Exercise reduces COVID-19 risk: real-time meta-analysis of 68 studies (Version 43)

Significantly lower risk is seen for mortality, ventilation, ICU admission, hospitalization, progression, recovery, and cases. 52 studies from 52 independent teams in 24 countries show significant benefit.

Meta-analysis using the most serious outcome reported shows 39% [33‑44%] lower risk. Results are similar for higher quality and peer-reviewed studies.

Results are very robust—in worst case exclusion sensitivity analysis 56 of 68 studies must be excluded before statistical significance is lost. Emergent results for the efficacy gradient across outcomes (p = 0.0007) that match the biological mechanisms confirm efficacy.

Results are consistent with the overall risk of all cause mortality based on cardiorespiratory fitness — Laukkanen show RR 0.55 [0.50-0.61] for the top vs. bottom tertiles.

Control Exercise

Most studies analyze activity levels before infection, comparing regular/moderate exercise and lower/no exercise. Risk may increase with more extreme activity levels. Exercise may also be beneficial after infection. One study shows lower COVID-19 mortality with exercise during hospitalization2. Exercise during infection may increase the risk of transmission to others3, precautions should be taken to avoid transmission if potentially infected.

No treatment is 100% effective. Protocols combine safe and effective options with individual risk/benefit analysis and monitoring. All data and sources to reproduce this analysis are in the appendix.

6 other meta-analyses show significant improvements with exercise for mortality4-8, ICU admission4, hospitalization4,5,8,9, severity5-7, and cases5.

6 meta-analyses show significant improvements with exercise for mortality1-5, ICU admission1, hospitalization1,2,5,6, severity2-4, and cases2.