Summary of COVID-19 exercise studies

100 patient exercise study: 89% lower need for oxygen therapy (p=0.05), 91% lower hospitalization (p=0.02), 84% lower progression (p<0.0001), and 47% improved recovery (p=0.0002).
Retrospective 100 COVID-19 patients in Bosnia and Herzegovina, showing lower symptom severity and faster recovery with a history of regular physical activity.
Jul 2023, Sports Science and Health, https://doisrpska.nub.rs/index.php/sportskenaukeizdravlje/article/view/9896, https://c19p.org/sebic

2. Steenkamp et al., Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes

42,835 patient exercise study: 42% lower mortality (p<0.0001), 45% lower ventilation (p<0.0001), 41% lower ICU admission (p<0.0001), and 34% lower hospitalization (p<0.0001).
Retrospective 65,361 COVID-19 patients in South Africa, showing significantly lower hospitalization, ICU admission, ventilation, and mortality with exercise.
Feb 2022, British J. Sports Medicine, https://bjsm.bmj.com/content/early/2022/02/08/bjsports-2021-105159.long, https://c19p.org/steenkamp

3. Lee et al., Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study

52,365 patient exercise study: 74% lower mortality (p=0.05), 58% lower severe cases (p=0.03), and 16% fewer cases (p=0.03).
Retrospective 212,768 adults in South Korea, showing lower risk of COVID-19 cases, severity, and mortality with physical activity. Notably, results for aerobic and muscle strengthening activities combined were much better than results for either one in isolation.
Jul 2021, British J. Sports Medicine, https://bjsm.bmj.com/content/early/2021/07/21/bjsports-2021-104203, https://c19p.org/lee6

4. Sallis et al., Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients

10,102 patient exercise study: 59% lower mortality (p=0.005), 42% lower ICU admission (p=0.006), and 53% lower hospitalization (p<0.0001).
Retrospective 48,440 COVID-19 patients in the USA, showing significantly lower mortality, ICU admission, and hospitalization with exercise.
Apr 2021, British J. Sports Medicine, https://bjsm.bmj.com/content/55/19/1099, https://c19p.org/sallis

5. Young et al., Associations of Physical Inactivity and COVID-19 Outcomes Among Subgroups

94,731 patient exercise study: 74% lower mortality (p<0.0001) and 48% lower hospitalization (p<0.0001).
Retrospective 194,191 COVID-19 patients in the USA, showing lower risk of hospitalization and mortality with physical activity, with a dose response relationship.
Dec 2022, American J. Preventive Medicine, https://www.sciencedirect.com/science/article/pii/S0749379722005268, https://c19p.org/young

6. af Geijerstam et al., Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts

655,173 patient exercise study: 50% lower mortality (p=0.005), 40% lower ICU admission (p=0.0003), and 27% lower hospitalization (p<0.0001).
Prospective study of 1,559,187 men in Sweden with cardiorespiratory fitness levels measured on military conscription, showing high cardiorespiratory fitness associated with lower risk of COVID-19 hospitalization, ICU admission, and death.
Jul 2021, BMJ Open, https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2021-051316, https://c19p.org/afgeijerstam

7. Yates et al., Obesity, walking pace and risk of severe COVID-19 and mortality: analysis of UK Biobank

194,031 patient exercise study: 45% lower mortality (p=0.001) and 47% lower severe cases (p<0.0001).
UK Biobank retrospective 412,596 people, showing severe COVID-19 and COVID-19 mortality inversely associated with self-reported walking pace.
Feb 2021, Int. J. Obesity, http://www.nature.com/articles/s41366-021-00771-z, https://c19p.org/yates

8. Li et al., Modifiable lifestyle factors and severe COVID-19 risk: a Mendelian randomisation study

exercise study: 81% lower severe cases (p=0.02) and 56% lower hospitalization (p=0.07).
Mendelian randomization study showing lower risk of severe COVID-19 with physical activity.
Feb 2021, BMC Medical Genomics, https://bmcmedgenomics.biomedcentral.com/articles/10.1186/s12920-021-00887-1, https://c19p.org/li17

9. Christensen et al., The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study

1,072 patient exercise study: 63% lower mortality (p=0.02) and 23% fewer cases (p=0.2).
Prospective study of 2,690 adults in the UK Biobank showing lower cardiorespiritory fitness associated with COVID-19 mortality.
May 2021, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250508, https://c19p.org/christensen

10. Cardoso et al., Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case–control study

614 patient exercise study: 73% lower severe cases (p<0.0001).
Case control study with 307 severe COVID-19 ICU patients and 307 matched COVID-19 outpatients in Brazil, showing significantly higher risk of severe cases with low physical activity.
May 2023, Medicina Clínica, https://www.sciencedirect.com/science/article/pii/S0025775323002518, https://c19p.org/cardoso

11. Kapusta et al., Do selected lifestyle parameters affect the severity and symptoms of COVID-19 among elderly patients? The retrospective evaluation of individuals from the STOP-COVID registry of the PoLoCOV study

568 patient exercise study: 71% lower severe cases (p=0.001).
Retrospective 568 convalescent COVID-19 patients in Poland, showing lower risk of severe cases with regular physical activity in the 3 months before COVID-19.
Dec 2022, J. Infection and Public Health, https://www.sciencedirect.com/science/article/pii/S1876034122003495, https://c19p.org/kapusta

12. Malisoux et al., Associations between physical activity prior to infection and COVID-19 disease severity and symptoms: results from the prospective Predi-COVID cohort study

224 patient exercise study: 63% lower progression (p=0.05).
Retrospective 452 participants in Luxembourg, showing lower risk of moderate cases with higher physical activity.
Apr 2022, BMJ Open, https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2021-057863, https://c19p.org/malisoux

13. Salgado-Aranda et al., Influence of Baseline Physical Activity as a Modifying Factor on COVID-19 Mortality: A Single-Center, Retrospective Study

520 patient exercise study: 83% lower mortality (p=0.003).
Retrospective 520 COVID-19 patients in Spain, showing significantly lower mortality with a history of physical activity.
Mar 2022, Infectious Diseases and Therapy, https://link.springer.com/article/10.1007/s40121-021-00418-6/fulltext.html, https://c19p.org/salgadoaranda

14. Lengelé et al., Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults

241 patient exercise study: 74% fewer cases (p=0.03).
Analysis of 241 adults >65yo in Belgium, showing lower risk of COVID-19 with a history of physical activity.
Oct 2021, Aging Clinical and Experimental Research, https://link.springer.com/10.1007/s40520-021-01991-z, https://c19p.org/lengele

15. Baynouna AlKetbi et al., Risk Factors for SARS-CoV-2 Infection Severity in Abu Dhabi

exercise study: 98% lower mortality (p=0.05).
Retrospective 234 COVID-19 cases in the United Arab Emirates, showing lower risk of mortality with increased physical activity.
Aug 2021, J. Epidemiology and Global Health, https://link.springer.com/article/10.1007/s44197-021-00006-4/fulltext.html, https://c19p.org/baynounaalketbi

16. Cho et al., Physical Activity and the Risk of COVID-19 Infection and Mortality: A Nationwide Population-Based Case-Control Study

97,123 patient exercise study: 53% lower mortality (p=0.01) and 10% fewer cases (p<0.0001).
Retrospective 6,288 COVID+ patients and 125,772 matched controls in South Korea, showing significantly lower risk of COVID-19 infection and mortality with higher physical activity.
Apr 2021, J. Clinical Medicine, https://www.mdpi.com/2077-0383/10/7/1539, https://c19p.org/cho

17. Brawner et al., Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019

exercise study: 74% lower hospitalization (p=0.001).
Retrospective 246 COVID-19 patients in the USA, showing the risk of hospitalization inversely associated with maximal exercise capacity. Adjusted results are only provided for MET as a continuous variable.
Oct 2020, Mayo Clinic Proceedings, https://www.mayoclinicproceedings.org/article/S0025-6196(20)31130-7/fulltext, https://c19p.org/brawner

18. Wang et al., Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalization, and death

68,896 patient exercise study: 30% lower mortality (p<0.0001), 12% lower hospitalization (p<0.0001), and 14% lower PASC (p<0.0001).
Prospective study of 68,896 UK Biobank participants with COVID-19 showing adherence to a healthy lifestyle prior to infection, characterized by 10 factors including adequate physical activity and sleep, not smoking, and a healthy BMI, was associated with a significantly lower risk of mortality, hospitalization, and post-COVID multisystem sequelae. Risk decreased monotonically for increasing numbers of healthy lifestyle factors from 5-10. Reduced risks were evident across cardiovascular, metabolic, neurologic, respiratory, and other disorders over 210 days following infection, during both acute and post-acute phases, regardless of age, sex, ethnicity, test setting, vaccination status, or SARS-CoV-2 variant.
Jan 2024, Nature Communications, https://www.nature.com/articles/s41467-024-50495-7, https://c19p.org/wang24

19. Yuan et al., Does pre-existent physical inactivity have a role in the severity of COVID-19?

164 patient exercise study: 91% lower mortality (p=0.09) and 70% lower severe cases (p=0.03).
Retrospective 164 COVID-19 patients in China, showing physical inactivity associated with an increased risk of severe COVID-19.
Jun 2021, Therapeutic Advances in Respiratory Disease, https://journals.sagepub.com/doi/10.1177/17534666211025221, https://c19p.org/yuan2

20. Antunes et al., The influence of physical activity level on the length of stay in hospital in older men survivors of COVID-19

39 patient exercise study: 80% lower ICU admission (p=0.06), 40% improvement (p=0.48), and 43% shorter hospitalization (p=0.03).
Retrospective 39 hospitalized COVID-19 survivors >60 years old, showing shorter hospitalization for patients with active lifestyles before COVID-19 symptoms.
Jun 2022, Sport Sciences for Health, https://link.springer.com/10.1007/s11332-022-00948-7, https://c19p.org/antunes

21. Huang et al., Reduced Sleep in the Week Prior to Diagnosis of COVID-19 is Associated with the Severity of COVID-19

164 patient exercise study: 47% lower severe cases (p=0.18) and 66% fewer cases (p=0.004).
Retrospective 164 COVID-19 patients and 188 controls in China, showing lower risk of cases with regular exercise.
Nov 2021, Nature and Science of Sleep, https://www.dovepress.com/reduced-sleep-in-the-week-prior-to-diagnosis-of-covid-19-is-associated-peer-reviewed-article-NSS, https://c19p.org/huang5

22. Pavlidou et al., Association of COVID-19 Infection with Sociodemographic, Anthropometric and Lifestyle Factors: A Cross-Sectional Study in an Older Adults’ Population Aged over 65 Years Old

5,197 patient exercise study: 42% fewer cases (p=0.001).
Retrospective 5,197 Greek adults over 65. After adjustment for confounders, COVID-19 infection was independently associated with poor sleep, low physical activity, low Mediterranean diet adherence, living in urban areas, smoking, obesity, depression, anxiety, stress, and poor health-related quality of life.
Nov 2023, Diseases, https://www.mdpi.com/2079-9721/11/4/165, https://c19p.org/pavlidou

23. Frish et al., The Association of Weight Reduction and Other Variables after Bariatric Surgery with the Likelihood of SARS-CoV-2 Infection

3,038 patient exercise study: 53% fewer cases (p=0.04).
Retrospective 3,038 bariatric surgery patients in Israel, showing higher risk of SARS-CoV-2 infection with vitamin D deficiency, and lower risk with physical activity.
Jun 2023, J. Clinical Medicine, https://www.mdpi.com/2077-0383/12/12/4054, https://c19p.org/frishex

24. Sanchez et al., Influence of Physical Exercise on the Severity of COVID-19

exercise study: 54% fewer symptomatic cases (p<0.0001).
Retrospective 29,875 university staff and students in Spain, 3,662 with data, showing lower risk of COVID-19 symptoms for people that exercise. Exercise more than 5 days/week was the most protective, and intense exercise was more effective than moderate exercise.
Apr 2023, Fisioterapia, https://www.sciencedirect.com/science/article/pii/S0211563823002006, https://c19p.org/sanchez

25. Fernandez et al., Intrahospital supervised exercise training improves survival rate among hypertensive COVID-19 patients

439 patient exercise study: 47% lower mortality (p=0.02).
Retrospective 439 severe COVID-19 hospitalized patients with hypertension, 201 receiving a supervised exercise program, showing significantly lower mortality with exercise. Exercise included of aerobic, breathing, and musculoskeletal exercises, 3 to 4 times per week. There were significantly more control patients on beta-adrenergic blockers and thiazide diuretics. There are many possible mechanisms of action, including improved circulation, stress reduction, hormone regulation, improved sleep, increased antioxidant levels, and increased nitric oxide levels in the respiratory system. Over-exercising may be detrimental and lead to impaired immune function.
Feb 2023, J. Applied Physiology, https://journals.physiology.org/doi/10.1152/japplphysiol.00544.2022, https://c19p.org/fernandez

26. Green et al., A higher frequency of physical activity is associated with reduced rates of SARS-CoV-2 infection

113,075 patient exercise study: 42% fewer cases (p<0.0001).
Retrospective 113,075 people in Israel, showing lower risk of COVID-19 cases with physical activity and a dose dependent response.
Nov 2022, European J. General Practice, https://www.tandfonline.com/doi/full/10.1080/13814788.2022.2138855, https://c19p.org/green

27. Ekblom-Bak et al., Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study

exercise study: 48% lower severe cases (p=0.02).
Retrospective 857 severe COVID-19 cases and matched controls in Sweden, showing lower risk of severe COVID-19 with higher cardiorespiratory fitness.
Oct 2021, Int. J. Behavioral Nutrition and Physical Activity, https://link.springer.com/article/10.1186/s12966-021-01198-5/fulltext.html, https://c19p.org/ekblombak

28. Maltagliati et al., Muscle strength explains the protective effect of physical activity against COVID-19 hospitalization among adults aged 50 years and older

exercise study: 52% lower hospitalization (p=0.02).
Retrospective 3,139 adults >50 in Europe, with 66 COVID-19 hospitalizations, showing lower risk of hospitalization with higher physical activity and with higher muscle strength. Note that model 2 includes muscle strength which is correlated with physical activity [eurapa.biomedcentral.com].
Aug 2021, J. Sports Sciences, https://www.tandfonline.com/doi/pdf/10.1080/02640414.2021.1964721, https://c19p.org/maltagliati

29. Marcus et al., Predictors of incident viral symptoms ascertained in the era of COVID-19

14,335 patient exercise study: 42% fewer symptomatic cases (p<0.0001).
Prospective survey based study with 14,335 participants, showing lower risk of viral symptoms with regular exercise.
Jun 2021, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253120, https://c19p.org/marcus

30. Muñoz-Vergara et al., Prepandemic Physical Activity and Risk of COVID-19 Diagnosis and Hospitalization in Older Adults

61,557 patient exercise study: 27% lower hospitalization (p=0.002) and 9% fewer cases (p=0.004).
Prospective study of 61,557 adults aged 45+ years showing reduced risk of COVID-19 diagnosis and hospitalization for those meeting physical activity guidelines of ≥7.5 MET-hours/week before the pandemic compared to inactive individuals.
Feb 2024, JAMA Network Open, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814993, https://c19p.org/munozvergara

31. de Souza et al., Association of physical activity levels and the prevalence of COVID-19-associated hospitalization

938 patient exercise study: 73% lower ventilation (p=0.07) and 34% lower hospitalization (p=0.05).
Retrospective survey of 938 COVID-19 recovered patients in Brazil, showing lower hospitalization with physical activity. NCT04396353.
Sep 2021, J. Science and Medicine in Sport, https://www.jsams.org/article/S1440-2440(21)00136-5/fulltext, https://c19p.org/desouza

32. Wang et al., Adherence to Healthy Lifestyle Prior to Infection and Risk of Post–COVID-19 Condition

1,285 patient exercise study: 11% lower PASC (p=0.2).
Prospective analysis of 32,249 women, showing lower risk of PASC with a healthy lifestyle, in a dose-dependent manner. Participants with 5 or 6 healthy lifestyle factors had significantly lower COVID-19 hospitalization and PASC. BMI and sleep were independently associated with risk of PASC.
Feb 2023, JAMA Internal Medicine, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2800885, https://c19p.org/wang10ex

33. Rocha et al., Physical activity status prevents symptoms of long covid: Sulcovid-19 survey

2,919 patient exercise study: 20% lower PASC (p=0.05).
Retrospective 2,919 non-hospitalized COVID-19 patients in Brazil showing remaining physically active before and after COVID-19 infection reduces the probability of experiencing long COVID symptoms, particularly those affecting the musculoskeletal, neurological and respiratory systems.
Dec 2023, BMC Sports Science, Medicine and Rehabilitation, https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-023-00782-5, https://c19p.org/rocha

34. Schmidt et al., Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey

5,338 patient exercise study: 31% fewer cases (p=0.02).
Retrospective 5,338 individuals with confirmed contact with a COVID-19 patient, showing lower risk of COVID-19 with exercise.
Jun 2023, Sports Medicine - Open, https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-023-00592-6, https://c19p.org/schmidt3

35. Sutkowska et al., Physical Activity Modifies the Severity of COVID-19 in Hospitalized Patients—Observational Study

131 patient exercise study: 62% lower mortality (p=0.21) and 61% improved recovery (p=0.19).
Prospective study of 131 hospitalized patients in Poland, showing lower mortality and improved recovery with a history of higher physical activity.
Jun 2023, J. Clinical Medicine, https://www.mdpi.com/2077-0383/12/12/4046, https://c19p.org/sutkowska

36. Feter et al., Physical activity and long COVID: findings from the Prospective Study About Mental and Physical Health in Adults cohort

237 patient exercise study: 26% lower PASC (p=0.02).
Analysis of 237 COVID-19 patients in Brazil, showing lower risk of long COVID with physical activity.
Jun 2023, Public Health, https://www.sciencedirect.com/science/article/pii/S0033350623001592, https://c19p.org/feter

37. Hamrouni et al., Associations of obesity, physical activity level, inflammation and cardiometabolic health with COVID-19 mortality: a prospective analysis of the UK Biobank cohort

153,833 patient exercise study: 29% lower mortality (p=0.009).
Prospective UK Biobank analysis, showing a history of low physical activity associated with COVID-19 mortality.
Nov 2021, BMJ Open, https://bmjopen.bmj.com/content/11/11/e055003.info, https://c19p.org/hamrouni

38. Nguyen et al., Single and Combinative Impacts of Healthy Eating Behavior and Physical Activity on COVID-19-like Symptoms among Outpatients: A Multi-Hospital and Health Center Survey

3,947 patient exercise study: 20% fewer symptomatic cases (p<0.0001).
Analysis of 3,947 participants in Vietnam, showing significantly lower risk of COVID-19-like symptoms with physical activity and with a healthy diet. The combination of being physically active and eating healthy reduced risk further compared to either alone. The analyzed period was Feb 14 to Mar 2, 2020, which may have been before testing was widely available.
Sep 2021, Nutrients, https://www.mdpi.com/2072-6643/13/9/3258, https://c19p.org/nguyen2

39. Ahmadi et al., Lifestyle risk factors and infectious disease mortality, including COVID-19, among middle aged and older adults: Evidence from a community-based cohort study in the United Kingdom

468,569 patient exercise study: 30% lower mortality (p=0.005).
Retrospective 468,569 adults in the UK, showing significantly lower COVID-19 mortality with physical activity.
Aug 2021, Brain, Behavior, and Immunity, https://www.sciencedirect.com/science/article/pii/S088915912100180X, https://c19p.org/ahmadi2

40. Lobelo et al., Clinical, behavioural and social factors associated with racial disparities in COVID-19 patients from an integrated healthcare system in Georgia: a retrospective cohort study

5,712 patient exercise study: 20% lower hospitalization (p=0.02).
Retrospective 5,712 COVID-19 patients in the USA, showing higher risk of COVID-19 hospitalization with a history of physical inactivity.
May 2021, BMJ Open, https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2020-044052, https://c19p.org/lobelo

41. Ho et al., Modifiable and non-modifiable risk factors for COVID-19, and comparison to risk factors for influenza and pneumonia: results from a UK Biobank prospective cohort study

138,475 patient exercise study: 35% lower hospitalization (p=0.007).
UK Biobank retrospective 235,928 participants using walking pace as a proxy for physical fitness, showing lower risk of COVID-19 hospitalization with an average vs. slow walking pace.
Nov 2020, BMJ Open, https://bmjopen.bmj.com/content/10/11/e040402, https://c19p.org/ho

42. Hamer et al., Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK

exercise study: 28% lower hospitalization (p=0.0004).
UK Biobank retrospective analysis of 387,109 people, showing lower risk of COVID-19 hospitalization with physical activity.
Jul 2020, Brain, Behavior, and Immunity, https://www.sciencedirect.com/science/article/pii/S088915912030996X?via%3Dihub, https://c19p.org/hamer

43. Tsuzuki et al., Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

4,868 patient exercise study: 56% lower severe cases (p<0.0001).
Retrospective 4,868 elderly COVID-19 patients in Japan, showing higher risk of severe cases with poor physical activity status.
Jul 2022, medRxiv, https://www.medrxiv.org/content/10.1101/2022.07.01.22277144, https://c19p.org/tsuzuki3

44. Kontopoulou et al., Exercise Preferences and Benefits in Patients Hospitalized with COVID-19

66 patient exercise study: 66% faster recovery (p<0.0001).
Retrospective 66 hospitalized COVID-19 patients in Greece, showing significantly improved recovery with a history of exercise in unadjusted results. Exercise after hospitalization was also associated with lower levels of dyspnea one month post hospitalization.
Apr 2022, J. Personalized Medicine, https://www.mdpi.com/2075-4426/12/4/645, https://c19p.org/kontopoulou

45. Tret'yakov et al., COVID-19 in individuals adapted to aerobic exercise

293 patient exercise study: 98% lower severe cases (p=0.007).
Retrospective 293 COVID+ patients in Russia, showing lower risk of severe COVID-19 for individuals who regularly practice aerobic training in unadjusted results.
Oct 2020, Pulmonologiya, https://journal.pulmonology.ru/pulm/article/view/1376, https://c19p.org/tretyakov

46. Zhang et al., Physical activity and COVID-19: an observational and Mendelian randomisation study

exercise study: 26% lower mortality (p=0.17) and 18% fewer cases (p=0.01).
UK Biobank retrospective showing significantly lower COVID-19 cases with objectively measured physical activity.
Dec 2020, J. Global Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719276/, https://c19p.org/zhang4

47. Latorre-Román et al., Protective role of physical activity patterns prior to COVID-19 confinement with the severity/duration of respiratory pathologies consistent with COVID-19 symptoms in Spanish populations

exercise study: 76% lower hospitalization (p=0.05).
Retrospective 420 people in Spain, showing lower risk of COVID-19 hospitalization with a history of physical activity.
Jun 2021, Research in Sports Medicine, https://www.tandfonline.com/doi/full/10.1080/15438627.2021.1937166, https://c19p.org/latorreroman

48. Halabchi et al., Regular Sports Participation as a Potential Predictor of Better Clinical Outcome in Adult Patients With COVID-19: A Large Cross-Sectional Study

4,694 patient exercise study: 89% lower mortality (p=0.08) and 28% lower hospitalization (p=0.04).
Retrospective 4,694 COVID-19 patients in Iran, showing lower risk of hospitalization and mortality with regular sports participation.
Nov 2020, J. Physical Activity and Health, https://journals.humankinetics.com/view/journals/jpah/18/1/article-p8.xml, https://c19p.org/halabchi

49. Park et al., Pre-pandemic physical activity as a predictor of infection and mortality associated with COVID-19: Evidence from the National Health Insurance Service

exercise study: 26% lower mortality (p=0.08) and 7% fewer cases (p=0.02).
Retrospective 4,363 COVID-19 patients and 67,125 controls in South Korea, showing higher risk of mortality and cases with insufficient physical activity.
Feb 2023, Frontiers in Public Health, https://www.frontiersin.org/articles/10.3389/fpubh.2023.1072198/full, https://c19p.org/park3

50. Reis et al., The Association between Lifestyle Risk Factors and COVID-19 Hospitalization in a Healthcare Institution

546 patient exercise study: 41% lower hospitalization (p=0.18).
Retrospective 546 COVID+ patients in the USA, showing lower risk of hospitalization with higher frequency of strength training, without statistical significance.
Oct 2022, American J. Lifestyle Medicine, http://journals.sagepub.com/doi/10.1177/15598276221135541, https://c19p.org/reis6ex

51. Beydoun et al., Socio-demographic, lifestyle and health characteristics as predictors of self-reported Covid-19 history among older adults: 2006-2020 Health and Retirement Study

2,158 patient exercise study: 43% fewer cases (p=0.05).
Retrospective 2,830 people in the USA, showing lower risk of COVID-19 with a history of moderate/vigorous exercise.
Mar 2022, American J. Infection Control, https://www.sciencedirect.com/science/article/pii/S0196655322001018, https://c19p.org/beydoun

52. Lin et al., Predictors of incident SARS-CoV-2 infections in an international prospective cohort study

exercise study: 47% fewer cases (p=0.4).
Prospective survey analysis of 28,575 people in 99 countries, showing a lower risk of COVID-19 with a exercise, without statistical significance.
Sep 2021, BMJ Open, https://bmjopen.bmj.com/content/11/9/e052025, https://c19p.org/lin

53. Pitanga et al., Leisure Time Physical Activity and SARS-CoV-2 Infection among ELSA-Brasil Participants

4,476 patient exercise study: 33% fewer cases (p=0.05).
Retrospective 4,476 participants in Brazil, showing lower risk of COVID-19 cases with a history of physical activity, statistically significant only for those following specific practices to protect against COVID-19.
Oct 2022, Int. J. Environmental Research and Public Health, https://www.mdpi.com/1660-4601/19/21/14155, https://c19p.org/pitanga

54. Pływaczewska-Jakubowska et al., Lifestyle, course of COVID-19, and risk of Long-COVID in non-hospitalized patients

1,847 patient exercise study: 11% fewer moderate/severe cases (p=0.3) and 14% lower PASC (p=0.24).
Retrospective 1,847 COVID+ patients in Poland, showing no significant difference in moderate/severe cases with physical activity. Hospitalized patients were excluded.
Oct 2022, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2022.1036556/full, https://c19p.org/plywaczewska

55. Hegazy et al., Beneficial role of healthy eating Index-2015 score & physical activity on COVID-19 outcomes

73 patient exercise study: 54% fewer moderate/severe cases (p=0.01).
Retrospective 68 COVID-19 patients showing physical activity and healthier nutrition associated with lower COVID-19 severity.
Oct 2023, BMC Nutrition, https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-023-00727-8, https://c19p.org/hegazy

56. Mohsin et al., Lifestyle and Comorbidity-Related Risk Factors of Severe and Critical COVID-19 Infection: A Comparative Study Among Survived COVID-19 Patients in Bangladesh

1,500 patient exercise study: 19% lower severe cases (p=0.04).
Retrospective 1,500 COVID+ patients in Bangladesh, showing lower risk of severe cases with regular exercise in unadjusted results.
Sep 2021, Infection and Drug Resistance, https://www.dovepress.com/lifestyle-and-comorbidity-related-risk-factors-of-severe-and-critical--peer-reviewed-fulltext-article-IDR, https://c19p.org/mohsinex

57. Tavakol et al., Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study

188 patient exercise study: 69% lower severe cases (p=0.05).
Retrospective 206 patients in Iran, showing COVID-19 disease severity associated with lower physical activity.
Feb 2021, J. Public Health, http://link.springer.com/article/10.1007/s10389-020-01468-9/fulltext.html, https://c19p.org/tavakol

58. Paul et al., Health behaviours the month prior to COVID-19 infection and the development of self-reported long COVID and specific long COVID symptoms: A longitudinal analysis of 1,811 UK adults

1,811 patient exercise study: 38% lower PASC (p=0.16).
Retrospective 1,811 COVID-19 patients in the UK, showing lower risk of self-reported long COVID with 3+ hours of exercise per week in the month before infection, without statistical significance (p=0.16).
Apr 2022, medRxiv, https://www.medrxiv.org/content/10.1101/2022.04.12.22273792, https://c19p.org/paulex

59. Hamdan et al., Risk factors associated with hospitalization owing to COVID-19: a cross-sectional study in Palestine

300 patient exercise study: 16% lower hospitalization (p=0.53).
Retrospective 300 participants in Palestine, showing lower risk of hospitalization with physical activity, without statistical significance.
Dec 2021, J. Int. Medical Research, http://journals.sagepub.com/doi/10.1177/03000605211064405, https://c19p.org/hamdan

60. Bielik et al., A Possible Preventive Role of Physically Active Lifestyle during the SARS-CoV-2 Pandemic; Might Regular Cold-Water Swimming and Exercise Reduce the Symptom Severity of COVID-19?

1,140 patient exercise study: 30% fewer moderate/severe cases (p=0.1) and 9% more cases (p=0.36).
Retrospective 1,544 participants in Slovakia, showing a lower risk of more severe COVID-19 for physically active participants, without statistical significance.
Jul 2021, Int. J. Environmental Research and Public Health, https://www.mdpi.com/1660-4601/18/13/7158, https://c19p.org/bielik

61. Hegazy et al., Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity

200 patient exercise study: 46% fewer moderate/severe cases (p=0.11).
Analysis of 200 mild and moderate COVID-19 outpatients showing an association between higher ESSAP scores (measuring exercise, sugar and prebiotic consumption, sleep, and antibiotic use) and milder COVID-19 disease. Authors find increased risk with daily yogurt containing probiotics. Probiotic intake based on yogurt only may be inaccurate. Authors hypothesize that commercial yogurt products may not contain sufficient beneficial bacteria or may be contaminated. Other research shows that probiotic food labels are often misleading—of 26 probiotic foods tested, only 5 contained Bifidobacterium in sufficient concentration for exhibiting a therapeutic effect [Hazan]. For sleep, authors compare <8 hours and ≥8 hours, while sleep for less than or longer than a recommended range may indicate increased risk.
Jun 2021, British J. Nutrition, https://www.cambridge.org/core/product/identifier/S0007114521001926/type/journal_article, https://c19p.org/hegazy2

62. Holt et al., Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)

15,227 patient exercise study: 17% fewer cases (p=0.18).
Prospective survey-based study with 15,227 people in the UK, showing reduced risk of COVID-19 cases with lower impact physical activity. NCT04330599. COVIDENCE UK.
Mar 2021, Thorax, https://thorax.bmj.com/content/early/2021/11/02/thoraxjnl-2021-217487, https://c19p.org/holtex

63. Akbar et al., The Association between Lifestyle Factors and COVID-19: Findings from Qatar Biobank

10,000 patient exercise study: 7% fewer cases (p=0.4).
Retrospective 10,000 adults in Qatar, showing lower risk of COVID-19 cases with increased leisure time physical activity, without statistical significance. Authors do not analyze COVID-19 severity.
Nov 2023, Nutrients, https://www.mdpi.com/2072-6643/16/7/1037, https://c19p.org/akbar2ex

64. Almansour et al., The Influence of Physical Activity on COVID-19 Prevention Among Quarantined Individuals: A Case–Control Study

142 patient exercise study: 6% fewer cases (p=0.85).
Retrospective 142 patients in Saudi Arabia, showing no significant difference in cases with physical activity.
Feb 2022, J. Multidisciplinary Healthcare, https://www.dovepress.com/the-influence-of-physical-activity-on-covid-19-prevention-among-quaran-peer-reviewed-fulltext-article-JMDH, https://c19p.org/almansour

65. Saadeh et al., Associations of pre-pandemic levels of physical function and physical activity with COVID-19-like symptoms during the outbreak

587 patient exercise study: 9% fewer symptomatic cases (p=0.71).
Retrospective 904 patients in Sweden, showing higher risk of COVID-19-like symptoms with poor muscle strength. Risk was slightly higher for physical inactivity, without statistical significance.
Oct 2021, Aging Clinical and Experimental Research, https://link.springer.com/article/10.1007/s40520-021-02006-7/fulltext.html, https://c19p.org/saadeh

66. Brandenburg et al., Does Higher Self-Reported Cardiorespiratory Fitness Reduce the Odds of Hospitalization From COVID-19?

211 patient exercise study: 6% higher hospitalization (p=0.6) and 35% lower severe cases (p=0.3).
Retrospective 263 COVID+ patients, showing lower hospitalization with higher self-reported cardiorespiratory fitness, but no significant differences for physical activity. Participants in the study were healthier and more fit than the general population.
Jun 2021, J. Physical Activity and Health, https://journals.humankinetics.com/view/journals/jpah/18/7/article-p782.xml, https://c19p.org/brandenburg

67. Gilley et al., Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: Observational Study Using the Roadmap App and Fitbit Wearable Sensors

1,996 patient exercise study: 42% more cases (p=0.55).
Retrospective survey of 1,997 college students in the USA, showing no significant difference in COVID-19 cases with exercise in unadjusted results.
Feb 2022, JMIR Mental Health, https://mental.jmir.org/2022/2/e34645, https://c19p.org/gilley

68. Gao et al., The impact of individual lifestyle and status on the acquisition of COVID-19: A case—Control study

315 patient exercise study: 105% more cases (p=0.0003).
Case control study in China with 105 cases and 210 matched controls, showing COVID-19 cases associated with physical activity ≥5 times per week. Authors note that people may choose gyms for exercise in winter, leading to higher exposure risk.
Nov 2020, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241540, https://c19p.org/gao5

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