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

Abstract: J PREV MED HYG 2023; 64: E123-E136 OPEN ACCESS COVID-19 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 FARZIN HALABCHI1, BEHNAZ MAHDAVIANI2, BEHNAZ TAZESH2, SAKINEH SHAB-BIDAR3, MARYAM SELK-GHAFFARI2* 1 Department of Sports and Exercise Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; 2 Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; 3 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Keywords Exercise • COVID‑19 • SARS-CoV-2 • Systematic Review • Meta-analysis Summary Objective. The COVID‑19 pandemic has caused serious conse‑ quences for global health and economy. The important question is whether the level of physical activity might influence the risk of COVID‑19 incidence or clinical outcomes, including the severity or mortality of infected patients. The objective of this systematic review and meta-analysis is to evaluate the association between sufficient physical activity and incidence, hospitalization, sever‑ ity, recovery, and mortality of COVID‑19. Methods. A systematic search of Web of Sciences, PubMed, and Scopus between December 2019 and November 2021 was con‑ ducted. Studies were screened based on the inclusion criteria, i.e. observational studies (case-control, prospective or retrospective longitudinal designs, and cross-sectional studies) which have determined the association of physical activity, exercise, sports participation, or sedentary behavior with COVID‑19 incidence or outcomes, including mortality, severity, recovery and hospi‑ talization in healthy population or population with any specific comorbidity. Results. Based on eligibility criteria, 27 articles were finally included in the qualitative synthesis. The meta-analysis of five studies evaluating the association of physical activity and COVID‑19 mortality showed a weighted OR of OR of 0.61 (CI 95%: 0.50‑0.75) with heterogeneity (I2 = 45.8%, P < 0.001) and in seven studies regarding physical activity and COVID‑19 hospitalization, weighted OR was 0.541 (CI 95%: 0.491-0.595) with heterogeneity (I2 = 81.7%, P < 0.001). Conclusion. Participating in sufficient physical activity might decrease COVID‑19 related COVID‑19-related hospitalization and mortality. Developing programs to increase physical activity during the COVID‑19 pandemic might be an appropriate health strategy.