Baseline physical activity is associated with reduced mortality and disease outcomes in COVID-19: A systematic review and meta-analysis
Masoud Rahmati
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Search for more papers by this authorMahdieh Molanouri Shamsi
Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
Search for more papers by this authorKayvan Khoramipour
Department of Physiology and Pharmacology, Neuroscience Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Search for more papers by this authorFatemeh Malakoutinia
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Search for more papers by this authorWongi Woo
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSeoyeon Park
Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorDong Keon Yon
Department of Pediatrics, Kyung HeeUniversity Hospital, Kyung HeeUniversity College of Medicine, Seoul, Korea
Search for more papers by this authorSeung Won Lee
Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
Sungkyunkwan University School of Medicine, Suwon, Korea
Search for more papers by this authorCorresponding 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]
Search for more papers by this authorLee Smith
Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Search for more papers by this authorMasoud Rahmati
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Search for more papers by this authorMahdieh Molanouri Shamsi
Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
Search for more papers by this authorKayvan Khoramipour
Department of Physiology and Pharmacology, Neuroscience Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Search for more papers by this authorFatemeh Malakoutinia
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Search for more papers by this authorWongi Woo
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSeoyeon Park
Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorDong Keon Yon
Department of Pediatrics, Kyung HeeUniversity Hospital, Kyung HeeUniversity College of Medicine, Seoul, Korea
Search for more papers by this authorSeung Won Lee
Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
Sungkyunkwan University School of Medicine, Suwon, Korea
Search for more papers by this authorCorresponding 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]
Search for more papers by this authorLee Smith
Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Search for more papers by this authorAbstract
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.
Open Research
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.
Supporting Information
Filename | Description |
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rmv2349-sup-0001-suppl-data.docx33.8 KB | Supporting Information S1 |
rmv2349-sup-0002-suppl-data.docx12.8 KB | Supporting Information S2 |
rmv2349-sup-0003-table_s1.docx21.6 KB | Table S1 |
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