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Background The rapid outbreak of coronavirus disease 2019 (COVID-19) is a major health concern, in response to which widespread risk factor research is being carried out. Objective To discover how physical activity and lifestyle affect the epidemic as well as the disease severity and prognosis of COVID-19 patients. Methods This multicenter, retrospective cohort study included 203 adults infected with COVID-19 and 228 uninfected adults in three Chinese provinces, with 164 (80.7%) of the infected participants and 188 (82.5%) of the uninfected participants answering a doctor-administered telephone questionnaire on lifestyle. The binary logistic regression model and the ordinal logit model were used to observe relevance. Results Comparing sick and non-sick patients, we found that irregular exercise ( P =0.004), sedentary lifestyle ( P =0.010), and overexertion ( P <0.001) may be associated with the susceptibility to COVID-19. In symptomatic patients, using the recommended status as a reference, risk of severe infection increased with decreased sleep status, being 6.729 (95% CI=2.138–21.181) times higher for potentially appropriate sleep ( P =0.001) and peaking at 8.612 (95% CI=1.913–38.760) times higher for lack of sleep ( P =0.005). Reduction in average daily sleep time significantly increased the likely severity ( P =0.002). Discussion Through further examination of damage of external lung organs, we found that lack of sleep affected not only disease severity but also prognosis. Based on these findings, the public should prioritize a healthy lifestyle and get adequate sleep in response to the outbreak. The study of life habits may bring new ideas for the prevention and treatment of COVID-19.

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A typical case of a girl >25 kg who received an initial dose of 5 mg twice daily of Janus kinase inhibitor (JAKi) but required the maximum dose of 7.5 mg twice daily. She received this dose for 6 months, and the dose was gradually tapered. In the meantime, glucocorticoids were also tapered, and the patient showed an increased growth rate. (A) The typical skin lesions before treatment with JAKi. (B) Those lesions had mostly disappeared after treatment.