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

Abstract

Purpose: This systematic review and meta-analysis investigated the association between Physical activity (PA) before Coronavirus Disease 2019 (COVID-19) infection and the severity of illness and mortality in COVID-19 patients.Methods: A comprehensive search was undertaken to identify retrospective and nonrandomized controlled trial studies comparing the severity and mortality of COVID-19 infection among COVID-19 patients who had previously reported their participation in PA with those who had not. The databases searched were PubMed, Cochrane Library, Scopus, Science Direct, EMBASE, OPENGREY.EU, and ClinicalTrials.gov. The risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model was used for determining pairwise meta-analyses. The protocol was registered with PROSPERO (CRD42021262548).Results: Eighteen studies met the inclusion criteria (5 cross-sectional, 12 cohort, and 1 case-control studies). All 1 618 680 subjects were adults. PA significantly decreased the risk of death in COVID-19 patients (odds ratio [OR] 0.34; 95% confidence interval [CI], 0.19–0.62; p < 0.001) and the risk of severe outcomes (OR 0.60; 95% CI, 0.48–0.76; p < 0.001). Subgroup analysis showed that PA for ≥150 min/wk at a moderate intensity or ≥75 min/wk at a vigorous intensity reduced the risks of severity and mortality. Vigorous PA reduced mortality risk, whereas moderate to vigorous PA reduced the risks of severity and mortality.Conclusion: PA before infection might reduce severity and mortality in COVID-19 patients, especially PA ≥ 150 min/wk of moderate activity or ≥75 min/wk of vigorous activity. However, careful interpretations should be considered due to the difference in PA patterns and severity definitions among included studies. This finding implies that engaging in regular PA, even in different patterns, has beneficial effects on the severity and mortality of COVID-19 patients.

Associations between Coronavirus and Immune Response, Cardiorespiratory Fitness Rehabilitation and Physical Activity: A Brief Report

“…Since this is a new disease, research is needed to better understand the acute and chronic effects, especially on the cardiorespiratory system, including lung functions. There are some studies evaluating post mortem pulmonary anatomy in patients with and without COVID-19 [1][2][3]5].…”

Impacto de la actividad física en la evolución de la enfermedad de pacientes con COVID-19 manejados de forma ambulatoria

“…De acuerdo con un análisis de subgrupos, la actividad física de hasta 150 minutos por semana a un nivel moderado o hasta 75 minutos por semana a una intensidad vigorosa disminuyó la probabilidad tanto de gravedad como de muerte. 7,9 Por otro lado, estos hallazgos se sustentan en otra revisión sistemática de 2022, esta vez de Rahmati M y su equipo, donde se concluye que los pacientes con COVID-19 que acostumbraban a realizar AF de alta resistencia experimentaron una tasa más baja de hospitalización y mortalidad. 10 Sin embargo, todavía hay mucha incertidumbre en cuanto a los niveles de AF y la predisposición a COVID-19.…”

The dose–response relationship between physical activity and the risk of death from pneumonia in middle-aged and older adults: A meta-analysis

“…A previous systematic review and meta-analysis by Rahmati et al [5] reported that increased PA levels reduced hospitalization rates, intensive care unit (ICU) admissions, and mortality in patients with COVID-19 across all study types. A meta-analysis by Sittichai et al [6 ] also showed that regular PA reduced the severity and risk of death in COVID-19 patients, particularly ≥150 min/wk of moderate activity or ≥75 min/wk of vigorous activity. There are many reviews and meta-analyses of studies on PA and mortality risk, mainly focusing on all-cause mortality and cancer mortality.…”