Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients
Sallis et al.
, Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult..
, British Journal of Sports Medicine, doi:10.1136/bjsports-2021-104080
Retrospective 48,440 COVID-19 patients in the USA, showing significantly lower mortality, ICU admission, and hospitalization with exercise.
risk of death, 59.2% lower, RR 0.41, p = 0.005, high activity levels 11 of 3,118 (0.4%), low activity levels 170 of 6,984 (2.4%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, consistently active vs. consistently inactive, multivariable.
risk of ICU admission, 41.5% lower, RR 0.58, p = 0.006, high activity levels 32 of 3,118 (1.0%), low activity levels 195 of 6,984 (2.8%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, consistently active vs. consistently inactive, multivariable.
risk of hospitalization, 53.0% lower, RR 0.47, p < 0.001, high activity levels 99 of 3,118 (3.2%), low activity levels 732 of 6,984 (10.5%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, consistently active vs. consistently inactive, multivariable.
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Sallis et al., 13 Apr 2021, retrospective, USA, peer-reviewed, 8 authors.
Abstract: Original research
Robert Sallis ,1 Deborah Rohm Young,2 Sara Y Tartof,2 James F Sallis,3 Jeevan Sall,1
Qiaowu Li,2 Gary N Smith,4 Deborah A Cohen2
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org/1 0.1136/b jsports-2021-
Department of Family and
Sports Medicine, Kaiser
Permanente Medical Center,
Fontana, California, USA
Research and Evaluation,
Southern California Permanente
Medical Group, Pasadena,
University of California San
Diego, La Jolla, California, USA
Pomona College, Claremont,
Dr Robert Sallis, Department
of Family and Sports Medicine,
Kaiser Permanente Medical
Center, Fontana, CA 92335,
USA; R obert.E.S firstname.lastname@example.org
Accepted 30 March 2021
Published Online First
13 April 2021
Objectives To compare hospitalisation rates, intensive
care unit (ICU) admissions and mortality for patients
with COVID-19 who were consistently inactive, doing
some activity or consistently meeting physical activity
Methods We identified 48 440 adult patients with
a COVID-19 diagnosis from 1 January 2020 to 21
October 2020, with at least three exercise vital sign
measurements from 19 March 2018 to 18 March
2020. We linked each patient’s self-reported physical
activity category (consistently inactive=0–10 min/
week, some activity=11–149 min/week, consistently
meeting guidelines=150+ min/week) to the risk of
hospitalisation, ICU admission and death after COVID-19
diagnosis. We conducted multivariable logistic regression
controlling for demographics and known risk factors to
assess whether inactivity was associated with COVID-19
Results Patients with COVID-19 who were consistently
inactive had a greater risk of hospitalisation (OR 2.26;
95% CI 1.81 to 2.83), admission to the ICU (OR 1.73;
95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI
1.33 to 4.67) due to COVID-19 than patients who
were consistently meeting physical activity guidelines.
Patients who were consistently inactive also had a
greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to
1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to
1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to
COVID-19 than patients who were doing some physical
Conclusions Consistently meeting physical activity
guidelines was strongly associated with a reduced risk
for severe COVID-19 outcomes among infected adults.
We recommend efforts to promote physical activity be
prioritised by public health agencies and incorporated
into routine medical care.
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