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0 0.5 1 1.5 2+ Mortality 63% Improvement Relative Risk Case 23% Exercise for COVID-19  Christensen et al.  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, May 2021 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
May 2021  
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Exercise for COVID-19
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*, now known with p < 0.00000000001 from 66 studies.
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4,100+ studies for 60+ treatments.
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.
This PaperExerciseAll
The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study
Rebecca A G Christensen, Jasleen Arneja, Kate St. Cyr, Shelby L Sturrock, Jennifer D Brooks
PLOS ONE, doi:10.1371/journal.pone.0250508
Background 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 COVID-19. Methods This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16 th , 2020 to July 26 th , 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20 th percentile), moderate (20 th to 80 th percentile) and high (�80 th 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 COVID-19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30 th , 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. Findings 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. Conclusions 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
Author Contributions Conceptualization: Rebecca A. G. Christensen. Formal analysis:
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