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1.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320613

ABSTRACT

Background: Of the studies examining risk factors for severe COVID-19 outcomes, none have examined inadequate physical activity (PA). We compared hospitalization rates, intensive care unit (ICU) admissions and mortality for COVID-19 patients who were inactive, inconsistently active, or regularly physically active.Methods: This retrospective observational study was done at Kaiser Permanente in Southern California. We identified 48,440 adult patients with a COVID-19 diagnosis from January 1, 2020 to October 21, 2020, with at least two Exercise Vital Sign (EVS) measurements from March 19, 2018 to March 18, 2020. We linked each patient’s self-reported PA category (consistently inactive = 0-10 min/week, inconsistently active = 11-149 min/week, consistently active = 150+ min/week) to risk of hospitalization, ICU admission and death after COVID-19 diagnosis. We conducted multivariate logistic regression controlling for known risk factors to assess whether regular PA was associated with COIVD -19 outcomes.Findings: COVID-19 patients who were consistently inactive were more likely to be hospitalized (OR 2.26;95% CI: 1.81, 2.83), admitted to the ICU (OR= 1.73;95% CI: 1.18, 2.55) and die (OR 2.49;95% CI: 1.33, 4.67) than patients who were consistently active. Patients who were inconsistently active were more likely to be hospitalized (OR 1.89;95% CI: 1.53, 2.33), admitted to the ICU (OR 1.58;95% CI: 1.10, 2.27) and die (OR 1.88;95% CI: 1.02, 3.47) compared to those who were consistently active. Patients who were consistently inactive had a greater risk of being hospitalized (OR= 1.20;95% CI: 1.10, 1.32), admitted to the ICU (OR 1.10;95% CI: 0.93, 1.29) and death (OR 1.32;95% CI: 1.09, 1.60) than patients who were inconsistently active.Interpretations: Regular PA is a strong, modifiable independent risk factor for protecting against severe COVID-19 outcomes. Pandemic control measures should prioritize supporting regular PA to lessen COVID-19 morbidity and mortality.Funding Statement: This study was in part supported through funding from the Kaiser Permanente Community Benefits Funds.Declaration of Interests: The authors report no conflict of interest except Dr. Tartof reports grants from Roche/Genentech, Inc., during the conduct of the study.Ethics Approval Statement: The study was approved by the KPSC Institutional Review Board.

2.
Prev Med ; 154: 106863, 2022 01.
Article in English | MEDLINE | ID: covidwho-1510415

ABSTRACT

Stressors associated with COVID-19 pandemic stay-at-home orders are associated with increased depression and anxiety and decreased physical activity. Given that physical activity and time spent outdoors in nature are associated with improved mental health, we examined the longitudinal association of these variables during the pandemic. Over 20,000 adults who participated in the U.S. Kaiser Permanente Research Bank, did not report COVID-19 symptoms, and responded to an online baseline and 3 follow-up surveys over approximately 3 months formed the cohort. Physical activity was assessed from a modified survey, time spent outdoors was assessed from one question, and anxiety and depression scores were assessed from validated instruments. Almost 60% were women, 82.8% were non-Hispanic white, and more than 93% of respondents were over the age of 50. Less in-person contact with friends and visiting crowded places was highly prevalent (>80%) initially and decreased somewhat (>70%). Participants in the lowest physical activity category (no physical activity) had the highest depression and anxiety scores compared to each successive physical activity category (p < 0.001). Spending less time outdoors was associated with higher depression and anxiety scores. This effect was greater for participants in the younger age categories compared with older age categories. The effect of less time spent outdoors on anxiety (p = 0.012) and depression (p < 0.001) scores was smaller for males than females. Results suggest that physical activity and time outdoors is associated with better mental health. People should be encouraged to continue physical activity participation during public health emergencies.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , Depression/epidemiology , Exercise , Female , Humans , Male , Pandemics , Physical Distancing , Quarantine , SARS-CoV-2 , United States
3.
Br J Sports Med ; 55(19): 1099-1105, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1325094

ABSTRACT

OBJECTIVES: To compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines. METHODS: We identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient's self-reported physical activity category (consistently inactive=0-10 min/week, some activity=11-149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes. RESULTS: Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity. CONCLUSIONS: Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Hospitalization/statistics & numerical data , Intensive Care Units , Sedentary Behavior , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , SARS-CoV-2
5.
Br J Sports Med ; 55(19): 1099-1105, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1183311

ABSTRACT

OBJECTIVES: To compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines. METHODS: We identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient's self-reported physical activity category (consistently inactive=0-10 min/week, some activity=11-149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes. RESULTS: Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity. CONCLUSIONS: Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Hospitalization/statistics & numerical data , Intensive Care Units , Sedentary Behavior , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , SARS-CoV-2
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