Volume 32, Issue 5 e2349
REVIEW

Baseline physical activity is associated with reduced mortality and disease outcomes in COVID-19: A systematic review and meta-analysis

Masoud Rahmati

Masoud Rahmati

Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran

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Mahdieh Molanouri Shamsi

Mahdieh Molanouri Shamsi

Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran

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Kayvan Khoramipour

Kayvan Khoramipour

Department of Physiology and Pharmacology, Neuroscience Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

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Fatemeh Malakoutinia

Fatemeh Malakoutinia

Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran

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Wongi Woo

Wongi Woo

Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

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Seoyeon Park

Seoyeon Park

Yonsei University College of Medicine, Seoul, Korea

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Dong Keon Yon

Dong Keon Yon

Department of Pediatrics, Kyung HeeUniversity Hospital, Kyung HeeUniversity College of Medicine, Seoul, Korea

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Seung Won Lee

Seung Won Lee

Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea

Sungkyunkwan University School of Medicine, Suwon, Korea

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Jae Il Shin

Corresponding Author

Jae Il Shin

Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea

Correspondence

Jae Il Shin, Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Korea.

Email: [email protected]

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Lee Smith

Lee Smith

Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK

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First published: 13 April 2022
Citations: 20

Abstract

Among coronavirus disease 2019 (COVID-19) patients, physically active individuals may be at lower risk of fatal outcomes. However, to date, no meta-analysis has been carried out to investigate the relationship between physical activity (PA) and fatal outcomes in patients with COVID-19. Therefore, this meta-analysis aims to explore the hospitalisation, intensive care unit (ICU) admissions, and mortality rates of COVID-19 patients with a history of PA participation before the onset of the pandemic, and to evaluate the reliability of the evidence. A systematic search of MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and medRxiv was conducted for articles published up to January 2022. A random-effects meta-analysis was performed to compare disease severity and mortality rates of COVID-19 patients in physically active and inactive cases. Twelve studies involving 1,256,609 patients (991,268 physically active and 265,341 inactive cases) with COVID-19, were included in the pooled analysis. The overall meta-analysis compared with inactive controls showed significant associations between PA with reduction in COVID-19 hospitalisation (risk ratio (RR) = 0.58, 95% confidence intervals (CI) 0.46–0.73, P = 0.001), ICU admissions (RR = 0.65, 95% CI 0.52–0.81, P = 0.001) and mortality (RR = 0.47, 95% CI 0.38–0.59, P = 0.001). The protective effect of PA on COVID-19 hospitalisation and mortality could be attributable to the types of exercise such as resistance exercise (RR = 0.27, 95% CI 0.15–0.49, P = 0.001) and endurance exercise (RR = 0.41, 95% CI 0.23–0.74, P = 0.003), respectively. Physical activity is associated with decreased hospitalisation, ICU admissions, and mortality rates of patients with COVID-19. Moreover, COVID-19 patients with a history of resistance and endurance exercises experience a lower rate of hospitalisation and mortality, respectively. Further studies are warranted to determine the biological mechanisms underlying these findings.

CONFLICT OF INTEREST

The authors declare that there are no conflict of interests.

DATA AVAILABILITY STATEMENT

All data relevant to the study are included in the article or uploaded as supplementary information. The data are available by accessing the published studies listed in Table 1.

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