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

{ 'indexed': {'date-parts': [[2022, 4, 4]], 'date-time': '2022-04-04T15:07:56Z', 'timestamp': 1649084876522}, 'reference-count': 42, 'publisher': 'BMJ', 'license': [ { 'start': { 'date-parts': [[2021, 7, 22]], 'date-time': '2021-07-22T00:00:00Z', 'timestamp': 1626912000000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://bmj.com/coronavirus/usage'}], 'funder': [ { 'DOI': '10.13039/501100003725', 'name': 'National Research Foundation of Korea', 'doi-asserted-by': 'crossref', 'award': ['NRF2019R1G1A109977913']}], 'content-domain': {'domain': ['bmj.com'], 'crossmark-restriction': True}, 'short-container-title': ['Br J Sports Med'], 'abstract': '<jats:sec><jats:title>Purpose</jats:title><jats:p>To determine the potential associations ' 'between physical activity and risk of SARS-CoV-2 infection, severe illness from COVID-19 and ' 'COVID-19 related death using a nationwide cohort from South ' 'Korea.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Data regarding ' '212 768 Korean adults (age ≥20 years), who tested for SARS-CoV-2, from 1 January 2020 to 30 ' 'May 2020, were obtained from the National Health Insurance Service of South Korea and further ' 'linked with the national general health examination from 1 January 2018 to 31 December 2019 ' 'to assess physical activity levels. SARS-CoV-2 positivity, severe COVID-19 illness and ' 'COVID-19 related death were the main outcomes. The observation period was between 1 January ' '2020 and 31 July ' '2020.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Out of 76 395 ' 'participants who completed the general health examination and were tested for SARS-CoV-2, ' '2295 (3.0%) were positive for SARS-CoV-2, 446 (0.58%) had severe illness from COVID-19 and 45 ' '(0.059%) died from COVID-19. Adults who engaged in both aerobic and muscle strengthening ' 'activities according to the 2018 physical activity guidelines had a lower risk of SARS-CoV-2 ' 'infection (2.6% vs 3.1%; adjusted relative risk (aRR), 0.85; 95% CI 0.72 to 0.96), severe ' 'COVID-19 illness (0.35% vs 0.66%; aRR 0.42; 95% CI 0.19 to 0.91) and COVID-19 related death ' '(0.02% vs 0.08%; aRR 0.24; 95% CI 0.05 to 0.99) than those who engaged in insufficient ' 'aerobic and muscle strengthening activities. Furthermore, the recommended range of metabolic ' 'equivalent task (MET; 500–1000 MET min/week) was associated with the maximum beneficial ' 'effect size for reduced risk of SARS-CoV-2 infection (aRR 0.78; 95% CI 0.66 to 0.92), severe ' 'COVID-19 illness (aRR 0.62; 95% CI 0.43 to 0.90) and COVID-19 related death (aRR 0.17; 95% CI ' '0.07 to 0.98). Similar patterns of association were observed in different sensitivity ' 'analyses.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Adults who ' 'engaged in the recommended levels of physical activity were associated with a decreased ' 'likelihood of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related death. Our ' 'findings suggest that engaging in physical activity has substantial public health value and ' 'demonstrates potential benefits to combat COVID-19.</jats:p></jats:sec>', 'DOI': '10.1136/bjsports-2021-104203', 'type': 'journal-article', 'created': {'date-parts': [[2021, 7, 22]], 'date-time': '2021-07-22T17:25:40Z', 'timestamp': 1626974740000}, 'page': 'bjsports-2021-104203', 'update-policy': 'http://dx.doi.org/10.1136/crossmarkpolicy', 'source': 'Crossref', 'is-referenced-by-count': 24, 'title': [ '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'], 'prefix': '10.1136', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-5632-5208', 'authenticated-orcid': False, 'given': 'Seung Won', 'family': 'Lee', 'sequence': 'first', 'affiliation': []}, {'given': 'Jinhee', 'family': 'Lee', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sung Yong', 'family': 'Moon', 'sequence': 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Sparse data bias: a problem ' 'hiding in plain sight. 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