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0 0.5 1 1.5 2+ Ventilation 73% unadjusted Improvement Relative Risk Hospitalization 34% Exercise for COVID-19  de Souza et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 938 patients in Brazil (June - August 2020) Lower hospitalization with higher activity levels (p=0.046) de Souza et al., J. Science and Medici.., Sep 2021 Favors exercise Favors inactivity

Association of physical activity levels and the prevalence of COVID-19-associated hospitalization

de Souza et al., Journal of Science and Medicine in Sport, doi:10.1016/j.jsams.2021.05.011, NCT04396353
Sep 2021  
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Exercise for COVID-19
9th treatment shown to reduce risk in October 2020
*, now known with p < 0.00000000001 from 66 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective survey of 938 COVID-19 recovered patients in Brazil, showing lower hospitalization with physical activity. NCT04396353 (history).
risk of mechanical ventilation, 73.2% lower, RR 0.27, p = 0.07, high activity levels 3 of 611 (0.5%), low activity levels 6 of 327 (1.8%), NNT 74, unadjusted, excluded in exclusion analyses: unadjusted results with no group details.
risk of hospitalization, 34.3% lower, RR 0.66, p = 0.046, high activity levels 49 of 611 (8.0%), low activity levels 42 of 327 (12.8%), NNT 21, adjusted per study, sufficient vs. insufficient, model 3, multivariable.
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de Souza et al., 30 Sep 2021, retrospective, Brazil, peer-reviewed, 8 authors, study period June 2020 - August 2020, trial NCT04396353 (history).
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Association of physical activity levels and the prevalence of COVID-19-associated hospitalization
Francis Ribeiro De Souza, Daisy Motta-Santos, Douglas Dos Santos Soares, Juliana Beust De Lima, Gustavo Gonçalves Cardozo, Luciano Santos Pinto Guimarães, Carlos Eduardo Negrão, Marcelo Rodrigues Dos Santos
Journal of Science and Medicine in Sport, doi:10.1016/j.jsams.2021.05.011
Objectives: We compared physical activity levels before the outbreak and quarantine measures with COVID-19associated hospitalization prevalence in surviving patients infected with SARS-CoV-2. Additionally, we investigated the association of physical activity levels with symptoms of the disease, length of hospital stay, and mechanical ventilation. Design: Observational, cross-sectional. Methods: Between June 2020 and August 2020, we invited Brazilian survivors and fully recovered patients infected with SARS-CoV-2 to respond to an online questionnaire. We shared the electronic link to the questionnaire on the internet. We collected data about clinical outcomes (symptoms, medications, hospitalization, and length of hospital stay) and cofactors, such as age, sex, ethnicity, preexisting diseases, socioeconomic and educational, and physical activity levels using the International Physical Activity Questionnaire (IPAQ short version). Results: Out of 938 patients, 91 (9.7%) were hospitalized due to COVID-19. In a univariate analysis, sex, age, and BMI were all associated with hospitalizations due to COVID-19. Men had a higher prevalence of hospitalization (66.6%, p = 0.013). Patients older than 65 years, obese, and with preexisting disease had a higher prevalence of COVID-19-related hospitalizations. In a multivariate regression model, performance of at least 150 min/wk (moderate) and/or 75 min/wk (vigorous) physical activity was associated with a lower prevalence of hospitalizations after adjustment for age, sex, BMI, and preexisting diseases (PR = 0.657; p = 0.046). Conclusions: Sufficient physical activity levels were associated with a lower prevalence of COVID-19-related hospitalizations. Performing at least 150 min a week of moderate-intensity, or 75 min a week of vigorous-intensity physical activity was associated with 34.3% reduction in prevalence.
Declaration of interest statement The authors declare that there is no conflict of interest. Confirmation of ethical compliance This study was approved by the local Human Subject Protection Committee at the Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (CAPPesq 5044-20-073), and all participants provided an online written informed consent. This study is registered on (NCT04396353), and its protocol has been published previously ( Data sharing All data are shared publicly through the tool Open Science Framework (
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