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0 0.5 1 1.5 2+ Severe case 73% Improvement Relative Risk Exercise for COVID-19  Cardoso et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 614 patients in Brazil (April 2020 - February 2022) Lower severe cases with higher activity levels (p<0.000001) Cardoso et al., Medicina Clínica, May 2023 Favors exercise Favors inactivity

Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case–control study

Cardoso et al., Medicina Clínica, doi:10.1016/j.medcli.2023.04.031
May 2023  
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Case control study with 307 severe COVID-19 ICU patients and 307 matched COVID-19 outpatients in Brazil, showing significantly higher risk of severe cases with low physical activity.
risk of severe case, 73.0% lower, OR 0.27, p < 0.001, high activity levels 307, low activity levels 307, adjusted per study, inverted to make OR<1 favor high activity levels, case control OR, moderate/high vs. low physical activity, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cardoso et al., 9 May 2023, retrospective, Brazil, peer-reviewed, 6 authors, study period April 2020 - February 2022.
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Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case–control study
Fortunato José Cardoso, Carla Adriane Fonseca Leal De Araújo, José Roberto Da Silva Junior, Angélica Guimarães, Michelle Ribeiro Viana Taveiro, João Guilherme Bezerra Alves
Medicina Clínica, doi:10.1016/j.medcli.2023.04.031
Background: Regular physical activity is associated with a low risk of severe community-acquired infections. However, the hypothesis that a physical inactivity pattern is associated with a higher risk for severe COVID-19 has not been completely proven, especially with severe pneumonia. Objective: The goal of this study was to confirm the link between physical activity patterns and severe SARS-CoV-2 pneumonia. Design: Case-control study. Methods: This study involved 307 patients who developed SARS-CoV-2 severe pneumonia and were hospitalized in an intensive care unit. Age-and sex-matched controls (307) were selected from the same population: patients with mild to moderate forms of COVID-19 who were not hospitalized. Physical activity patterns were assessed using the short version of the International Physical Activity Questionnaire. Results: The mean physical activity levels were lower in the SARS-CoV-2 severe pneumonia group as compared to the control group: 1576 ± 2939 vs 2438 ± 2999, metabolic equivalent of task (MET-min/week), p < 0.001. A high or moderate physical activity level was more common in the control group, and a low physical activity level was more observed in the case group (p < 0.001). Obesity was also associated with severe SARS-CoV-2 pneumonia (p < 0.001). Multivariable analysis showed that a low physical activity level was associated with a higher risk for severe SARS-CoV-2 pneumonia, independent of nutritional status (CI 3.7; 2.24-5.99), p < 0.001). Conclusion: A higher and moderate level of physical activity is linked to a lower risk of SARS-CoV-2 severe pneumonia.
Conflict of interest All the authors declare no conflict of interest.
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