Exercise can prevent severe COVID outcomes, says ACU study

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A study of nearly 50,000 patients found that engaging in exercise was the biggest factor, apart from age and a history of organ transplant. PHOTO: Unsplash

Physically inactive patients more vulnerable to virus

Physically inactive COVID-19 patients were two-and-a-half times more likely to die from the infection than those who consistently met exercise guidelines, according to a major international study into the deadly disease.

One of the study’s authors, Australian Catholic University Professor Jim Sallis, has called for a heightened focus on physical activity as a pandemic control in this country where meeting vaccine rollout targets has become increasingly difficult. Professor Sallis’s plea to public health agencies follows the publication of the research this month in the British Journal of Sports Medicine.

The study of 48,440 patients with COVID-19 who were consistently inactive during the two years preceding the pandemic found they were more likely to be admitted to hospital, to require intensive care, and to die than were patients who had consistently met physical activity guidelines.

“…regular physical activity may be the single most important action individuals can take to prevent severe COVID-19 and its complications, including death” -Professor Sallis, ACU

As a risk factor for severe disease, physical inactivity was trumped only by advanced age and a history of organ transplant.

“These findings should be a wake-up call for clinical medicine and public health practice,” said Professor Sallis, a Professorial Fellow at ACU’s Mary MacKillop Institute for Health Research. “Getting vaccinated and following public health safety guidelines such as social distancing and mask use remain critical for reducing risk of transmission.

“But we recommend public health authorities inform all populations that engaging in regular physical activity may be the single most important action individuals can take to prevent severe COVID-19 and its complications, including death. We also recommend clinicians encourage their patients to be physically active, especially those who have other risk factors.”

The research was funded and conducted by US health care provider Kaiser Permanente to explore potential risk factors on the severity of the infection, including hospital admission rates, need for intensive care, and death in adults with confirmed COVID-19 infection between January and October 2020.

A nurse speaks with patients at the door of a new COVID-19 clinic opening at Mount Barker Hospital in Adelaide, Australia, March 17, 2020. PHOTO: CNS/Kelly Barnes, AAP Image via Reuters

There was already evidence that being active improves immune system functioning, reduces inflammation, and both prevents and treats chronic conditions like heart disease, cancer, and diabetes that increase risk of severe COVID-19. However, this is the first direct evidence that physical activity has direct benefits specific to COVID-19.

Study participants reported their level of regular physical activity at least three times between March 2018 and March 2020 at outpatient clinics. This was classified as consistently inactive (0–10 minutes per week); some activity (11–149 mins/week); or consistently meeting (WHO) physical activity guidelines (150+ mins/week).

Two per cent of the patients died, three per cent required intensive care treatment and nine per cent were hospitalised. However consistently meeting physical activity guidelines was strongly associated with a reduced risk of these outcomes.

After taking account of potentially influential factors, such as race, age, and underlying conditions, patients with COVID-19 who were consistently physically inactive were more than twice as likely to be admitted to hospital as patients who clocked up 150+ minutes of physical activity every week. They were also 73 per cent more likely to require intensive care, and 2.5 times more likely to die of the infection.

“It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by The Centers for Disease Control except for age and a history of organ transplant,” Professor Sallis said.

The patients’ average age was 47 and nearly two thirds were women (62 per cent). Their average BMI was 31, which is classified as overweight.

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