Exercise for COVID-19: real-time analysis of all 88 studies

Exercise for COVID-19

61 studies from 553 scientists

1,801,085 patients in 26 countries

Statistically significant lower risk for mortality, ventilation, ICU, hospitalization, progression, recovery, and cases.

47 studies from 47 teams in 23 countries show statistically significant improvements.

50% lower mortality in 18 studies CI 39-60%

Most studies analyze exercise before infection.

COVID-19 Exercise studies. Oct 2023. c19early.org

Most studies analyze exercise/physical activity levels before infection, comparing regular/moderate exercise and lower/no exercise. Risk may increase with more extreme activity levels. Recent:

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Oct 3	Covid Analysis	Exercise for COVID-19: real-time meta analysis of 61 studies
	Statistically significant lower risk is seen for mortality, ventilation, ICU admission, hospitalization, progression, recovery, and cases. 47 studies from 47 independent teams in 23 countries show statistically significant improvements...
Aug 14	Araujo et al., Jornal de Pediatria, doi:10.1016/j.jped.2023.07.006	Lifestyle and quality of life in children and adolescents during the covid-19 social distancing period
	Cross-sectional analysis of 2,574 families in Brazil, showing that pandemic social distancing caused negative changes in exercise, diet, and sleep for children.
Aug 1	Halabchi et al., Journal of Preventive Medicine and Hygiene, doi:10.15167/2421-4248/jpmh2023.64.2.2625	Association between physical activity and risk of COVID-19 infection or clinical outcomes of the patients with COVID-19; A systematic review and meta-analysis
	39% lower mortality (p<0.0001) and 46% lower hospitalization (p<0.0001). Systematic review and meta analysis showing significantly lower COVID-19 mortality and hospitalization with regular physical activity.
Jul 15	Graydon et al., Current Research in Immunology, doi:10.1016/j.crimmu.2023.100064	High baseline frequencies of natural killer cells are associated with asymptomatic SARS-CoV-2 infection
	Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection. Improved NK cell numbers and functioning has been shown for exercise [Oh], better sleep [Ir..
Jul 15	Šebić et al., Sports Science and Health, doi:10.7251/SSH2301078S	Influence of the Level of Physical Activity on Symptoms and Duration of Recovery From Covid-19
	89% lower need for oxygen therapy (p=0.05), 91% lower hospitalization (p=0.02), 84% lower progression (p<0.0001), and 47% improved recovery (p=0.0002). Retrospective 100 COVID-19 patients in Bosnia and Herzegovina, showing lower symptom severity and faster recovery with a history of regular physical activity.
Jun 21	Schmidt et al., Sports Medicine - Open, doi:10.1186/s40798-023-00592-6	Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey
	31% fewer cases (p=0.02). Retrospective 5,338 individuals with confirmed contact with a COVID-19 patient, showing lower risk of COVID-19 with exercise.
Jun 15	Frish et al., Journal of Clinical Medicine, doi:10.3390/jcm12124054	The Association of Weight Reduction and Other Variables after Bariatric Surgery with the Likelihood of SARS-CoV-2 Infection
	53% fewer cases (p=0.04). Retrospective 3,038 bariatric surgery patients in Israel, showing higher risk of SARS-CoV-2 infection with vitamin D deficiency, and lower risk with physical activity.
Jun 14	Sutkowska et al., Journal of Clinical Medicine, doi:10.3390/jcm12124046	Physical Activity Modifies the Severity of COVID-19 in Hospitalized Patients—Observational Study
	62% lower mortality (p=0.21) and 61% improved recovery (p=0.19). Prospective study of 131 hospitalized patients in Poland, showing lower mortality and improved recovery with a history of higher physical activity.
Jun 14	Rigolon et al., PLOS ONE, doi:10.1371/journal.pone.0286119	The neighborhood built environment and COVID-19 hospitalizations
	Analysis of neighborhood built environment characteristics in the USA with 18,042 COVID+ individuals, showing lower risk of hospitalization with higher walkability and higher bikeability scores.
Jun 13	Feter et al., Public Health, doi:10.1016/j.puhe.2023.05.011	Physical activity and long COVID: findings from the Prospective Study About Mental and Physical Health in Adults cohort
	26% lower PASC (p=0.02). Analysis of 237 COVID-19 patients in Brazil, showing lower risk of long COVID with physical activity.
Jun 7	Stavrinos et al., Journal of Pediatric Nursing, doi:10.1016/j.pedn.2023.06.003	COVID-19 effects on diet, sleep, and physical activity among mid- to late-adolescents residing in the deep south in the United States
	Prospective study tracking sleep, diet, and physical activity for adolescents in the USA before and during the COVID-19 pandemic, showing negative health effects of the pandemic / restrictions.
May 23	Nindenshuti et al., INQUIRY: The Journal of Health Care Organization, Provision, and Financing, doi:10.1177/00469580231175780	Changes in Diet, Physical Activity, Alcohol Consumption, and Tobacco Use in Adults During the COVID-19 Pandemic: A Systematic Review
	Systematic review showing 25 of 25 studies reported a decrease in physical activity and 13 of 13 studies reported an increase in sedentary behavior during the pandemic.
May 10	Longobardi et al., British Journal of Sports Medicine, doi:10.1136/bjsports-2022-106681	Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial
	RCT 50 post-severe/critical COVID-19 patients in Brazil, showing improved health-related quality of life with an exercise program (3 times a week, ~60–80 minutes/session, for 16 weeks).
May 9	Cardoso et al., Medicina Clínica, doi:10.1016/j.medcli.2023.04.031	Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case–control study
	73% lower severe cases (p<0.0001). Case control study with 307 severe COVID-19 ICU patients and 307 matched COVID-19 outpatients in Brazil, showing significantly higher risk of severe cases with low physical activity.
May 8	Wierenga et al., Heart & Lung, doi:10.1016/j.hrtlng.2023.05.002	Impact of risk for severe COVID-19 illness on physical activity during the pandemic
	Analysis of 640 adults in the USA, showing that adults at high risk of severe COVID-19 were disproportionately more likely to be physically inactive and had lower activity levels during the early months of the pandemic.
May 5	Massar et al., Frontiers in Psychology, doi:10.3389/fpsyg.2023.1145893	Working-from-home persistently influences sleep and physical activity 2 years after the Covid-19 pandemic onset: a longitudinal sleep tracker and electronic diary-based study
	Analysis of 225 adults in Singapore showing working from home associated with lower physical activity (as measured by step count) during August 2021 - January 2022.
Apr 25	Sanchez et al., Fisioterapia, doi:10.1016/j.ft.2023.04.003	Influence of Physical Exercise on the Severity of COVID-19
	54% fewer symptomatic cases (p<0.0001). Retrospective 29,875 university staff and students in Spain, 3,662 with data, showing lower risk of COVID-19 symptoms for people that exercise. Exercise more than 5 days/week was the most protective, and intense exercise was more effectiv..
Apr 12	Jääskeläinen et al., Scandinavian Journal of Public Health, doi:10.1177/14034948231163960	Poor health status before the COVID-19 pandemic is associated with unfavourable changes in health-related lifestyle
	Analysis of 3,834 adults in Finland, showing that people with poor health status were more likely to have unfavorable lifestyle changes during the pandemic, including decreased vegetable consumption, decreased leisure-time physical activi..
Mar 27	Galluzzo et al., Journal of Clinical Medicine, doi:10.3390/jcm12072517	Inadequate Physical Activity Is Associated with Worse Physical Function in a Sample of COVID-19 Survivors with Post-Acute Symptoms
	Retrospective 1,846 post-acute COVID-19 patients in Italy, showing inadequate physical activity after recovering from COVID-19 associated with lower physical function.
Mar 23	ÓhAiseadha et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph20075223	Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities
	Review of studies on non-pharmaceutical interventions for COVID-19 showing negative impacts on mental health, physical activity, and obesity.
Mar 8	Zhang et al., Frontiers in Physiology, doi:10.3389/fphys.2023.1089637	The causal effect of physical activity intensity on COVID-19 susceptibility, hospitalization, and severity: Evidence from a mendelian randomization study
	Mendelian randomization study showing lower risk of COVID-19 severity, hospitalization, and cases with light physical activity, but no significant difference for moderate-to-vigorous physical activity. Authors note that they were unable t..
Feb 14	Park et al., Frontiers in Public Health, doi:10.3389/fpubh.2023.1072198	Pre-pandemic physical activity as a predictor of infection and mortality associated with COVID-19: Evidence from the National Health Insurance Service
	26% lower mortality (p=0.08) and 7% fewer cases (p=0.02). Retrospective 4,363 COVID-19 patients and 67,125 controls in South Korea, showing higher risk of mortality and cases with insufficient physical activity.
Feb 11	Liu et al., Preventive Medicine Reports, doi:10.1016/j.pmedr.2023.102130	Baseline physical activity and the risk of severe illness and mortality from COVID-19: A dose–response meta-analysis
	Meta analysis of 14 studies showing a negative dose-response relationship between the level of physical activity and COVID-19 severity and mortality.
Feb 6	Wang et al., JAMA Internal Medicine, doi:10.1001/jamainternmed.2022.6555	Adherence to Healthy Lifestyle Prior to Infection and Risk of Post–COVID-19 Condition
	11% lower PASC (p=0.2). Prospective analysis of 32,249 women, showing lower risk of PASC with a healthy lifestyle, in a dose-dependent manner. Participants with 5 or 6 healthy lifestyle factors had significantly lower COVID-19 hospitalization and PASC. BMI and s..
Feb 2	Fernandez et al., Journal of Applied Physiology, doi:10.1152/japplphysiol.00544.2022	Intrahospital supervised exercise training improves survival rate among hypertensive COVID-19 patients
	47% lower mortality (p=0.02). Retrospective 439 severe COVID-19 hospitalized patients with hypertension, 201 receiving a supervised exercise program, showing significantly lower mortality with exercise. Exercise included of aerobic, breathing, and musculoskeletal exer..
Dec 28 2022	Kucharska et al., Annals of Agricultural and Environmental Medicine, doi:10.26444/aaem/156939	Diet and selected elements of lifestyle in the Polish population before and during the COVID-19 pandemic – a population study
	Retrospective 964 people in Poland showing decreased physical activity during the COVID-19 pandemic.
Dec 14 2022	Young et al., American Journal of Preventive Medicine, doi:10.1016/j.amepre.2022.10.007	Associations of Physical Inactivity and COVID-19 Outcomes Among Subgroups
	74% lower mortality (p<0.0001) and 48% lower hospitalization (p<0.0001). Retrospective 194,191 COVID-19 patients in the USA, showing lower risk of hospitalization and mortality with physical activity, with a dose response relationship.
Dec 12 2022	Kapusta et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.12.008	Do selected lifestyle parameters affect the severity and symptoms of COVID-19 among elderly patients? The retrospective evaluation of individuals from the STOP-COVID registry of the PoLoCOV study
	71% lower severe cases (p=0.001). Retrospective 568 convalescent COVID-19 patients in Poland, showing lower risk of severe cases with regular physical activity in the 3 months before COVID-19.
Nov 24 2022	Khandker et al., Frontiers in Rehabilitation Sciences, doi:10.3389/fresc.2022.1037649	Post-COVID-19 complications in home and hospital-based care: A study from Dhaka city, Bangladesh
	Retrospective 925 COVID-19 patients in Bangladesh reporting that "physical activity and exposure to sunlight was positively associated with earlier recovery from COVID-19 both in home and hospital care". Details are not provided.
Nov 8 2022	Sittichai et al., Frontiers in Physiology, doi:10.3389/fphys.2022.1030568	Effects of physical activity on the severity of illness and mortality in COVID-19 patients: A systematic review and meta-analysis
	Systematic review and meta analysis of 18 studies, showing significantly lower COVID-19 severity and mortality with physical activity.
Nov 7 2022	Green et al., European Journal of General Practice, doi:10.1080/13814788.2022.2138855	A higher frequency of physical activity is associated with reduced rates of SARS-CoV-2 infection
	42% fewer cases (p<0.0001). Retrospective 113,075 people in Israel, showing lower risk of COVID-19 cases with physical activity and a dose dependent response.
Oct 31 2022	Tison et al., The Lancet Global Health, doi:10.1016/S2214-109X(22)00361-8	Worldwide physical activity trends since COVID-19 onset
	Analysis of 1.2 million global users showing a significant decline in physical activity during the COVID-19 pandemic, which remained below the pre-pandemic baseline as of February 2022.
Oct 29 2022	Pitanga et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph192114155	Leisure Time Physical Activity and SARS-CoV-2 Infection among ELSA-Brasil Participants
	33% fewer cases (p=0.05). Retrospective 4,476 participants in Brazil, showing lower risk of COVID-19 cases with a history of physical activity, statistically significant only for those following specific practices to protect against COVID-19.
Oct 24 2022	Pływaczewska-Jakubowska et al., Frontiers in Medicine, doi:10.3389/fmed.2022.1036556	Lifestyle, course of COVID-19, and risk of Long-COVID in non-hospitalized patients
	11% fewer moderate/severe cases (p=0.3) and 14% lower PASC (p=0.24). Retrospective 1,847 COVID+ patients in Poland, showing no significant difference in moderate/severe cases with physical activity. Hospitalized patients were excluded.
Oct 24 2022	Reis et al., American Journal of Lifestyle Medicine, doi:10.1177/15598276221135541	The Association between Lifestyle Risk Factors and COVID-19 Hospitalization in a Healthcare Institution
	41% lower hospitalization (p=0.18). Retrospective 546 COVID+ patients in the USA, showing lower risk of hospitalization with higher frequency of strength training, without statistical significance.
Aug 22 2022	Ezzatvar et al., British Journal of Sports Medicine, doi:10.1136/bjsports-2022-105733	Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose–response meta-analysis of data from 1 853 610 adults
	43% lower mortality (p<0.0001), 34% lower severe cases (p<0.0001), 36% lower hospitalization (p<0.0001), and 11% fewer cases (p=0.0002). Systematic review and meta-analysis of 16 studies, showing lower risk of cases, hospitalization, severe cases, and mortality with regular physical activity. A non-linear dose-response relationship was seen with benefits reducing above 500..
Jul 5 2022	Tsuzuki et al., medRxiv, doi:10.1101/2022.07.01.22277144	Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults
	56% lower severe cases (p<0.0001). Retrospective 4,868 elderly COVID-19 patients in Japan, showing higher risk of severe cases with poor physical activity status.
Jun 23 2022	Li et al., medRxiv, doi:10.1101/2022.06.22.22276789	Association of physical activity and the risk of COVID-19 hospitalization: a dose-response meta-analysis
	40% lower hospitalization (p<0.0001). Meta analysis of 17 studies, showing a dose-response relationship with higher levels of physical activity reducing risk of COVID-19 hospitalization.
Jun 11 2022	Antunes et al., Sport Sciences for Health, doi:10.1007/s11332-022-00948-7	The influence of physical activity level on the length of stay in hospital in older men survivors of COVID-19
	80% lower ICU admission (p=0.06), 40% improvement (p=0.48), and 43% shorter hospitalization (p=0.03). Retrospective 39 hospitalized COVID-19 survivors >60 years old, showing shorter hospitalization for patients with active lifestyles before COVID-19 symptoms.
May 13 2022	Chen et al., Journal of Translational Medicine, doi:10.1186/s12967-022-03407-6	Causal relationship between physical activity, leisure sedentary behaviors and COVID-19 risk: a Mendelian randomization study
	UK Biobank Mendelian randomization study showing decreased risk of COVID-19 hospitalization with genetically predicted accelerometer-assessed physical activity, and increased risk with television watching.
Apr 29 2022	Malisoux et al., BMJ Open, doi:10.1136/bmjopen-2021-057863	Associations between physical activity prior to infection and COVID-19 disease severity and symptoms: results from the prospective Predi-COVID cohort study
	63% lower progression (p=0.05). Retrospective 452 participants in Luxembourg, showing lower risk of moderate cases with higher physical activity.
Apr 17 2022	Kontopoulou et al., Journal of Personalized Medicine, doi:10.3390/jpm12040645	Exercise Preferences and Benefits in Patients Hospitalized with COVID-19
	66% faster recovery (p<0.0001). Retrospective 66 hospitalized COVID-19 patients in Greece, showing significantly improved recovery with a history of exercise in unadjusted results. Exercise after hospitalization was also associated with lower levels of dyspnea one month..
Apr 13 2022	Paul et al., medRxiv, doi:10.1101/2022.04.12.22273792	Health behaviours the month prior to COVID-19 infection and the development of self-reported long COVID and specific long COVID symptoms: A longitudinal analysis of 1,811 UK adults
	38% lower PASC (p=0.16). Retrospective 1,811 COVID-19 patients in the UK, showing lower risk of self-reported long COVID with 3+ hours of exercise per week in the month before infection, without statistical significance (p=0.16).
Apr 13 2022	Rahmati et al., Reviews in Medical Virology, doi:10.1002/rmv.2349	Baseline physical activity is associated with reduced mortality and disease outcomes in COVID-19: A systematic review and meta-analysis
	53% lower mortality (p=0.001), 35% lower ICU admission (p=0.001), and 42% lower hospitalization (p=0.001). Meta analysis of 12 physical activity and COVID-19 studies, showing lower mortality, ICU admission, and hospitalization with physical activity.
Mar 15 2022	Carta et al., Clinical Practice & Epidemiology in Mental Health, doi:10.2174/17450179-v18-e2112231	Exercise in Older Adults to Prevent Depressive Symptoms at the Time of Covid-19: Results of a Randomized Controlled Trial with Follow-Up
	82% improvement (p=0.009). Exercise RCT with followup during COVID-19 lockdowns, showing lower risk of depression during lockdowns for the exercise group.
Mar 14 2022	Salgado-Aranda et al., Infectious Diseases and Therapy, doi:10.1007/s40121-021-00418-6	Influence of Baseline Physical Activity as a Modifying Factor on COVID-19 Mortality: A Single-Center, Retrospective Study
	83% lower mortality (p=0.003). Retrospective 520 COVID-19 patients in Spain, showing significantly lower mortality with a history of physical activity.
Mar 12 2022	Beydoun et al., American Journal of Infection Control, doi:10.1016/j.ajic.2022.02.021	Socio-demographic, lifestyle and health characteristics as predictors of self-reported Covid-19 history among older adults: 2006-2020 Health and Retirement Study
	43% fewer cases (p=0.05). Retrospective 2,830 people in the USA, showing lower risk of COVID-19 with a history of moderate/vigorous exercise.
Feb 17 2022	Almansour et al., Journal of Multidisciplinary Healthcare, doi:10.2147/JMDH.S352753	The Influence of Physical Activity on COVID-19 Prevention Among Quarantined Individuals: A Case–Control Study
	6% fewer cases (p=0.85). Retrospective 142 patients in Saudi Arabia, showing no significant difference in cases with physical activity.
Feb 10 2022	Gilley et al., JMIR Mental Health, doi:10.2196/34645	Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: Observational Study Using the Roadmap App and Fitbit Wearable Sensors
	42% more cases (p=0.55). Retrospective survey of 1,997 college students in the USA, showing no significant difference in COVID-19 cases with exercise in unadjusted results.
Feb 9 2022	Steenkamp et al., British Journal of Sports Medicine, doi:10.1136/bjsports-2021-105159	Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes
	42% lower mortality (p<0.0001), 45% lower ventilation (p<0.0001), 41% lower ICU admission (p<0.0001), and 34% lower hospitalization (p<0.0001). Retrospective 65,361 COVID-19 patients in South Africa, showing significantly lower hospitalization, ICU admission, ventilation, and mortality with exercise.
Dec 31 2021	Rowlands et al., Mayo Clinic Proceedings: Innovations, Quality & Outcomes, doi:10.1016/j.mayocpiqo.2021.08.011	Association Between Accelerometer-Assessed Physical Activity and Severity of COVID-19 in UK Biobank
	UK Biobank retrospective showing lower risk of severe COVID-19 with higher moderate to vigorous physical activity. Results are only provided for physical activity as a continuous variable.
Dec 23 2021	Hamdan et al., Journal of International Medical Research, doi:10.1177/03000605211064405	Risk factors associated with hospitalization owing to COVID-19: a cross-sectional study in Palestine
	16% lower hospitalization (p=0.53). Retrospective 300 participants in Palestine, showing lower risk of hospitalization with physical activity, without statistical significance.
Nov 30 2021	Huang et al., Nature and Science of Sleep, doi:10.2147/NSS.S263488	Reduced Sleep in the Week Prior to Diagnosis of COVID-19 is Associated with the Severity of COVID-19
	47% lower severe cases (p=0.18) and 66% fewer cases (p=0.004). Retrospective 164 COVID-19 patients and 188 controls in China, showing lower risk of cases with regular exercise.
Nov 3 2021	Hamrouni et al., BMJ Open, doi:10.1136/bmjopen-2021-055003	Associations of obesity, physical activity level, inflammation and cardiometabolic health with COVID-19 mortality: a prospective analysis of the UK Biobank cohort
	29% lower mortality (p=0.009). Prospective UK Biobank analysis, showing a history of low physical activity associated with COVID-19 mortality.
Oct 30 2021	Saadeh et al., Aging Clinical and Experimental Research, doi:10.1007/s40520-021-02006-7	Associations of pre-pandemic levels of physical function and physical activity with COVID-19-like symptoms during the outbreak
	9% fewer symptomatic cases (p=0.71). Retrospective 904 patients in Sweden, showing higher risk of COVID-19-like symptoms with poor muscle strength. Risk was slightly higher for physical inactivity, without statistical significance.
Oct 23 2021	Lengelé et al., Aging Clinical and Experimental Research, doi:10.1007/s40520-021-01991-z	Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults
	74% fewer cases (p=0.03). Analysis of 241 adults >65yo in Belgium, showing lower risk of COVID-19 with a history of physical activity.
Oct 19 2021	Ekblom-Bak et al., International Journal of Behavioral Nutrition and Physical Activity, doi:10.1186/s12966-021-01198-5	Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study
	48% lower severe cases (p=0.02). Retrospective 857 severe COVID-19 cases and matched controls in Sweden, showing lower risk of severe COVID-19 with higher cardiorespiratory fitness.
Sep 30 2021	Cunningham, G., Journal of Sport and Health Science, doi:10.1016/j.jshs.2021.03.008	Physical activity and its relationship with COVID-19 cases and deaths: Analysis of U.S. counties
	Analysis of US counties showing physical activity levels negatively associated with COVID-19 cases and deaths.
Sep 30 2021	Mohsin et al., Infection and Drug Resistance, doi:10.2147/IDR.S331470	Lifestyle and Comorbidity-Related Risk Factors of Severe and Critical COVID-19 Infection: A Comparative Study Among Survived COVID-19 Patients in Bangladesh
	19% lower severe cases (p=0.04). Retrospective 1,500 COVID+ patients in Bangladesh, showing lower risk of severe cases with regular exercise in unadjusted results.
Sep 30 2021	de Souza et al., Journal of Science and Medicine in Sport, doi:10.1016/j.jsams.2021.05.011	Association of physical activity levels and the prevalence of COVID-19-associated hospitalization
	73% lower ventilation (p=0.07) and 34% lower hospitalization (p=0.05). Retrospective survey of 938 COVID-19 recovered patients in Brazil, showing lower hospitalization with physical activity. NCT04396353.
Sep 22 2021	Ehsani et al., Middle East Journal of Rehabilitation and Health Studies, doi:10.5812/mejrh.114607	Evaluation of the Relationship Between Daily Physical Activity Level and Laboratory Factors and the Length of Hospitalization in Patients with COVID-19
	61% faster recovery (p=0.0001). Retrospective 71 hospitalized COVID-19 patients in Iran, showing faster recovery with a history of moderate to high physical exercise. Exercise was assessed during the last seven days when patients may already have had COVID-19 symptoms. ..
Sep 21 2021	Lin et al., BMJ Open, doi:10.1136/bmjopen-2021-052025	Predictors of incident SARS-CoV-2 infections in an international prospective cohort study
	47% fewer cases (p=0.4). Prospective survey analysis of 28,575 people in 99 countries, showing a lower risk of COVID-19 with a exercise, without statistical significance.
Sep 18 2021	Nguyen et al., Nutrients, doi:10.3390/nu13093258	Single and Combinative Impacts of Healthy Eating Behavior and Physical Activity on COVID-19-like Symptoms among Outpatients: A Multi-Hospital and Health Center Survey
	20% fewer symptomatic cases (p<0.0001). Analysis of 3,947 participants in Vietnam, showing significantly lower risk of COVID-19-like symptoms with physical activity and with a healthy diet. The combination of being physically active and eating healthy reduced risk further compa..
Aug 31 2021	Ahmadi et al., Brain, Behavior, and Immunity, doi:10.1016/j.bbi.2021.04.022	Lifestyle risk factors and infectious disease mortality, including COVID-19, among middle aged and older adults: Evidence from a community-based cohort study in the United Kingdom
	30% lower mortality (p=0.005). Retrospective 468,569 adults in the UK, showing no significant difference in COVID-19 mortality based on diet quality, however significantly lower mortality was seen with higher diet quality for pneumonia and infectious diseases.
Aug 23 2021	Baynouna AlKetbi et al., Journal of Epidemiology and Global Health, doi:10.1007/s44197-021-00006-4	Risk Factors for SARS-CoV-2 Infection Severity in Abu Dhabi
	98% lower mortality (p=0.05). Retrospective 234 COVID-19 cases in the United Arab Emirates, showing lower risk of mortality with increased physical activity.
Aug 12 2021	Pinto et al., Journal of Sport and Health Science, doi:10.1016/j.jshs.2021.08.001	No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19
	30% lower mortality (p=0.27), 20% lower ventilation (p=0.21), and 10% lower ICU admission (p=0.46). Prospective analysis of 209 hospitalized COVID-19 patients, showing no significant difference in COVID-19 outcomes with physical activity. Mortality, ventilation, and ICU results are only provided for activity as a continuous variable.
Aug 11 2021	Maltagliati et al., Journal of Sports Sciences, doi:10.1080/02640414.2021.1964721	Muscle strength explains the protective effect of physical activity against COVID-19 hospitalization among adults aged 50 years and older
	52% lower hospitalization (p=0.02). Retrospective 3,139 adults >50 in Europe, with 66 COVID-19 hospitalizations, showing lower risk of hospitalization with higher physical activity and with higher muscle strength. Note that model 2 includes muscle strength which is correlat..
Aug 6 2021	Cheval et al., Journal of Cachexia, Sarcopenia and Muscle, doi:10.1002/jcsm.12738	Muscle strength is associated with COVID‐19 hospitalization in adults 50 years of age or older
	36% lower hospitalization (p=0.02). Retrospective 3,600 adults showing that higher grip strength was associated with a lower risk of COVID-19 hospitalization.
Jul 22 2021	Lee et al., British Journal of Sports Medicine, doi:10.1136/bjsports-2021-104203	Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study
	74% lower mortality (p=0.05), 58% lower severe cases (p=0.03), and 16% fewer cases (p=0.03). Retrospective 212,768 adults in South Korea, showing lower risk of COVID-19 cases, severity, and mortality with physical activity. Notably, results for aerobic and muscle strengthening activities combined were much better than results for..
Jul 9 2021	Rabail et al., Food Science & Nutrition, doi:10.1002/fsn3.2458	Nutritional and lifestyle changes required for minimizing the recovery period in home quarantined COVID-19 patients of Punjab, Pakistan
	Survey of 80 recovered COVID-19 patients in Pakistan, showing faster recovery with higher physical activity before infection.
Jul 5 2021	af Geijerstam et al., BMJ Open, doi:10.1136/bmjopen-2021-051316	Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts
	50% lower mortality (p=0.005), 40% lower ICU admission (p=0.0003), and 27% lower hospitalization (p<0.0001). Prospective study of 1,559,187 men in Sweden with cardiorespiratory fitness levels measured on military conscription, showing high cardiorespiratory fitness associated with lower risk of COVID-19 hospitalization, ICU admission, and death.
Jul 5 2021	Buckley et al., European Journal of Preventive Cardiology, doi:10.1093/eurjpc/zwaa135	Exercise rehabilitation associates with lower mortality and hospitalisation in cardiovascular disease patients with COVID-19
	76% lower mortality (p<0.0001) and 51% lower hospitalization (p<0.0001). PSM retrospective 643 COVID-19 patients with cardiovascular disease undergoing exercise rehabilitation within 3 months of diagnosis, showing significantly lower re-hospitalization and mortality with exercise rehabilitation.
Jul 4 2021	Bielik et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18137158	A Possible Preventive Role of Physically Active Lifestyle during the SARS-CoV-2 Pandemic; Might Regular Cold-Water Swimming and Exercise Reduce the Symptom Severity of COVID-19?
	30% fewer moderate/severe cases (p=0.1) and 9% more cases (p=0.36). Retrospective 1,544 participants in Slovakia, showing a lower risk of more severe COVID-19 for physically active participants, without statistical significance.
Jul 1 2021	Brandenburg et al., Journal of Physical Activity and Health, doi:10.1123/jpah.2020-0817	Does Higher Self-Reported Cardiorespiratory Fitness Reduce the Odds of Hospitalization From COVID-19?
	6% higher hospitalization (p=0.6) and 35% lower severe cases (p=0.3). Retrospective 263 COVID+ patients, showing lower hospitalization with higher self-reported cardiorespiratory fitness, but no significant differences for physical activity. Participants in the study were healthier and more fit than the gen..
Jun 23 2021	Oh et al., Frontiers in Immunology, doi:10.3389/fimmu.2021.594356	Vitamin D and Exercise Are Major Determinants of Natural Killer Cell Activity, Which Is Age- and Gender-Specific
	Analysis of 2,095 patients in South Korea, showing exercise and vitamin D associated with improved natural killer cell activity. showed that a lower frequency of natural killer cells was associated with symptomatic COVID-19 infection.
Jun 20 2021	Yuan et al., Therapeutic Advances in Respiratory Disease, doi:10.1177/17534666211025221	Does pre-existent physical inactivity have a role in the severity of COVID-19?
	91% lower mortality (p=0.09) and 70% lower severe cases (p=0.03). Retrospective 164 COVID-19 patients in China, showing physical inactivity associated with an increased risk of severe COVID-19.
Jun 17 2021	Marcus et al., PLOS ONE, doi:10.1371/journal.pone.0253120	Predictors of incident viral symptoms ascertained in the era of COVID-19
	42% fewer symptomatic cases (p<0.0001). Prospective survey based study with 14,335 participants, showing lower risk of viral symptoms with regular exercise.
Jun 15 2021	Latorre-Román et al., Research in Sports Medicine, doi:10.1080/15438627.2021.1937166	Protective role of physical activity patterns prior to COVID-19 confinement with the severity/duration of respiratory pathologies consistent with COVID-19 symptoms in Spanish populations
	76% lower hospitalization (p=0.05). Retrospective 420 people in Spain, showing lower risk of COVID-19 hospitalization with a history of physical activity.
May 19 2021	Lobelo et al., BMJ Open, doi:10.1136/bmjopen-2020-044052	Clinical, behavioural and social factors associated with racial disparities in COVID-19 patients from an integrated healthcare system in Georgia: a retrospective cohort study
	20% lower hospitalization (p=0.02). Retrospective 5,712 COVID-19 patients in the USA, showing higher risk of COVID-19 hospitalization with a history of physical inactivity.
May 5 2021	Christensen et al., PLOS ONE, doi:10.1371/journal.pone.0250508	The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study
	63% lower mortality (p=0.02) and 23% fewer cases (p=0.2). Prospective study of 2,690 adults in the UK Biobank showing lower cardiorespiritory fitness associated with COVID-19 mortality.
Apr 13 2021	Sallis et al., British Journal of Sports Medicine, doi:10.1136/bjsports-2021-104080	Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients
	59% lower mortality (p=0.005), 42% lower ICU admission (p=0.006), and 53% lower hospitalization (p<0.0001). Retrospective 48,440 COVID-19 patients in the USA, showing significantly lower mortality, ICU admission, and hospitalization with exercise.
Apr 6 2021	Cho et al., Journal of Clinical Medicine, doi:10.3390/jcm10071539	Physical Activity and the Risk of COVID-19 Infection and Mortality: A Nationwide Population-Based Case-Control Study
	53% lower mortality (p=0.01) and 10% fewer cases (p<0.0001). 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.
Mar 30 2021	Holt et al., Thorax, doi:10.1136/thoraxjnl-2021-217487	Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
	17% fewer cases (p=0.18). Prospective survey-based study with 15,227 people in the UK, showing reduced risk of COVID-19 cases with lower impact physical activity. NCT04330599. COVIDENCE UK.
Feb 26 2021	Yates et al., International Journal of Obesity, doi:10.1038/s41366-021-00771-z	Obesity, walking pace and risk of severe COVID-19 and mortality: analysis of UK Biobank
	45% lower mortality (p=0.001) and 47% lower severe cases (p<0.0001). UK Biobank retrospective 412,596 people, showing severe COVID-19 and COVID-19 mortality inversely associated with self-reported walking pace.
Feb 4 2021	Tavakol et al., Journal of Public Health, doi:10.1007/s10389-020-01468-9	Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study
	69% lower severe cases (p=0.05). Retrospective 206 patients in Iran, showing COVID-19 disease severity associated with lower physical activity.
Feb 3 2021	Li et al., BMC Medical Genomics, doi:10.1186/s12920-021-00887-1	Modifiable lifestyle factors and severe COVID-19 risk: a Mendelian randomisation study
	81% lower severe cases (p=0.02) and 56% lower hospitalization (p=0.07). Mendelian randomization study showing lower risk of severe COVID-19 with physical activity.
Dec 6 2020	Zhang et al., J. Glob. Health, doi:10.7189/jogh-10-020514	Physical activity and COVID-19: an observational and Mendelian randomisation study
	26% lower mortality (p=0.17) and 18% fewer cases (p=0.01). UK Biobank retrospective showing significantly lower COVID-19 cases with objectively measured physical activity.
Dec 1 2020	Halabchi et al., Journal of Physical Activity and Health, doi:10.1123/jpah.2020-0392	Regular Sports Participation as a Potential Predictor of Better Clinical Outcome in Adult Patients With COVID-19: A Large Cross-Sectional Study
	89% lower mortality (p=0.08) and 28% lower hospitalization (p=0.04). Retrospective 4,694 COVID-19 patients in Iran, showing lower risk of hospitalization and mortality with regular sports participation.
Nov 19 2020	Ho et al., BMJ Open, doi:10.1136/bmjopen-2020-040402	Modifiable and non-modifiable risk factors for COVID-19, and comparison to risk factors for influenza and pneumonia: results from a UK Biobank prospective cohort study
	35% lower hospitalization (p=0.007). UK Biobank retrospective 235,928 participants using walking pace as a proxy for physical fitness, showing lower risk of COVID-19 hospitalization with an average vs. slow walking pace.
Nov 5 2020	Gao et al., PLOS ONE, doi:10.1371/journal.pone.0241540	The impact of individual lifestyle and status on the acquisition of COVID-19: A case—Control study
	105% more cases (p=0.0003). Case control study in China with 105 cases and 210 matched controls, showing COVID-19 cases associated with physical activity ≥5 times per week. Authors note that people may choose gyms for exercise in winter, leading to higher exposure r..
Oct 31 2020	Mohamed et al., Journal of Bodywork and Movement Therapies, doi:10.1016/j.jbmt.2021.07.012	The effect of aerobic exercise on immune biomarkers and symptoms severity and progression in patients with COVID-19: A randomized control trial
	Small RCT with 30 mild/moderate COVID-19 patients, 15 performing 2 weeks of moderate-intensity aerobic exercise, showing decreased severity (WURSS) and improved immune markers with exercise.
Oct 26 2020	Tret'yakov et al., Pulmonologiya, doi:10.18093/0869-0189-2020-30-5-553-560	COVID-19 in individuals adapted to aerobic exercise
	98% lower severe cases (p=0.007). Retrospective 293 COVID+ patients in Russia, showing lower risk of severe COVID-19 for individuals who regularly practice aerobic training in unadjusted results.
Oct 21 2020	Cloosterman et al., Journal of Science and Medicine in Sport, doi:10.1016/j.jsams.2020.10.009	Running behavior and symptoms of respiratory tract infection during the COVID-19 pandemic
	Analysis of 2,586 participants of a running injury prevention RCT in the Netherlands, showing lower risk of COVID-19 symptoms with interval training and increased training hours, without statistical significance.
Oct 10 2020	Brawner et al., Mayo Clinic Proceedings, doi:10.1016/j.mayocp.2020.10.003	Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019
	74% lower hospitalization (p=0.001). Retrospective 246 COVID-19 patients in the USA, showing the risk of hospitalization inversely associated with maximal exercise capacity. Adjusted results are only provided for MET as a continuous variable.
Jul 31 2020	Hamer et al., Brain, Behavior, and Immunity, doi:10.1016/j.bbi.2020.05.059	Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK
	28% lower hospitalization (p=0.0004). UK Biobank retrospective analysis of 387,109 people, showing lower risk of COVID-19 hospitalization with physical activity.
Oct 31 2018	Guthold et al., The Lancet Global Health, doi:10.1016/S2214-109X(18)30357-7	Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants
	Meta analysis of 358 surveys showing the prevalence of insufficient physical activity around the world. Prevalence in high-income countries was over twice as high, and has increased over time.

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