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Obesity, walking pace and risk of severe COVID-19 and mortality: analysis of UK Biobank

Yates et al., International Journal of Obesity, doi:10.1038/s41366-021-00771-z
Feb 2021  
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Mortality 45% Improvement Relative Risk Severe case 47% Exercise for COVID-19  Yates et al.  Prophylaxis Does physical activity reduce risk for COVID-19? Retrospective 194,031 patients in the United Kingdom Lower mortality (p=0.0015) and severe cases (p<0.0001) c19early.org Yates et al., Int. J. Obesity, February 2021 Favorsexercise Favorsinactivity 0 0.5 1 1.5 2+
Exercise for COVID-19
9th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 68 studies.
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5,100+ studies for 109 treatments. c19early.org
UK Biobank retrospective 412,596 people, showing severe COVID-19 and COVID-19 mortality inversely associated with self-reported walking pace.
risk of death, 45.3% lower, RR 0.55, p = 0.001, high activity levels 72 of 163,912 (0.0%), low activity levels 62 of 30,119 (0.2%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, multivariable.
risk of severe case, 46.7% lower, RR 0.53, p < 0.001, high activity levels 291 of 163,912 (0.2%), low activity levels 180 of 30,119 (0.6%), adjusted per study, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yates et al., 26 Feb 2021, retrospective, United Kingdom, peer-reviewed, 7 authors.
This PaperExerciseAll
Obesity, walking pace and risk of severe COVID-19 and mortality: analysis of UK Biobank
Thomas Yates, Cameron Razieh, Francesco Zaccardi, Alex V Rowlands, Samuel Seidu, Melanie J Davies, Kamlesh Khunti
International Journal of Obesity, doi:10.1038/s41366-021-00771-z
Obesity is an emerging risk factor for coronavirus disease-2019 (COVID-19). Simple measures of physical fitness, such as self-reported walking pace, may also be important risk markers. This analysis includes 412,596 UK Biobank participants with linked COVID-19 data (median age at linkage = 68 years, obese = 24%, median number of comorbidities = 1). As of August 24th 2020, there were 1001 cases of severe (in-hospital) disease and 336 COVID-19 deaths. Compared to normal weight individuals, the adjusted odds ratio (OR) of severe COVID-19 in overweight and obese individuals was 1.
Author contributions Concept and design: TY, CR, FZ, KK, Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: TY. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: TY. Statistical support: FZ. Compliance with ethical standards Conflict of interest Prof. Kamlesh Khunti is Chair of the UK SAGE subgroup on ethnicity and COVID-19. No other conflicts have been declared. Financial support This research was supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, the NIHR Applied Research Collaboration -East Midlands, and a grant from the UKRI-DHSC COVID-19 Rapid Response Rolling Call (MR/V020536/1). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
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Armstrong, Rudkin, Allen, Crook, Wilson et al., Dynamic linkage of COVID-19 test results between Public Health England's Second Generation Surveillance System and UK Biobank, Microbial Genomics Online
Bayer, Krüger, Kries, Toschke, Factors associated with tracking of BMI: a meta-regression analysis on BMI tracking, Obesity
Hewitt, Carter, Vilches-Moraga, Quinn, Braude et al., The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study, Lancet Public Health
Kruglikov, Scherer, The role of adipocytes and adipocytelike cells in the severity of COVID-19 infections, Obesity
Lighter, Phillips, Hochman, Sterling, Johnson et al., Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission, Clin Infect Dis
Maltese, Corsonello, Rosa, Soraci, Vitale et al., Frailty and COVID-19: a systematic scoping review, J Clin Med
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Zaccardi, Franks, Dudbridge, Davies, Khunti et al., Mortality risk comparing walking pace to handgrip strength and a healthy lifestyle: a UK Biobank study, Eur J Prev Cardiol
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No other conflicts have been declared.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflict of interest'}}, { 'value': 'This research was supported by the National Institute for Health Research ' '(NIHR) Leicester Biomedical Research Centre, the NIHR Applied Research ' 'Collaboration – East Midlands, and a grant from the UKRI-DHSC COVID-19 Rapid ' 'Response Rolling Call (MR/V020536/1). The funder had no role in the design and ' 'conduct of the study; collection, management, analysis, and interpretation of ' 'the data; preparation, review, or approval of the manuscript; and decision to ' 'submit the manuscript for publication.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Financial support'}}, { 'value': 'This content has been made available to all.', 'name': 'free', 'label': 'Free to read'}]}
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