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0 0.5 1 1.5 2+ Severe case 69% Improvement Relative Risk Exercise for COVID-19  Tavakol et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 188 patients in Iran (March - April 2020) Lower severe cases with higher activity levels (not stat. sig., p=0.05) Tavakol et al., J. Public Health, February 2021 Favors exercise Favors inactivity

Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study

Tavakol et al., Journal of Public Health, doi:10.1007/s10389-020-01468-9
Feb 2021  
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Retrospective 206 patients in Iran, showing COVID-19 disease severity associated with lower physical activity.
risk of severe case, 68.5% lower, RR 0.31, p = 0.05, high activity levels 3 of 64 (4.7%), low activity levels 19 of 124 (15.3%), NNT 9.4, adjusted per study, odds ratio converted to relative risk, moderate to high activity versus low activity, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tavakol et al., 4 Feb 2021, retrospective, Iran, peer-reviewed, 9 authors, study period 20 March, 2020 - 24 April, 2020.
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Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study
Zahra Tavakol, Shima Ghannadi, Mastaneh Rajabian Tabesh, Farzin Halabchi, Pardis Noormohammadpour, Samaneh Akbarpour, Zahra Alizadeh, Malihe Hassan Nezhad, Sahar Karimpour Reyhan
Journal of Public Health, doi:10.1007/s10389-020-01468-9
Aim The COVID-19 pandemic is a global health emergency, and therefore the prevention and treatment of this disease is an important priority of world health. In the present study, some risk factors, including unhealthy nutrition, obesity, and physical inactivity, were assessed in patients infected with SARS-CoV-2, and their effects on the severity and duration of disease were evaluated. Subject and methods The present study was a cross-sectional study. Data was collected from all patients who visited the respiratory emergency department from March 20, 2020 to April 24, 2020 in the University Hospital. The outcome measures were body mass index, diet quality that was evaluated with a 16-item food intake questionnaire, and physical activity level that was assessed by the global physical activity questionnaire. Results Two hundred and six patients' data was analyzed. The results investigated that patients with lower levels of physical activity or lower MET.min/week were affected by a more severe form of the disease (p = 0.05 and p = 0.03, respectively). We found that patients with a healthier dietary pattern were affected by lower severity of illness (p < 0.05). Conclusion It seems that increasing levels of physical activity may partly reduce the severity of COVID-19 disease. Some dietary patterns such as increasing fruit and poultry consumption as well as drinking less tea were correlated significantly with a less severe form of the disease. The results did not confirm previous concerns regarding a potentially harmful effect of smoking on the severity or duration of symptoms.
Author's contribution All authors contributed to the study conception and design. Material preparation was performed by Zahra Tavakol, Mastaneh Rajabian Tabesh, Malihe Hassan Nezhad, and Sahar Karimpour Reyhan. Data collection and analysis were performed by Zahra Alizadeh, Pardis Noormohammadpour, Samaneh Akbarpour, and Farzin Halabchi. The first draft of the manuscript was written by Shima Ghannadi and Zahra Alizadeh, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Compliance with ethical standards Conflict of interest The authors declare that they have no conflict of interest. Ethics approval This study was approved by the ethical committee at Tehran University of Medical Sciences, Tehran, Iran (IRCTID: IR.TUMS.VCR.REC.1399.151). Informed consent Informed consent was obtained from all individual participants included in the study.
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