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0 0.5 1 1.5 2+ Mortality 29% Improvement Relative Risk Exercise for COVID-19  Hamrouni et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Prospective study of 153,833 patients in the United Kingdom Lower mortality with higher activity levels (p=0.0093) c19early.org Hamrouni et al., BMJ Open, November 2021 Favors exercise Favors inactivity

Associations of obesity, physical activity level, inflammation and cardiometabolic health with COVID-19 mortality: a prospective analysis of the UK Biobank cohort

Hamrouni et al., BMJ Open, doi:10.1136/bmjopen-2021-055003
Nov 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.
4,100+ studies for 60+ treatments. c19early.org
Prospective UK Biobank analysis, showing a history of low physical activity associated with COVID-19 mortality.
risk of death, 29.0% lower, RR 0.71, p = 0.009, high activity levels 138 of 106,006 (0.1%), low activity levels 109 of 47,827 (0.2%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, high vs. low physical activity, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Hamrouni et al., 3 Nov 2021, prospective, United Kingdom, peer-reviewed, 5 authors.
This PaperExerciseAll
Associations of obesity, physical activity level, inflammation and cardiometabolic health with COVID-19 mortality: a prospective analysis of the UK Biobank cohort
Malik Hamrouni, Matthew J Roberts, Alice Thackray, David J Stensel, Professor Nicolette Bishop
BMJ Open, doi:10.1136/bmjopen-2021-055003
Objectives To investigate the associations of physical activity level with COVID-19 mortality risk across body mass index (BMI) categories, and to determine whether any protective association of a higher physical activity level in individuals with obesity may be explained by favourable levels of cardiometabolic and inflammatory biomarkers. Design Prospective cohort study (baseline data collected between 2006 and 2010). Physical activity level was assessed using the International Physical Activity Questionnaire (high: ≥3000 Metabolic Equivalent of Task (MET)-min/week, moderate: ≥600 MET-min/ week, low: not meeting either criteria), and biochemical assays were conducted on blood samples to provide biomarker data. Setting UK Biobank. Main outcome measures Logistic regressions adjusted for potential confounders were performed to determine the associations of exposure variables with COVID-19 mortality risk. Mortality from COVID-19 was ascertained by death certificates through linkage with National Health Service (NHS) Digital. Results Within the 259 397 included participants, 397 COVID-19 deaths occurred between 16 March 2020 and 27 February 2021. Compared with highly active individuals with a normal BMI (reference group), the ORs (95% CIs) for COVID-19 mortality were 1.61 (0.98 to 2.64) for highly active individuals with obesity, 2.85 (1.78 to 4.57) for lowly active individuals with obesity and 1.94 (1.04 to 3.61) for lowly active individuals with a normal BMI. Of the included biomarkers, neutrophil count and monocyte count were significantly positively associated with COVID-19 mortality risk. In a subanalysis restricted to individuals with obesity, adjusting for these biomarkers attenuated the higher COVID-19 mortality risk in lowly versus highly active individuals with obesity by 10%. Conclusions This study provides novel evidence suggesting that a high physical activity level may attenuate the COVID-19 mortality risk associated with obesity. Although the protective association may be partly explained by lower neutrophil and monocyte counts, it still remains largely unexplained by the biomarkers included in this analysis.
Competing interests None declared. Patient consent for publication Not required. Ethics approval UK Biobank obtained ethical approval from the North West Multi-Centre Research Ethics Committee (REC reference: 11/NW/03820). All participants gave written informed consent before enrolment in the study. Direct dissemination of the results to participants is not applicable. This study was performed under UK Biobank application number 70184. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise. Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC..
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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