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0 0.5 1 1.5 2+ Mortality 53% Improvement Relative Risk Case 10% Exercise for COVID-19  Cho et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 97,123 patients in South Korea Lower mortality (p=0.014) and fewer cases (p<0.0001) Cho et al., J. Clinical Medicine, April 2021 Favors exercise Favors inactivity

Physical Activity and the Risk of COVID-19 Infection and Mortality: A Nationwide Population-Based Case-Control Study

Cho et al., Journal of Clinical Medicine, doi:10.3390/jcm10071539
Apr 2021  
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Retrospective 6,288 COVID+ patients and 125,772 matched controls in South Korea, showing significantly lower risk of COVID-19 infection and mortality with higher physical activity.
risk of death, 53.0% lower, OR 0.47, p = 0.01, high activity levels 17 of 48 (35.4%) cases, 3,223 of 4,536 (71.1%) controls, case control OR, moderate to vigorous vs. inactive.
risk of case, 10.0% lower, OR 0.90, p < 0.001, high activity levels 3,223 of 4,536 (71.1%) cases, 68,609 of 92,587 (74.1%) controls, NNT 142, case control OR, moderate to vigorous vs. inactive.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cho et al., 6 Apr 2021, retrospective, South Korea, peer-reviewed, 9 authors.
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Physical Activity and the Risk of COVID-19 Infection and Mortality: A Nationwide Population-Based Case-Control Study
Dong-Hyuk Cho, Sun Ju Lee, Sae Young Jae, Woo Joo Kim, Seong Jun Ha, Jun Gyo Gwon, Jimi Choi, Dong Wook Kim, Jang Young Kim
Journal of Clinical Medicine, doi:10.3390/jcm10071539
Regular physical activity (PA) is known to reduce the risk of serious community-acquired infections. We examined the association of PA with the morbidity and mortality resulting from coronavirus disease (COVID-19) infection in the South Korean population. Patients who tested positive for severe acute respiratory coronavirus 2 and who underwent public health screening between 2014 and 2017 (n = 6288) were included. Age-and sex-matched controls (n = 125,772) were randomly selected from the Korean National Health Insurance Service database. Leisure-time PA was assessed using a self-reported questionnaire. The mean PA levels were lower in the patient than in the control group (558.2 ± 516.3 vs. 580.2 ± 525.7 metabolic equivalent of task (MET)-min/week, p = 0.001). Patients with moderate to vigorous PA (MVPA) were associated with a lower risk of COVID-19 morbidity (odds ratio (OR), 0.90; 95% confidence interval (CI), 0.86-0.95). In addition, a standard deviation (SD) increment in MET/week (525.3 MET-min/week) was associated with a 4% decrease in the risk of COVID-19 morbidity (OR, 0.96; 95% CI, 0.93-0.99). MVPA and an SD increment in MET/week were associated with lower mortality (MVPA: OR, 0.47; 95% CI, 0.26-0.87; per SD increment: OR, 0.65; 95% CI, 0.48-0.88). Higher levels of regular PA were associated with a lower risk of COVID-19 infection and mortality, highlighting the importance of maintaining appropriate levels of PA along with social distancing amid the COVID-19 pandemic.
Author Contributions: Conceptualization, D.-H.C., S.J.L., and J.Y.K.; methodology, S.J.L. and D.W.K.; software, S.J.H. and J.C.; validation, D.W.K.; formal analysis, S.J.L. and D.W.K.; investigation, S.J.L.; resources, S.J.L. and J.G.G.; data curation, S.J.L.; writing-original draft preparation, D.-H.C.; writingreview and editing, S.Y.J. and J.Y.K.; visualization, S.J.L.; supervision, W.J.K., J.Y.K. and D.W.K.; project administration, J.Y.K.; funding acquisition, D.W.K. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflict of interest.
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