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0 0.5 1 1.5 2+ Hospitalization 40% Improvement Relative Risk Exercise for COVID-19  Li et al.  META ANALYSIS Favors exercise Favors inactivity

Association of physical activity and the risk of COVID-19 hospitalization: a dose-response meta-analysis

Jun 2022  
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Meta analysis of 17 studies, showing a dose-response relationship with higher levels of physical activity reducing risk of COVID-19 hospitalization.
6 meta analyses show significant improvements with exercise for mortality Ezzatvar, Halabchi, Liu, Rahmati, Sittichai, ICU admission Rahmati, hospitalization Ezzatvar, Halabchi, Li, Rahmati, severity Ezzatvar, Liu, Sittichai, and cases Ezzatvar.
Currently there are 61 exercise for COVID-19 studies, showing 50% lower mortality [39‑60%], 46% lower ventilation [32‑57%], 41% lower ICU admission [35‑47%], 35% lower hospitalization [27‑42%], and 23% fewer cases [13‑32%].
risk of hospitalization, 40.0% lower, RR 0.60, p < 0.001.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Li et al., 23 Jun 2022, preprint, 3 authors.
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Association of physical activity and the risk of COVID-19 hospitalization: a dose–response meta-analysis
Dan Li, Shengzhen Jin, Songtao Lu
Background Many people have experienced a high burden due to the spread of the coronavirus disease (COVID-19) and its serious consequences for health and everyday life. Prior studies have reported that physical activity (PA) may lower the risk of COVID-19 hospitalization. The present meta-analysis (PROSPERO registration number: CRD42022339672) explored the doseresponse relationship between PA and the risk of COVID-19 hospitalization. Methods Epidemiological observational studies on the relationship between PA and the risk of COVID-19 hospitalization were included. Categorical dose-response relationships between PA and the risk of COVID-19 hospitalization were assessed using random effect models. Robust error meta-regression models assessed the continuous relationship between PA (metabolic equivalent [MET]-h/week) and COVID-19 hospitalization risk across studies reporting quantitative PA estimates. Results Seventeen observational studies (cohort\case-control\cross-section) met the criteria for inclusion in the meta-analysis. Categorical dose-relationship analysis showed a 40% (risk ratio (RR) 0.60, 95% confidence intervals (CI): 0.48-0.71) reduction in the risk of COVID-19 hospitalization compared to the lowest dose of PA. The results of the continuous dose-response . NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. / 14 relationship showed a non-linear inverse relationship (Pnon-linearity < 0.05) between PA and the risk of COVID-19 hospitalization. When total PA was less than or greater than 10 Met-h/week, an increase of 4 Met-h/week was associated with a 14% (RR = 0.83, 95%CI: 0.85-0.87) and 11% (RR = 0.89, 95%CI: 0.87-0.90) reduction in the risk of COVID-19 hospitalization, respectively. Conclusions There was an inverse non-linear dose-response relationship between PA level and the risk of COVID-19 hospitalization. Doses of the guideline-recommended minimum PA levels by WTO may be required for more substantial reductions in the COVID-19 hospitalization risk.
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