Equipo Nizkor - Physical activity cuts risk of poor COVID outcomes, study finds.

Adults who were more physically active before testing positive for COVID-19 were at lower risk for hospitalization, clinical deterioration, and death by 90 days, finds a study published yesterday in the American Journal of Preventive Medicine.

Kaiser Permanente Southern California researchers led the study of the electronic health records of 194,191 patients diagnosed as having COVID-19 from Jan 1, 2020, to May 31, 2021, before vaccines were widely available.

Of all patients, 61.3% were Hispanic, 21.4% were White, 7.3% were Black, 6.8% were Asian or Pacific Islander, over half were obese, 21.8% had high blood pressure, 9.2% had cardiovascular disease, and 2% were vaccinated against COVID-19.

Participants completed at least three Exercise Vital Sign reports (average, 6.4 reports) on their physical activity level before they tested positive. They were considered always inactive (10 minutes per week or less), mostly inactive (0 to 60 minutes/week), somewhat active (60 to 150 minutes/week), consistently active (more than 150 minutes/week), or always active (more than 300 minutes/week).

Exercise as pandemic control strategy

A total of 15.0% of participants were categorized as always inactive, 43.0% were mostly inactive, 21.9% were somewhat active, 14.3% were consistently active, and 5.8% were always active. Patients who were always active were most often younger, men, never-smokers with a lower body mass index (BMI). Participants who were mostly or always inactive had higher odds of being Hispanic or Black and having cardiovascular disease, high blood pressure, and obesity.

A total of 6.3% of participants were hospitalized, 3.1% experienced clinical deterioration, and 2.8% died by 90 days. Dose-response effects were robust except in those younger than 40, with patients in the somewhat active group having a higher likelihood of hospitalization (odds ratio [OR], 1.43), deterioration (OR, 1.83), and death (OR, 1.92) than those in the consistently or always-active groups.

While Black, Asian, and Hispanic patients were at greater risk for adverse outcomes than their White peers, the results were mostly consistent across sex, race, age, and BMI classifications and among those who had cardiovascular disease or high blood pressure, conditions usually associated with severe COVID-19 outcomes.

"There were protective associations of physical activity for adverse COVID-19 outcomes across demographic and clinical characteristics," the study authors wrote. "Public health leaders should add physical activity to pandemic control strategies."

'The more exercise, the better'

The researchers said that the poorer outcomes among Black, Hispanic, and Asian participants probably are the result of social inequities stemming from historical disenfranchisement and discrimination.

"It is more difficult to be physically active for people of low SES [socioeconomic status] (who are disproportionately non-White), who have fewer financial resources, who are more likely to live in unsafe neighborhoods, and who may have limited time for physical activity owing to multiple jobs," they wrote.

All adults should be urged to become more physically active to mitigate the physical effects of the COVID-19 pandemic, they added.

In a Kaiser Permanente news release, lead author Deborah Rohm Young, PhD, said every little bit of physical activity counts. "The more exercise the better, no matter a person's race, ethnicity, age, sex, or chronic conditions," she said.

Senior author Robert Sallis, MD, said physicians should emphasize the benefits of vaccination and exercise when talking with patients. "This is a powerful opportunity to develop stronger policies supporting physical activity as a pandemic-mitigation strategy," he said. "Our study provides new evidence to inform appropriate interventions across demographic groups."

15Dec22

Physical activity cuts risk of poor COVID outcomes, study finds

[Source: By Mary Van Beusekom, CIDRAP News, University of Minnesota, 15Dec22]

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