Abstract: TYPE Original Research PUBLISHED 14 February 2023 DOI 10.3389/fpubh.2023.1072198 OPEN ACCESS EDITED BY Yanan Zhao, Nanjing Normal University, China REVIEWED BY Jennifer Hale-Gallardo, United States Department of Veterans Affairs, United States WenSheng Zhou, Nanjing Xiaozhuang University, China *CORRESPONDENCE In-Hwan Oh parenchyme@gmail.com SPECIALTY SECTION This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health RECEIVED 17 October 2022 ACCEPTED 17 January 2023 PUBLISHED 14 February 2023 CITATION Park S, Kim H, Park S-Y and Oh I-H (2023) Pre-pandemic physical activity as a predictor of infection and mortality associated with COVID-19: Evidence from the National Health Insurance Service. Front. Public Health 11:1072198. doi: 10.3389/fpubh.2023.1072198 COPYRIGHT © 2023 Park, Kim, Park and Oh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Pre-pandemic physical activity as a predictor of infection and mortality associated with COVID-19: Evidence from the National Health Insurance Service Saengryeol Park1 , Hyeseong Kim1 , So-Youn Park2 and In-Hwan Oh3* 1 Department of Physical Education, College of Education, Chonnam National University, Gwangju, Republic of Korea, 2 Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, Republic of Korea, 3 Preventive Medicine (AgeTech-Service Convergence Major), College of Medicine, Kyung Hee University, Seoul, Republic of Korea Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, many populations have experienced reduced physical activity (PA) levels, weight gain, and increased anxiety and depression. However, according to a previous study, engaging in PA has a positive effect on damages caused by COVID-19. Therefore, this study aimed to investigate the association between PA and COVID-19 using the National Health Insurance Sharing Service Database in South Korea. Methods: Logistic regression analysis was used to analyze the association of PA with COVID-19 and mortality. The analysis was adjusted for body mass index, sex, age, insurance type, comorbidity, and region of residence at baseline. Disability and lifestyle (weight, smoking, and drinking status) were adjusted consecutively. Results: The results indicated that engaging in insufficient PA as per the WHO guidelines predicts a higher risk of COVID-19 when controlling for personal characteristics, comorbidity, lifestyle, disability, and mortality. Discussion: This study revealed the need to engage in PA and manage weight to reduce the risk of infection and mortality associated with COVID-19. Because engaging in PA is an important component of weight management and can help restore physical and mental health after the COVID-19 pandemic, it should be emphasized as a pillar of recovery after COVID-19. KEYWORDS physical activity, COVID-19, quarantine, lifestyle, COVID-19-associated mortality