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The Association between Lifestyle Risk Factors and COVID-19 Hospitalization in a Healthcare Institution

Reis et al., American Journal of Lifestyle Medicine, doi:10.1177/15598276221135541
Oct 2022  
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Hospitalization 41% Improvement Relative Risk Exercise for COVID-19  Reis et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 546 patients in the USA (December 2020 - February 2021) Lower hospitalization with higher activity levels (not stat. sig., p=0.18) c19early.org Reis et al., American J. Lifestyle Med.., Oct 2022 Favorsexercise Favorsinactivity 0 0.5 1 1.5 2+
Exercise for COVID-19
9th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 68 studies.
No treatment is 100% effective. Protocols combine treatments.
5,300+ studies for 116 treatments. c19early.org
Retrospective 546 COVID+ patients in the USA, showing lower risk of hospitalization with higher frequency of strength training, without statistical significance.
Although the 41% lower hospitalization is not statistically significant, it is consistent with the significant 33% lower hospitalization [25‑40%] from meta analysis of the 20 hospitalization results to date.
Standard of Care (SOC): SOC for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved. Low-cost treatments were excluded, reducing the probability of treatment—especially early—due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
Study covers exercise and diet.
risk of hospitalization, 40.7% lower, RR 0.59, p = 0.18, high activity levels 9 of 241 (3.7%), low activity levels 29 of 305 (9.5%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, strength training 2+/week vs. <2, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Reis et al., 24 Oct 2022, retrospective, USA, peer-reviewed, survey, 6 authors, study period December 2020 - February 2021. Contact: hdossantos@llu.edu.
This PaperExerciseAll
The Association between Lifestyle Risk Factors and COVID-19 Hospitalization in a Healthcare Institution
Wenes Pereira Reis, MHS, DrPH Olivia Moses, MPH, DrPH Jisoo Oh, MPH, DrPH April Wilson, MPH, FACPM Josileide Gaio, Hildemar Dos Santos
American Journal of Lifestyle Medicine, doi:10.1177/15598276221135541
COVID-19 is an acute infectious respiratory disease caused by SARS-CoV-2, a subtype of the coronavirus. In addition to normal levels of biometric measures, a healthy lifestyle has been considered an indispensable element in preventing complications of coronavirus infection. Demographic characteristics are also critical in determining risk levels. Aim: Investigate potential significant associations between health behaviors, biometric screenings, demographics, and COVID-19 hospitalization in Loma Linda University Health employees. Methods: Participants are employees covered under the employersponsored health plan at
ORCID iDs Wenes Pereira Reis  https://orcid.org/0000-0001-9983-2664 Jisoo Oh  https://orcid.org/0000-0001-8905-7633
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DOI record: { "DOI": "10.1177/15598276221135541", "ISSN": [ "1559-8276", "1559-8284" ], "URL": "http://dx.doi.org/10.1177/15598276221135541", "abstract": "<jats:p> COVID-19 is an acute infectious respiratory disease caused by SARS-CoV-2, a subtype of the coronavirus. In addition to normal levels of biometric measures, a healthy lifestyle has been considered an indispensable element in preventing complications of coronavirus infection. Demographic characteristics are also critical in determining risk levels. Aim: Investigate potential significant associations between health behaviors, biometric screenings, demographics, and COVID-19 hospitalization in Loma Linda University Health employees. Methods: Participants are employees covered under the employer-sponsored health plan at Loma Linda University Health, Loma Linda, CA, who tested positive for COVID-19. Logistic regression models were applied to analyze demographics, biometric screenings, and lifestyle factors associated with COVID-19 hospitalization. In our study, 7% of participants required hospitalization. Variables independently associated with COVID-19 hospitalization included higher age (OR = 1.05 [1.01–1.08], P = .005), non-White race compared to the White race (OR = 3.2 [1.22–8.38], P = .018), higher HbA1C levels showing a marginal association (OR = 1.31 [.99–1.72], P = .057), and lower vegetable consumption (OR = 4.39 [2.06–9.40], P &lt; .001). Lower protein consumption decreased the Odds of hospitalization (OR = .40 [.19–.87], P = .021). Our results suggest that a diet that includes more vegetables and lower protein may confer some protection against COVID-19 hospitalization. </jats:p>", "alternative-id": [ "10.1177/15598276221135541" ], "author": [ { "ORCID": "http://orcid.org/0000-0001-9983-2664", "affiliation": [ { "name": "Public Health, Loma Linda University, Loma Linda, CA, USA (WPR, OM, JO, AW, JG, HDS)" } ], "authenticated-orcid": false, "family": "Reis", "given": "Wenes Pereira", "sequence": "first" }, { "affiliation": [ { "name": "Public Health, Loma Linda University, Loma Linda, CA, USA (WPR, OM, JO, AW, JG, HDS)" } ], "family": "Moses", "given": "Olivia", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-8905-7633", "affiliation": [ { "name": "Public Health, Loma Linda University, Loma Linda, CA, USA (WPR, OM, JO, AW, JG, HDS)" } ], "authenticated-orcid": false, "family": "Oh", "given": "Jisoo", "sequence": "additional" }, { "affiliation": [ { "name": "Public Health, Loma Linda University, Loma Linda, CA, USA (WPR, OM, JO, AW, JG, HDS)" } ], "family": "Wilson", "given": "April", "sequence": "additional" }, { "affiliation": [ { "name": "Public Health, Loma Linda University, Loma Linda, CA, USA (WPR, OM, JO, AW, JG, HDS)" } ], "family": "Gaio", "given": "Josileide", "sequence": "additional" }, { "affiliation": [ { "name": "Public Health, Loma Linda University, Loma Linda, CA, USA (WPR, OM, JO, AW, JG, HDS)" } ], "family": "Dos Santos", "given": "Hildemar", "sequence": "additional" } ], "container-title": "American Journal of Lifestyle Medicine", "container-title-short": "American Journal of Lifestyle Medicine", "content-domain": { "crossmark-restriction": true, "domain": [ "journals.sagepub.com" ] }, "created": { "date-parts": [ [ 2022, 10, 25 ] ], "date-time": "2022-10-25T01:50:06Z", "timestamp": 1666662606000 }, "deposited": { "date-parts": [ [ 2022, 10, 25 ] ], "date-time": "2022-10-25T01:50:18Z", "timestamp": 1666662618000 }, "indexed": { "date-parts": [ [ 2022, 10, 25 ] ], "date-time": "2022-10-25T05:04:31Z", "timestamp": 1666674271878 }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2022, 10, 24 ] ] }, "language": "en", "license": [ { "URL": "http://journals.sagepub.com/page/policies/text-and-data-mining-license", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 10, 24 ] ], "date-time": "2022-10-24T00:00:00Z", "timestamp": 1666569600000 } } ], "link": [ { "URL": "http://journals.sagepub.com/doi/pdf/10.1177/15598276221135541", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "http://journals.sagepub.com/doi/full-xml/10.1177/15598276221135541", "content-type": "application/xml", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "http://journals.sagepub.com/doi/pdf/10.1177/15598276221135541", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "179", "original-title": [], "page": "155982762211355", "prefix": "10.1177", "published": { "date-parts": [ [ 2022, 10, 24 ] ] }, "published-online": { "date-parts": [ [ 2022, 10, 24 ] ] }, "publisher": "SAGE Publications", "reference": [ { "author": "Cascella M", "key": "bibr1-15598276221135541", "volume-title": "Features, evaluation, and treatment of coronavirus (COVID-19). 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