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0 0.5 1 1.5 2+ Hospitalization 52% Improvement Relative Risk Exercise for COVID-19  Maltagliati et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective study in multiple countries Lower hospitalization with higher activity levels (p=0.02) Maltagliati et al., J. Sports Sciences, Aug 2021 Favors exercise Favors inactivity

Muscle strength explains the protective effect of physical activity against COVID-19 hospitalization among adults aged 50 years and older

Maltagliati et al., Journal of Sports Sciences, doi:10.1080/02640414.2021.1964721
Aug 2021  
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Retrospective 3,139 adults >50 in Europe, with 66 COVID-19 hospitalizations, showing lower risk of hospitalization with higher physical activity and with higher muscle strength. Note that model 2 includes muscle strength which is correlated with physical activity
risk of hospitalization, 52.0% lower, OR 0.48, p = 0.02, adjusted per study, model 1, more than once a week vs. hardly ever or never, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Maltagliati et al., 11 Aug 2021, retrospective, multiple countries, peer-reviewed, survey, 8 authors.
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Muscle Strength Explains the Protective Effect of Physical Activity against COVID-19 Hospitalization among Adults aged 50 Years and Older
Silvio Maltagliati, Stephen Sieber, Philippe Sarrazin, Stéphane Cullati, Aïna Chalabaev, Grégoire P Millet, Matthieu P Boisgontier, Boris Cheval
Objectives. Physical activity has been proposed as a protective factor for COVID-19 hospitalization. However, the mechanisms underlying this association are unclear. Here, we examined the association between physical activity and COVID-19 hospitalization and whether this relationship was explained by other risk factors for severe COVID-19. Method. We used data from adults aged 50 years and older from the Survey of Health, Ageing and Retirement in Europe. The outcome was self-reported hospitalization due to COVID-19 measured before August 2020. The main exposure was usual physical activity, self-reported between 2004 and 2017. Data were analyzed using logistic regression models. Results. Among the 3139 participants included in the study (69.3 ± 8.5 years, 1763 women), 266 were tested positive for COVID-19 and 66 were hospitalized. Results showed that individuals who engaged in physical activity more than once a week had lower odds of COVID-19 hospitalization than individuals who hardly ever or never engaged in physical activity (odds ratios = 0.41, 95% confidence interval = 0.22-0.74, p = .004). This association between physical activity and COVID-19 hospitalization was explained by muscle strength, but not by other risk factors. Conclusion. These findings suggest that, after 50 years of age, engaging in physical activity more than once a week is associated with lower odds of COVID-19 hospitalization. The protective effect of physical activity on COVID-19 hospitalization is explained by muscle strength.
Supplementary material Table S1 . Results of the general logistic models testing the associations of low-to-moderate physical activity and other risk factors with COVID-19 hospitalizations. Table S2 . Results of the general logistic models testing the associations of vigorous physical activity and other risk factors with COVID-19 hospitalizations. Table S3 . Results based on the rare-events logistic regression with a tau parameter of 84/100,000. . Table S3 . Results based on the rare-events logistic regression with a tau parameter of 84/100,000. Model
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