Among people with COVID-19, a lack of exercise is linked to more severe symptoms and a higher risk of death, a study published on Tuesday showed.
People physically inactive for at least two years before the pandemic were more likely to be hospitalized, to require intensive care and to die, researchers reported in the study, which covered nearly 50,000 people who were infected with the virus.
As a risk factor for serious COVID-19 disease, physical inactivity was surpassed only by advanced age and a history of organ transplant, said the study, which was published in the British Journal of Sports Medicine.
Compared with other modifiable risk factors such as smoking, obesity or hypertension, “physical inactivity was the strongest risk factor across all outcomes,” the authors said.
The pre-existing conditions most associated with severe COVID-19 infection are advanced age, being male, and having diabetes, obesity or cardiovascular disease.
Up to now, a sedentary lifestyle had not been included.
To see whether a lack of exercise increases the odds of severe infection, hospitalization, admission into an intensive care unit (ICU) and death, the researchers compared these outcomes in 48,440 adults in the US infected with COVID-19 between January and October last year.
The average age of those in the study was 47, and three out of five were women, the researchers said.
On average, their body-mass index was 31, just above the threshold for obesity.
About half had no underlying illnesses, such as diabetes, chronic lung conditions, heart or kidney disease, or cancer, the study said, adding that nearly 20 percent had one, and more than 30 percent had two or more.
All of the people in the study had reported their level of regular physical activity at least three times between March 2018 and March last year at outpatient clinics.
Fifteen percent described themselves as inactive (none to 10 minutes of physical activity per week), nearly 80 percent reported “some activity” (11 to 149 minutes per week), and 7 percent were consistently active in keeping with US health guidelines (150 minutes per week or more), the study showed.
After allowing for differences due to race, age and underlying medical conditions, sedentary COVID-19 patients were more than twice as likely to be admitted to hospital as those who were most active, the study showed.
They were also 73 percent more likely to require intensive care and 2.5 times more likely to die due to the infection, it said.
Compared with patients in the habit of doing occasional physical activity, couch potatoes were 20 percent more likely to be admitted to hospital, 10 percent more likely to require intensive care and 32 percent more likely to die, it said.
While the link is statistically strong, the study — which is observational, as opposed to a clinical trial — cannot be construed as direct evidence that a lack of exercise directly caused the difference in outcomes, the researchers said.
The findings also depend on self-reporting, which has a potential for bias, they said.
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