality in COVID-19 patients, especially PA ≥ 150 min/wk of moderate activity or ≥75 min/wk of vigorous activity. However, careful interpretations should be considered due to the difference in PA patterns and severity definitions among included studies. This finding implies that engaging in regular PA, even in different patterns, has beneficial effects on the severity and mortality of COVID-19 patients.

Effects of physical activity on the severity of illness and mortality in COVID-19 patients: A systematic review and meta-analysis

Since the WHO declared COVID19 a pandemic in March 2020, scientists have put great effort into increasing our understanding of the linkages between this new disease and the multiple factors that potentially affect its prognosis. Evidence began to accumulate that COVID19 can be more lethal in individuals with clinical conditions that weaken immune function. As regular physical activity (PA) knowingly improves immunity, a growing number of studies have investigated whether PA could change the natural course of COVID19.

https://bjsm.bmj.com/content/bjsports/56/12/653.full.pdf

Evidence-based physical activity for COVID-19: what do we know and what do we need to know?

Association between accelerometer-assessed physical activity and severity of COVID-19 in UK Biobank.

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Association between accelerometer-assessed physical activity and severity of COVID-19 in UK Biobank.