High fitness levels, frequent sauna bathing and risk of pneumonia in a cohort study: Are there potential implications for COVID‐19?

{ 'indexed': {'date-parts': [[2023, 12, 7]], 'date-time': '2023-12-07T15:30:27Z', 'timestamp': 1701963027720}, 'reference-count': 41, 'publisher': 'Wiley', 'issue': '3', 'license': [ { 'start': { 'date-parts': [[2021, 1, 22]], 'date-time': '2021-01-22T00:00:00Z', 'timestamp': 1611273600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'DOI': '10.13039/501100000272', 'name': 'National Institute for Health Research', 'doi-asserted-by': 'publisher', 'award': ['BRC‐1215‐20011']}, { 'DOI': '10.13039/501100005633', 'name': 'Sydäntutkimussäätiö', 'doi-asserted-by': 'publisher'}], 'content-domain': {'domain': ['onlinelibrary.wiley.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2021, 3]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>There ' 'is an ongoing debate on a potential protective role of habitual physical activity and passive ' 'heat therapy on the risk of COVID‐19, a respiratory infectious disease that can manifest as ' 'severe pneumonia. To explore these putative roles, we evaluated the independent and joint ' 'associations of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) with ' 'pneumonia risk in a prospective cohort study of 2275 men aged 42‐61\xa0years at ' 'recruitment.</jats:p></jats:sec><jats:sec><jats:title>Material and ' 'Methods</jats:title><jats:p>Objectively measured CRF and self‐reported sauna bathing habits ' 'were assessed at baseline. CRF was categorized as low and high (median cut‐offs) and FSB as ' 'low and high (defined as ≤1 and 2‐7\xa0sessions/wk, respectively). Multivariable‐adjusted ' 'hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident ' 'pneumonia.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>During a ' 'median follow‐up of 26.6\xa0years, 529 cases of pneumonia occurred. Comparing high vs low ' 'CRF, the multivariable‐adjusted HR (95% CIs) for pneumonia was 0.75 (0.61‐0.91). Comparing ' 'high vs low FSB, the corresponding HR was 0.81 (0.68‐0.97). Compared to men with low CRF ' '&amp; low FSB, the multivariable‐adjusted HRs of pneumonia for the following groups: high CRF ' '&amp; low FSB; low CRF &amp; high FSB; and high CRF &amp; high FSB were 0.88 (0.65‐1.20), ' '0.89 (0.71‐1.13), and 0.62 (0.48‐0.80) ' 'respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In a ' 'general male Caucasian population, a combination of high fitness levels and frequent sauna ' 'baths is associated with a substantially lowered future pneumonia risk compared with each ' 'modality alone. The implications of these findings in altering COVID‐19 disease or its ' 'severity deserve study.</jats:p></jats:sec>', 'DOI': '10.1111/eci.13490', 'type': 'journal-article', 'created': {'date-parts': [[2021, 1, 15]], 'date-time': '2021-01-15T04:22:50Z', 'timestamp': 1610684570000}, 'update-policy': 'http://dx.doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 11, 'title': 'High fitness levels, frequent sauna bathing and risk of pneumonia in a cohort study: Are there ' 'potential implications for COVID‐19?', 'prefix': '10.1111', 'volume': '51', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-2625-0273', 'authenticated-orcid': False, 'given': 'Setor K.', 'family': 'Kunutsor', 'sequence': 'first', 'affiliation': [ { 'name': 'National Institute for Health Research Bristol Biomedical ' 'Research Centre University Hospitals Bristol and Weston NHS ' 'Foundation Trust and the University of Bristol Bristol UK'}, { 'name': 'Musculoskeletal Research Unit, Translational Health Sciences ' 'Bristol Medical School Learning &amp; Research Building (Level ' '1), Southmead Hospital University of Bristol Bristol UK'}]}, { 'ORCID': 'http://orcid.org/0000-0002-3738-1586', 'authenticated-orcid': False, 'given': 'Jari A.', 'family': 'Laukkanen', 'sequence': 'additional', 'affiliation': [ { 'name': 'Institute of Public Health and Clinical Nutrition University of ' 'Eastern Finland Kuopio Finland'}, { 'name': 'Department of Medicine Institute of Clinical Medicine University ' 'of Eastern Finland Kuopio Finland'}, { 'name': 'Department of Medicine Central Finland Health Care District ' 'Hospital District Jyväskylä Finland'}]}], 'member': '311', 'published-online': {'date-parts': [[2021, 1, 22]]}, 'reference': [ { 'key': 'e_1_2_9_2_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1136/thoraxjnl-2013-204282'}, {'key': 'e_1_2_9_3_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.pcad.2020.04.006'}, { 'key': 'e_1_2_9_4_1', 'doi-asserted-by': 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