Daniel E. Hogan, Beth W. Glace, Ian J. Kremenic.
Northwell Health, New York, NY. (Sponsor: Malachy McHugh, FACSM)
PURPOSE: Physical activity’s role in prevention of excess body mass may be important to recovery after COVID-19. Independent of exercise’s effect on body mass, moderate habitual physical activity (PA) stimulates the immune system and attenuates symptoms in viral infections. Thus, habitual PA may lessen COVID-19 severity. We examined the role of pre-COVID-19 (pre-dx) PA in hospitalization.
METHODS: Invitations were emailed to 21,933 adults who were SARS-CoV-2 positive in a large healthcare system between March, 2020 and February, 2021. Participants (n=757) completed a medical history and a Physical Activity History questionnaire regarding PA during the 3-months pre-dx. PA was categorized as moderate, heavy and as total PA. Logistic regressions were used to assess if PA pre-dx was protective against severe disease, defined as hospitalization. Since BMI and age are likely to affect activity levels, these were included as covariates, as were any comorbidities that were significantly different (P < 0.05) between those hospitalized or not.
RESULTS: Thirty-one percent of participants had required hospitalization, for an average of just over 2 weeks. Total pre-dx PA reduced odds of hospitalization by 0.7% (p = 0.016) for each one-point increase in PA score. Each additional year of age and unit increase in BMI increased the odds of hospitalization by 3.3% (p<0.001) and 3.1% (p=0.023), respectively. Diabetes was the only comorbidity analyzed to significantly increase odds of hospitalization in the logistic regression, approximately doubling the odds of hospitalization (p=0.004). Heavy (p=0.018), but not moderate (p=0.093) PA reduced odds of hospitalization.
CONCLUSION: Prior habitual PA, especially heavy PA, was protective against hospitalization due to COVID-19. For example, engaging in an hour of lap swimming over the course of one month would provide the same protective effect against hospitalization as 3 kg of weight loss for the average subject in our cohort. Habitual PA is a strong predictor of disease severity, even after accounting for BMI and age. A relatively small and easily achievable amount of PA may be an effective method of reducing the risk of hospitalization due to COVID-19.