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0 0.5 1 1.5 2+ Mortality 42% Improvement Relative Risk Ventilation 45% ICU admission 41% Hospitalization 34% c19early.org/ex Steenkamp et al. Exercise for COVID-19 Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 42,835 patients in South Africa (Mar 2020 - Jun 2021) Lower mortality (p<0.0001) and ventilation (p<0.0001) Steenkamp et al., British J. Sports Medicine, doi:10.1136/bjsports-2021-105159 Favors exercise Favors inactivity
Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes
Steenkamp et al., British Journal of Sports Medicine, doi:10.1136/bjsports-2021-105159
Steenkamp et al., Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with.., British Journal of Sports Medicine, doi:10.1136/bjsports-2021-105159
Feb 2022   Source   PDF  
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Retrospective 65,361 COVID-19 patients in South Africa, showing significantly lower hospitalization, ICU admission, ventilation, and mortality with exercise.
risk of death, 42.0% lower, RR 0.58, p < 0.001, high activity levels 29,469, low activity levels 13,366, adjusted per study, high activity vs. low activity, poisson regression, multivariable.
risk of mechanical ventilation, 45.0% lower, RR 0.55, p < 0.001, high activity levels 29,469, low activity levels 13,366, adjusted per study, high activity vs. low activity, poisson regression, multivariable.
risk of ICU admission, 41.0% lower, RR 0.59, p < 0.001, high activity levels 29,469, low activity levels 13,366, adjusted per study, high activity vs. low activity, poisson regression, multivariable.
risk of hospitalization, 34.0% lower, RR 0.66, p < 0.001, high activity levels 29,469, low activity levels 13,366, adjusted per study, high activity vs. low activity, poisson regression, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Steenkamp et al., 9 Feb 2022, retrospective, South Africa, peer-reviewed, 10 authors, study period 19 March, 2020 - 30 June, 2021.
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Abstract: Original research Lizelle Steenkamp,1 Robin Terence Saggers ‍ ‍,2,3 Rossella Bandini,4 Saverio Stranges,5,6 Yun-­Hee Choi,7 Jane S Thornton ‍ ‍,8 Simon Hendrie,9 Deepak Patel,1 Shannon Rabinowitz,9 Jon Patricios ‍ ‍2 ►► Additional supplemental material is published online only. To view, please visit the journal online (http://d​ x.​doi.​ org/1​ 0.​1136/b​ jsports-​2021-​ 105159). For numbered affiliations see end of article. Correspondence to Professor Jon Patricios, Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-­Braamfontein, South Africa; ​jpat@​mweb.c​ o.​za Accepted 21 January 2022 © Author(s) (or their employer(s)) 2022. Re-­use permitted under CC BY-­NC. No commercial re-­use. See rights and permissions. Published by BMJ. To cite: Steenkamp L, Saggers RT, Bandini R, et al. Br J Sports Med Epub ahead of print: [please include Day Month Year]. doi:10.1136/ bjsports-2021-105159 ABSTRACT Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with a confirmed diagnosis of COVID-­19. Methods Directly measured physical activity data from 65 361 adult patients with a COVID-­19 diagnosis from 19 March 2020 to 30 June 2021, were grouped by activity level: low (<60 min/week), moderate (60–149 min/week) and high activity (≥150 min/week). The association of physical activity levels and the risk of adverse outcomes was analysed using modified Poisson regression. We accounted for demographics and comorbidities including conditions known to influence COVID-­19 outcomes, as well as patient complexity as measured by the Johns Hopkins Adjusted Clinical Group system. The regression approach was further validated with a Bayesian network model built off a directed acyclic graph. Results High physical activity was associated with lower rates of hospitalisation (risk ratio, RR 0.66, 95% CI 0.63 to 0.70), ICU admission (RR 0.59, 95% CI 0.52 to 0.66), ventilation (RR 0.55, 95% CI 0.47 to 0.64) and death (RR 0.58, 95% CI 0.50 to 0.68) due to COVID-­19 than those who engaged in low physical activity. Moderate physical activity also was associated with lower rates of hospitalisation (RR 0.87, 95% CI 0.82 to 0.91), admission to ICU (RR 0.80, 95% CI 0.71 to 0.89), ventilation (RR 0.73, 95% CI 0.62 to 0.84) and death (RR 0.79, 95% CI 0.69 to 0.91). Conclusions Adults with high and moderate physical activity levels had significantly better outcomes than those with low activity when contracting COVID-­19. The apparent protective effects of regular physical activity extended to those with concomitant chronic medical conditions.
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