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Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey

Schmidt et al., Sports Medicine - Open, doi:10.1186/s40798-023-00592-6, CoCo-Fakt
Jun 2023  
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0 0.5 1 1.5 2+ Case, above vs. below g.. 31% Improvement Relative Risk Case, above vs. meeting.. 34% Case, any vs. none 23% Case, moderate/vigorous.. 22% Exercise for COVID-19  CoCo-Fakt  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 5,338 patients in Germany Fewer cases with higher activity levels (p=0.02) c19early.org Schmidt et al., Sports Medicine - Open, Jun 2023 Favors exercise Favors inactivity
Exercise for COVID-19
9th treatment shown to reduce risk in October 2020
 
*, now known with p < 0.00000000001 from 66 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 5,338 individuals with confirmed contact with a COVID-19 patient, showing lower risk of COVID-19 with exercise.
risk of case, 31.1% lower, OR 0.69, p = 0.02, high activity levels 956, low activity levels 2,705, adjusted per study, inverted to make OR<1 favor high activity levels, above guidelines vs. below guidelines, multivariable, RR approximated with OR.
risk of case, 34.5% lower, OR 0.66, p = 0.02, high activity levels 956, low activity levels 1,113, adjusted per study, inverted to make OR<1 favor high activity levels, above guidelines vs. meeting guidelines, multivariable, RR approximated with OR.
risk of case, 22.7% lower, OR 0.77, p = 0.02, high activity levels 3,658, low activity levels 1,680, adjusted per study, inverted to make OR<1 favor high activity levels, exercise vs. no exercise, multivariable, RR approximated with OR.
risk of case, 21.6% lower, OR 0.78, p = 0.03, high activity levels 3,371, low activity levels 1,716, adjusted per study, inverted to make OR<1 favor high activity levels, moderate-to-vigorous vs. low intensity, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Schmidt et al., 21 Jun 2023, retrospective, Germany, peer-reviewed, 8 authors, CoCo-Fakt trial.
This PaperExerciseAll
Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey
Nikola Schmidt, Andreas Gehlhar, Barbara Grüne, Annelene Kossow, Thomas Kraus, Johannes Nießen, Stefanie Wessely, Christine Joisten
Sports Medicine - Open, doi:10.1186/s40798-023-00592-6
Objectives To investigate the potential protective role of exercise on the odds of COVID-19 infection in unvaccinated contact persons (CPs) who were at higher risk of infection due to confirmed contact with infected persons. Methods Before the onset of the vaccination campaign, the first wave of the CoCo-Fakt online survey was conducted with SARS-CoV-2-positive persons and their confirmed contacts who were isolated/quarantined between 1 March 2020 and 9 December 2020. Within this analysis, 5338 CPs were included and divided into those who subsequently tested positive (CP-P) and those who remained negative (CP-N). We assessed demographics as well as prepandemic lifestyle characteristics including physical activity (PA; type, frequency, time, intensity; duration clustered as 'below PA guidelines' , 'meeting PA guidelines' , and 'above PA guidelines'; intensity clustered as 'low intensity' and 'moderate-to-vigorous intensity') and sedentary behaviour. Results A greater percentage of CP-Ns reported being active before the pandemic compared to CP-Ps (69% vs. 63%; p = .004). Moreover, CP-Ns reported higher PA duration (164.1 min/week vs. 143.2 min/week; p = .038) and higher PA intensities than CP-Ps (67% vs. 60% moderate-to-vigorous intensity, 33% vs. 40% low intensity; p = .003). Adjusting for age, sex, socioeconomic status, migration background, and pre-existing chronic diseases, the odds of infection were negatively associated with exercise (yes/no) (Nagelkerke R 2 = 1.9%), PA levels above PA guidelines (Nagelkerke R 2 = 2.0%), and PA intensity (Nagelkerke R 2 = 1.8%). Conclusion Due to the beneficial effects of PA on the odds of infection, an active lifestyle should be promoted especially during possible subsequent pandemics (while taking into account necessary hygiene measures). Moreover, inactive and chronically ill persons should be especially encouraged to adopt a healthier lifestyle.
Abbreviations Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s40798-023-00592-6. Additional file 1. Online survey of the first wave of the CoCo-Fakt cohort study. Author Contributions NS wrote the manuscript. CJ, BG, AK and JN conceived and conducted the study. NS, SW and CJ ran all data analyses. AG conducted the questions regarding physical activity and sedentary lifestyle. TK contributed to the application at the Ethics Committee of the Medical Faculty of RWTH Aachen University as well as the evaluation and interpretation of this analysis. All authors read the manuscript and agreed to publication. Declarations Ethics Approval and Consent to Participate Participants were asked to actively consent to their participation in the online survey. Human Ethics Research Committee ethics approval was obtained from the Rheinisch-Westfälische Technische Hochschule Aachen Human Ethics Research Committee (351/20) and the research was conducted in accordance with the approved protocol. Consent for Publication Not applicable. Competing Interests Nikola Schmidt, Andreas Gehlhar, Barbara Grüne, Annelene Kossow, Thomas Kraus, Johannes Nießen, Stefanie Wessely and Christine Joisten declare that they have no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Epidemiol ' 'Bull. 2020;23:3–11. https://doi.org/10.25646/6923.', 'journal-title': 'Epidemiol Bull'}, { 'key': '592_CR18', 'unstructured': 'Tivian. Startseite|Unipark, 2023. https://www.unipark.com/en/. Accessed ' '18 Feb 2023.'}, { 'key': '592_CR19', 'doi-asserted-by': 'publisher', 'unstructured': 'WHO Regional Office for Europe. COVID-19 Snapshot MOnitoring (COSMO ' 'Standard): Monitoring knowledge, risk perceptions, preventive ' 'behaviours, and public trust in the current coronavirus outbreak—WHO ' 'standard protocol; PsychArchives 2020. ' 'https://doi.org/10.23668/PSYCHARCHIVES.2782', 'DOI': '10.23668/PSYCHARCHIVES.2782'}, { 'key': '592_CR20', 'doi-asserted-by': 'publisher', 'first-page': 'e048001', 'DOI': '10.1136/bmjopen-2020-048001', 'volume': '11', 'author': 'C Joisten', 'year': '2021', 'unstructured': 'Joisten C, Kossow A, Book J, Broichhaus L, Daum M, Eisenburger N, et al. 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J Health ' 'Monit. 2017;2:83–90. https://doi.org/10.17886/RKI-GBE-2017-012.', 'journal-title': 'J Health Monit'}, { 'key': '592_CR22', 'doi-asserted-by': 'publisher', 'first-page': '631', 'DOI': '10.1007/s00103-012-1663-4', 'volume': '56', 'author': 'T Lampert', 'year': '2013', 'unstructured': 'Lampert T, Kroll L, Müters S, et al. Messung des sozioökonomischen ' 'Status in der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). ' 'Bundesgesundheitsbl. 2013;56:631–6. ' 'https://doi.org/10.1007/s00103-012-1663-4.', 'journal-title': 'Bundesgesundheitsbl'}, { 'key': '592_CR23', 'doi-asserted-by': 'publisher', 'first-page': '52', 'DOI': '10.1186/s40814-016-0092-9', 'volume': '2', 'author': 'C Graf', 'year': '2016', 'unstructured': 'Graf C, Schlepper S, Bauer C, Ferrari N, Frank S, Gartner L, et al. ' 'Feasibility and acceptance of exercise recommendations (10,000 steps a ' 'day) within routine German health check (check-up 35/GOÄ29)-study ' 'protocol. Pilot Feasibility Stud. 2016;2:52. ' 'https://doi.org/10.1186/s40814-016-0092-9.', 'journal-title': 'Pilot Feasibility Stud'}, { 'key': '592_CR24', 'doi-asserted-by': 'publisher', 'first-page': '1575', 'DOI': '10.1249/mss.0b013e31821ece12', 'volume': '43', 'author': 'BE Ainsworth', 'year': '2011', 'unstructured': 'Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR, Tudor-Locke ' 'C, et al. 2011 compendium of physical activities: a second update of ' 'codes and MET values. Med Sci Sports Exerc. 2011;43:1575–81. ' 'https://doi.org/10.1249/mss.0b013e31821ece12.', 'journal-title': 'Med Sci Sports Exerc'}, { 'key': '592_CR25', 'unstructured': 'World Health Organization. WHO guidelines on physical activity and ' 'sedentary behaviour, 2020. ' 'https://apps.who.int/iris/bitstream/handle/10665/336657/9789240015111-eng.pdf. 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' '2021;10:570–6. https://doi.org/10.1016/j.jshs.2021.03.008.', 'journal-title': 'J Sport Health Sci'}, { 'key': '592_CR28', 'doi-asserted-by': 'publisher', 'first-page': '201', 'DOI': '10.1016/j.jshs.2018.09.009', 'volume': '8', 'author': 'DC Nieman', 'year': '2019', 'unstructured': 'Nieman DC, Wentz LM. The compelling link between physical activity and ' 'the body’s defense system. J Sport Health Sci. 2019;8:201–17. ' 'https://doi.org/10.1016/j.jshs.2018.09.009.', 'journal-title': 'J Sport Health Sci'}, { 'key': '592_CR29', 'doi-asserted-by': 'publisher', 'first-page': '987', 'DOI': '10.1136/bjsm.2010.077875', 'volume': '45', 'author': 'DC Nieman', 'year': '2011', 'unstructured': 'Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract ' 'infection is reduced in physically fit and active adults. 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' 'https://doi.org/10.3961/jpmph.21.640.', 'journal-title': 'J Prev Med Public Health'}, { 'key': '592_CR32', 'doi-asserted-by': 'publisher', 'first-page': '1319', 'DOI': '10.1111/add.15276', 'volume': '116', 'author': 'D Simons', 'year': '2021', 'unstructured': 'Simons D, Shahab L, Brown J, Perski O. The association of smoking status ' 'with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: ' 'a living rapid evidence review with Bayesian meta-analyses (version 7). ' 'Addiction. 2021;116:1319–68. https://doi.org/10.1111/add.15276.', 'journal-title': 'Addiction'}, { 'key': '592_CR33', 'doi-asserted-by': 'publisher', 'DOI': '10.25646/8460', 'author': 'A Richter', 'year': '2021', 'unstructured': 'Richter A, Schienkiwitz A, Starker A, Krug S, Domanska O, Kuhnert R, et ' 'al. Gesundheitsfördernde Verhaltensweisen bei Erwachsenen in ' 'Deutschland—Ergebnisse der Studie GEDA 2019/2020-EHIS. J Health Monit. ' '2021. https://doi.org/10.25646/8460.', 'journal-title': 'J Health Monit'}, { 'key': '592_CR34', 'doi-asserted-by': 'publisher', 'first-page': '767', 'DOI': '10.7326/m20-2665', 'volume': '173', 'author': 'GH Tison', 'year': '2020', 'unstructured': 'Tison GH, Avram R, Kuhar P, Abreau S, Marcus GM, Pletcher MJ, et al. ' 'Worldwide effect of COVID-19 on physical activity: a descriptive study. ' 'Ann Intern Med. 2020;173:767–70. https://doi.org/10.7326/m20-2665.', 'journal-title': 'Ann Intern Med'}, { 'key': '592_CR35', 'doi-asserted-by': 'publisher', 'first-page': 'e063358', 'DOI': '10.1136/bmjopen-2022-063358', 'volume': '12', 'author': 'J Book', 'year': '2022', 'unstructured': 'Book J, Broichhaus L, Grüne B, Nießen J, Wiesmüller GA, Joisten C, et ' 'al. Adherence to stay-at-home orders: awareness, implementation and ' 'difficulties of officially ordered quarantine measures in the context of ' 'the COVID-19 pandemic in Cologne—a retrospective cohort study. BMJ Open. ' '2022;12:e063358. https://doi.org/10.1136/bmjopen-2022-063358.', 'journal-title': 'BMJ Open'}, { 'key': '592_CR36', 'unstructured': 'Mathieu E, Ritchie H, Rodés-Guirao L, Appel C, Giattino C, Hasell J et ' 'al. Coronavirus Pandemic (COVID-19). Our World in Data 2020. ' 'https://ourworldindata.org/covid-vaccinations. Accessed 3 Mar 2023'}], 'container-title': 'Sports Medicine - Open', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s40798-023-00592-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s40798-023-00592-6/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s40798-023-00592-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 6, 21]], 'date-time': '2023-06-21T12:03:16Z', 'timestamp': 1687348996000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-023-00592-6'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 6, 21]]}, 'references-count': 36, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 12]]}}, 'alternative-id': ['592'], 'URL': 'http://dx.doi.org/10.1186/s40798-023-00592-6', 'relation': {}, 'ISSN': ['2198-9761'], 'subject': ['Physical Therapy, Sports Therapy and Rehabilitation', 'Orthopedics and Sports Medicine'], 'container-title-short': 'Sports Med - Open', 'published': {'date-parts': [[2023, 6, 21]]}, 'assertion': [ { 'value': '14 November 2022', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '30 May 2023', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '21 June 2023', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'Participants were asked to actively consent to their participation in the ' 'online survey. Human Ethics Research Committee ethics approval was obtained ' 'from the Rheinisch-Westfälische Technische Hochschule Aachen Human Ethics ' 'Research Committee (351/20) and the research was conducted in accordance with ' 'the approved protocol.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics Approval and Consent to Participate'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for Publication'}}, { 'value': 'Nikola Schmidt, Andreas Gehlhar, Barbara Grüne, Annelene Kossow, Thomas Kraus, ' 'Johannes Nießen, Stefanie Wessely and Christine Joisten declare that they have ' 'no competing interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing Interests'}}], 'article-number': '48'}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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