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0 0.5 1 1.5 2+ Hospitalization, PA -6% Improvement Relative Risk Hospitalization, CRF 78% Hospitalization, CRF (b) 64% Severe case, PA 35% Severe case, CRF 24% Exercise for COVID-19  Brandenburg et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 211 patients in multiple countries Lower severe cases with higher activity levels (not stat. sig., p=0.3) c19early.org Brandenburg et al., J. Physical Activi.., Jul 2021 Favors exercise Favors inactivity

Does Higher Self-Reported Cardiorespiratory Fitness Reduce the Odds of Hospitalization From COVID-19?

Brandenburg et al., Journal of Physical Activity and Health, doi:10.1123/jpah.2020-0817
Jul 2021  
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Exercise for COVID-19
9th treatment shown to reduce risk in October 2020
 
*, now known with p < 0.00000000001 from 66 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,900+ studies for 60+ treatments. c19early.org
Retrospective 263 COVID+ patients, showing lower hospitalization with higher self-reported cardiorespiratory fitness, but no significant differences for physical activity. Participants in the study were healthier and more fit than the general population.
risk of hospitalization, 6.0% higher, OR 1.06, p = 0.60, high activity levels 102, low activity levels 39, adjusted per study, multivariable, PA, >1h vigorous vs. no/low, RR approximated with OR.
risk of hospitalization, 78.0% lower, OR 0.22, p = 0.05, high activity levels 177, low activity levels 34, adjusted per study, multivariable, CRF, 6.2-8.7 vs. >10, RR approximated with OR.
risk of hospitalization, 64.0% lower, OR 0.36, p = 0.04, high activity levels 97, low activity levels 34, adjusted per study, multivariable, CRF, 8.7-10 vs. >10, RR approximated with OR.
risk of severe case, 35.0% lower, OR 0.65, p = 0.30, high activity levels 102, low activity levels 39, adjusted per study, multivariable, PA, >1h vigorous vs. no/low, RR approximated with OR.
risk of severe case, 24.0% lower, OR 0.76, p = 0.60, high activity levels 52, low activity levels 34, adjusted per study, multivariable, CRF, 4.4-6.2 vs. >10, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Brandenburg et al., 1 Jul 2021, retrospective, multiple countries, peer-reviewed, survey, 4 authors.
This PaperExerciseAll
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.
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