Physical Activity and the Risk of COVID-19 Infection and Mortality: A Nationwide Population-Based Case-Control Study
Cho et al.,
Physical Activity and the Risk of COVID-19 Infection and Mortality: A Nationwide Population-Based Case-Control..,
Journal of Clinical Medicine, doi:10.3390/jcm10071539
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.
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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.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Cho et al., 6 Apr 2021, retrospective, South Korea, peer-reviewed, 9 authors.
Abstract: Journal of
Clinical Medicine
Article
Physical Activity and the Risk of COVID-19 Infection and
Mortality: A Nationwide Population-Based Case-Control Study
Dong-Hyuk Cho 1,† , Sun Ju Lee 2,† , Sae Young Jae 3 , Woo Joo Kim 4 , Seong Jun Ha 2 , Jun Gyo Gwon 5 ,
Jimi Choi 6 , Dong Wook Kim 2, * and Jang Young Kim 1, *
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†
Citation: Cho, D.-H.; Lee, S.J.; Jae,
S.Y.; Kim, W.J.; Ha, S.J.; Gwon, J.G.;
Choi, J.; Kim, D.W.; Kim, J.Y. Physical
Activity and the Risk of COVID-19
Infection and Mortality: A
Nationwide Population-Based
Case-Control Study. J. Clin. Med.
2021, 10, 1539. https://doi.org/
10.3390/jcm10071539
Academic Editor:
Jose-Manuel Ramos-Rincon
Received: 23 February 2021
Accepted: 2 April 2021
Published: 6 April 2021
Publisher’s Note: MDPI stays neutral
with regard to jurisdictional claims in
Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine,
Wonju 26426, Korea; why012@yonsei.ac.kr
Department of Big Data Strategy, National Health Insurance Service, Wonju 26464, Korea;
ju6801@nhis.or.kr (S.J.L.); haagoon@nhis.or.kr (S.J.H.)
Department of Sport Science, University of Seoul, Seoul 02504, Korea; syjae@uos.ac.kr
Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine,
Seoul 02841, Korea; wjkim@korea.ac.kr
Division of Transplantation and Vascular Surgery, Department of Surgery, Korea University College of
Medicine, Seoul 02841, Korea; doctorgjg@gmail.com
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of
Medicine, Seoul 02841, Korea; jjimchoi@gmail.com
Correspondence: kimdw2269@gmail.com (D.W.K.); kimjang713@gmail.com (J.Y.K.);
Tel.: +82-33-741-0916 (J.Y.K.)
D.-H.C. and S.J.L. contributed equally to this work.
Abstract: 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.
Keywords: severe acute respiratory coronavirus 2; COVID-19; physical activity; mortality
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