Does Higher Self-Reported Cardiorespiratory Fitness Reduce the Odds of Hospitalization From COVID-19?
Jason P Brandenburg, Iris A Lesser, Cynthia J Thomson, Luisa V Giles
Journal of Physical Activity and Health, doi:10.1123/jpah.2020-0817
Background: Regular physical activity and higher cardiorespiratory (CR) fitness enhance immune function, possibly reducing coronavirus disease 2019 (COVID-19) infection severity. The aim was to assess the association between physical activity and self-reported CR fitness on COVID-19 infection characteristics. Methods: Participants formerly testing positive for COVID-19 completed an online questionnaire measuring COVID-19 infection characteristics and complications, self-reported CR fitness level, physical activity, and sociodemographic and health-related characteristics. Self-reported CR fitness was determined as the pace to cover 4.8 km without becoming overly fatigued (with slow walking, brisk walking, jogging, and running corresponding to low, moderate, good, and excellent levels of fitness, respectively). Results: A total of 263 individuals completed the survey. Compared with the lowest level of self-reported CR fitness, the odds of hospitalization significantly decreased by 64% (odds ratio = 0.36; 95% confidence interval, 0.13-0.98; P = .04) in individuals reporting the ability to maintain a brisk walk. In individuals reporting the ability to maintain a jogging pace, the further reduction in hospitalization was not significant (odds ratio = 0.22; 95% confidence interval, 0.05-1.04; P = .05). For COVID-19 symptom severity and number, there were no significant associations with self-reported CR fitness or physical activity levels. Conclusions: For individuals with low self-reported CR fitness, improving CR fitness represents a strategy to reduce the risk of hospitalization from COVID-19.
References
Ahmed, COVID-19-does exercise prescription and maximal oxygen uptake (VO 2 max) have a role in risk-stratifying patients?, Clin Med J R Coll Physicians Lond,
doi:10.7861/clinmed.2020-0111Brawner, Ehrman, Bole, Maximal exercise capacity is inversely related to hospitalization secondary to coronavirus disease 2019, Mayo Clin Proc,
doi:10.1016/j.mayocp.2020.10.003Duggal, Niemiro, Harridge, Simpson, Lord, Can physical activity ameliorate immunosenescence and thereby reduce age-related multi-morbidity?, Nat Rev Immunol,
doi:10.1038/s41577-019-0177-9Hamer, Kivimäki, Gale, Batty, Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: a community-based cohort study of 387,109 adults in UK, Brain Behav Immun,
doi:10.1016/j.bbi.2020.05.059Hjelstuen, Anderssen, Holme, Seljeflot, Klemsdal, Markers of inflammation are inversely related to physical activity and fitness in sedentary men with treated hypertension, Am J Hypertens,
doi:10.1016/j.amjhyper.2005.11.012Krajewska, Krajewski, Zub, Zatoński, COVID-19 in otolaryngologist practice: a review of current knowledge, Eur Arch Oto-Rhino-Laryngology,
doi:10.1007/s00405-020-05968-yLesser, Nienhuis, The impact of COVID-19 on physical activity behavior and well-being of Canadians, Int J Environ Res Public Health,
doi:10.3390/ijerph17113899Nieman, Coronavirus disease-2019: a tocsin to our aging, unfit, corpulent, and immunodeficient society, J Sport Heal Sci,
doi:10.1016/j.jshs.2020.05.001Razai, Doerholt, Ladhani, Oakeshott, Coronavirus disease 2019 (COVID-19): a guide for UK GPS, BMJ,
doi:10.1136/bmj.m800Reinholdsson, Palstam, Sunnerhagen, Prestroke physical activity could influence acute stroke severity (part of PAPSIGOT), Neurology,
doi:10.1212/WNL.0000000000006354Sallis, Adlakha, Oyeyemi, Salvo, An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices, J Sport Heal Sci,
doi:10.1016/j.jshs.2020.05.005Schuler, Leblanc, Marzilli, Effect of physical activity on the production of specific antibody in response to the 1998-99 influenza virus vaccine in older adults, J Sports Med Phys Fitness
Sebastiano, Chulak-Bozzer, Vanderloo, Faulkner, Don't walk so close to me: physical distancing and adult physical activity in Canada, Front Psychol,
doi:10.3389/fpsyg.2020.01895Simpson, Katsanis, The immunological case for staying active during the COVID-19 pandemic, Brain Behav Immun
Simpson, Kunz, Agha, Graff, Exercise and the regulation of immune functions, Prog Mol Biol Transl Sci
Sokolow, Naleway, Li, Severity of influenza and noninfluenza acute respiratory illness among pregnant women, 2010-2012, Am J Obstet Gynecol,
doi:10.1016/j.ajog.2014.08.004Wang, Li, Lu, Huang, Does comorbidity increase the risk of patients with covid-19: evidence from meta-analysis, Aging,
doi:10.18632/aging.103000Wong, Narang, Lu, Hallmarks of improved immunological responses in the vaccination of more physically active elderly females, Exerc Immunol Rev
Zbinden-Foncea, Francaux, Deldicque, Hawley, Does high cardiorespiratory fitness confer some protection against proinflammatory responses after infection by SARS-CoV-2?, Obesity,
doi:10.1002/oby.22849Zheng, SARS-coV-2: an emerging coronavirus that causes a global threat, Int J Biol Sci,
doi:10.7150/ijbs.45053{ 'indexed': {'date-parts': [[2022, 3, 30]], 'date-time': '2022-03-30T18:57:55Z', 'timestamp': 1648666675312},
'reference-count': 60,
'publisher': 'Human Kinetics',
'issue': '7',
'content-domain': {'domain': [], 'crossmark-restriction': False},
'short-container-title': [],
'published-print': {'date-parts': [[2021, 7, 1]]},
'abstract': '<jats:p><jats:bold>Background</jats:bold>: Regular physical activity and higher '
'cardiorespiratory (CR) fitness enhance immune function, possibly reducing coronavirus disease '
'2019 (COVID-19) infection severity. The aim was to assess the association between physical '
'activity and self-reported CR fitness on COVID-19 infection characteristics. '
'<jats:bold>Methods</jats:bold>: Participants formerly testing positive for COVID-19 completed '
'an online questionnaire measuring COVID-19 infection characteristics and complications, '
'self-reported CR fitness level, physical activity, and sociodemographic and health-related '
'characteristics. Self-reported CR fitness was determined as the pace to cover 4.8\xa0km '
'without becoming overly fatigued (with slow walking, brisk walking, jogging, and running '
'corresponding to low, moderate, good, and excellent levels of fitness, respectively). '
'<jats:bold>Results</jats:bold>: A total of 263 individuals completed the survey. Compared '
'with the lowest level of self-reported CR fitness, the odds of hospitalization significantly '
'decreased by 64% (odds ratio\u2009=\u20090.36; 95% confidence interval, 0.13–0.98; '
'<jats:italic>P</jats:italic>\u2009=\u2009.04) in individuals reporting the ability to '
'maintain a brisk walk. In individuals reporting the ability to maintain a jogging pace, the '
'further reduction in hospitalization was not significant (odds ratio\u2009=\u20090.22; 95% '
'confidence interval, 0.05–1.04; <jats:italic>P</jats:italic>\u2009=\u2009.05). For COVID-19 '
'symptom severity and number, there were no significant associations with self-reported CR '
'fitness or physical activity levels. <jats:bold>Conclusions</jats:bold>: For individuals with '
'low self-reported CR fitness, improving CR fitness represents a strategy to reduce the risk '
'of hospitalization from COVID-19.</jats:p>',
'DOI': '10.1123/jpah.2020-0817',
'type': 'journal-article',
'created': {'date-parts': [[2021, 5, 13]], 'date-time': '2021-05-13T04:26:52Z', 'timestamp': 1620880012000},
'page': '782-788',
'source': 'Crossref',
'is-referenced-by-count': 3,
'title': [ 'Does Higher Self-Reported Cardiorespiratory Fitness Reduce the Odds of Hospitalization From '
'COVID-19?'],
'prefix': '10.1123',
'volume': '18',
'author': [ {'given': 'Jason P.', 'family': 'Brandenburg', 'sequence': 'first', 'affiliation': []},
{'given': 'Iris A.', 'family': 'Lesser', 'sequence': 'additional', 'affiliation': []},
{'given': 'Cynthia J.', 'family': 'Thomson', 'sequence': 'additional', 'affiliation': []},
{'given': 'Luisa V.', 'family': 'Giles', 'sequence': 'additional', 'affiliation': []}],
'member': '100',
'container-title': ['Journal of Physical Activity and Health'],
'original-title': [],
'link': [ { 'URL': 'https://journals.humankinetics.com/view/journals/jpah/18/7/article-p782.xml',
'content-type': 'text/html',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://journals.humankinetics.com/downloadpdf/journals/jpah/18/7/article-p782.xml',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2021, 7, 23]],
'date-time': '2021-07-23T09:13:36Z',
'timestamp': 1627031616000},
'score': 1,
'resource': { 'primary': { 'URL': 'https://journals.humankinetics.com/view/journals/jpah/18/7/article-p782.xml'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2021, 7, 1]]},
'references-count': 60,
'journal-issue': {'issue': '7'},
'URL': 'http://dx.doi.org/10.1123/jpah.2020-0817',
'relation': {},
'ISSN': ['1543-3080', '1543-5474'],
'issn-type': [{'value': '1543-3080', 'type': 'print'}, {'value': '1543-5474', 'type': 'electronic'}],
'subject': ['Orthopedics and Sports Medicine'],
'published': {'date-parts': [[2021, 7, 1]]}}
