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0 0.5 1 1.5 2+ Mortality 63% Improvement Relative Risk Case 23% c19early.org/ex Christensen et al. Exercise for COVID-19 Prophylaxis Does physical activity reduce risk for COVID-19? Prospective study of 1,072 patients in the United Kingdom (Mar - Jul 2020) Lower mortality with higher activity levels (p=0.019) Christensen et al., PLOS ONE, doi:10.1371/journal.pone.0250508 Favors exercise Favors inactivity
The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study
Christensen et al., PLOS ONE, doi:10.1371/journal.pone.0250508
Christensen et al., The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study, PLOS ONE, doi:10.1371/journal.pone.0250508
May 2021   Source   PDF  
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Prospective study of 2,690 adults in the UK Biobank showing lower cardiorespiritory fitness associated with COVID-19 mortality.
risk of death, 63.0% lower, RR 0.37, p = 0.02, high activity levels 543, low activity levels 529, adjusted per study, high fitness vs. low fitness, multivariable.
risk of case, 23.0% lower, RR 0.77, p = 0.20, high activity levels 55 of 543 (10.1%), low activity levels 77 of 529 (14.6%), NNT 23, adjusted per study, high fitness vs. low fitness, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Christensen et al., 5 May 2021, prospective, United Kingdom, peer-reviewed, 5 authors, study period 16 March, 2020 - 26 July, 2020.
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Abstract: PLOS ONE RESEARCH ARTICLE The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study Rebecca A. G. Christensen ID*, Jasleen Arneja, Kate St. Cyr, Shelby L. Sturrock, Jennifer D. Brooks Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 * r.christensen@mail.utoronto.ca Abstract Background OPEN ACCESS Citation: Christensen RAG, Arneja J, St. Cyr K, Sturrock SL, Brooks JD (2021) The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study. PLoS ONE 16(5): e0250508. https://doi.org/10.1371/journal. pone.0250508 Editor: Robert Siegel, Cincinnati Children’s, UNITED STATES Received: September 29, 2020 Accepted: April 7, 2021 Published: May 5, 2021 Copyright: © 2021 Christensen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID19. Methods This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16th, 2020 to July 26th, 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20th percentile), moderate (20th to 80th percentile) and high (�80th percentile) within sex and ten-year age groups (e.g. 50–60 years). Participants were classified as having COVID-19 if they tested positive (primarily PCR tests) at an in-patient or outpatient setting as of July 26, 2020. Participants were classified as having died from COVID19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30th, 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. Data Availability Statement: Data cannot be shared publicly because this is third party data which also contains identifiable information. Data are available from the UK Biobank for researchers who meet the criteria for access to the data. Researchers interested in accessing the data can contact access@ukbiobank.ac.uk. There was no significant association between eCRF and testing positive for COVID-19. Conversely, individuals with moderate (aRR = 0.43, 95% CI: 0.25, 0.75) and high fitness (aRR = 0.37, 95% CI: 0.16, 0.85) had a significantly lower risk of dying from COVID-19 than those with low fitness. Funding: The authors received no specific funding for this work. Conclusions Competing interests: The authors have declared no competing interests exist. While eCRF was not significantly associated with testing positive for COVID-19, we observed a significant dose-response between having higher eCRF and a decreased risk of Findings PLOS ONE | https://doi.org/10.1371/journal.pone.0250508 May 5, 2021 1 / 10 PLOS ONE eCRF with COVID-19 incidence and mortality dying from COVID-19. This suggests that prior..
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