Associations between physical activity prior to infection and COVID-19 disease severity and symptoms: results from the prospective Predi-COVID cohort study

Abstract

ObjectiveTo investigate if the physical activity (PA) prior to infection is associated with the severity of the disease in patients positively tested for COVID-19, as well as with the most common symptoms.DesignA cross-sectional study using baseline data from a prospective, hybrid cohort study (Predi-COVID) in Luxembourg. Data were collected from May 2020 to June 2021.SettingReal-life setting (at home) and hospitalised patients.ParticipantsAll volunteers aged >18 years with confirmed SARS-CoV-2 infection, as determined by reverse transcription-PCR, and having completed the PA questionnaire (n=452).Primary and secondary outcome measuresThe primary outcome was disease severity (asymptomatic, mild illness and moderate illness). The secondary outcomes were self-reported symptoms.ResultsFrom the 452 patients included, 216 (48%) were female, the median (IQR) age was 42 (31–51) years, 59 (13%) were classified as asymptomatic, 287 (63%) as mild illness and 106 (24%) as moderate illness. The most prevalent symptoms were fatigue (n=294; 65%), headache (n=281; 62%) and dry cough (n=241; 53%). After adjustment, the highest PA level was associated with a lower risk of moderate illness (OR 0.37; 95% CI 0.14 to 0.98, p=0.045), fatigue (OR 0.54; 95% CI 0.30 to 0.97, p=0.040), dry cough (OR 0.55; 95% CI 0.32 to 0.96, p=0.034) and chest pain (OR 0.32; 95% CI 0.14 to 0.77, p=0.010).ConclusionsPA before COVID-19 infection was associated with a reduced risk of moderate illness severity and a reduced risk of experiencing fatigue, dry cough and chest pain, suggesting that engaging in PA may be an effective approach to minimise the severity of COVID-19.Trial registration numberNCT04380987.

Association of physical activity and the risk of COVID-19 hospitalization: a dose–response meta-analysis

“…As for the continuous analysis, Malisoux et al observed an inverse dose–response association between PA and the risk of moderate COVID-19 illness, and increased PA was associated with a slightly lower risk of moderate illness (OR:0.99) [25]. In the present study, we observed a similar inverse dose–response association between PA and the risk of COVID-19 hospitalization.…”

“…However, the threshold is 30 Met-h/week according to the j-shaped association of PA and risk of moderate illness by Malisoux et al. [25]. Meanwhile, our meta-analysis findings are more robust and specific, and we observed increasing PA benefits for the inpatient burden due to COVID-19.…”

“…The steps for retrieval and inclusion are shown in Fig 1 . The characteristics of the literature are listed in Table 1. Among the 17 studies, 3 were from North America [10,19,20], 7 were from Asia [11,12,21,22,23,24,25], 6 were from Europe [26,27,28,29,30,31], and 1 was from Oceania [32]. The NOS was used to score the included studies.…”

Effects of physical activity on the severity of illness and mortality in COVID-19 patients: A systematic review and meta-analysis

“…In all, 1 618 680 subjects were adults. Five studies used cross-sectional designs ( Halabchi et al, 2021 ; Tavakol et al, 2021 ; Yuan et al, 2021 ; Tret’yakov et al, 2020 ; Latorre-Román et al, 2021 ), 12 had cohort study designs ( Sallis et al, 2021 ; Cho et al, 2021 ; Lee et al, 2021 ; Hamrouni et al, 2021 ; Ahmadi et al, 2021 ; Hamer et al, 2020 ; Maltagliati et al, 2021 ; Malisoux et al, 2022 ; Baynouna Alketbi et al, 2021 ; Rowlands et al, 2021 ; Salgado-Aranda et al, 2021 ; Pinto et al, 2021 ), and only one employed a case-control design ( Ekblom-Bak et al, 2021 ). We discovered four studies in the United Kingdom: Hamrouni et al, 2021 ; Ahmadi et al, 2021 ; Hamer et al, 2020 ; and Rowlands et al, 2021 .…”

“…Five studies used cross-sectional designs (Halabchi et al, 2021;Tavakol et al, 2021;Yuan et al, 2021;Tret'yakov et al, 2020;Latorre-Román et al, 2021), 12 had cohort study designs (Sallis et al, 2021;Cho et al, 2021;Lee et al, 2021;Hamrouni et al, 2021;Ahmadi et al, 2021;Hamer et al, 2020;Maltagliati et al, 2021;Malisoux et al, 2022;Baynouna Alketbi et al, 2021;Rowlands et al, 2021;Salgado-Aranda et al, 2021;Pinto et al, 2021), and only one employed a casecontrol design (Ekblom-Bak et al, 2021). We discovered four studies in the United Kingdom: Hamrouni et al, 2021;Ahmadi et al, 2021;Hamer et al, 2020;and Rowlands et al, 2021. Meanwhile, four studies were conducted in Europe: Latorre-Román et al, 2021;Salgado-Aranda et al, 2021;Ekblom-Bak et al, 2021;and Malisoux et al, 2022. In the meantime, six studies were carried out in Asia (Halabchi et al, 2021;Tavakol et al, 2021;Cho et al, 2021;Lee et al, 2021;Yuan et al, 2021;Baynouna AlKetbi et al, 2021). Besides that, three studies were discovered in the United States (Sallis et al, 2021), Brazil (Pinto et al, 2021), andRussia (Tret'yakov et al, 2020).…”