Association of physical activity and the risk of COVID-19 hospitalization: a dose–response meta-analysis
Dan Li, Shengzhen Jin, Songtao Lu
doi:10.1101/2022.06.22.22276789
Background Many people have experienced a high burden due to the spread of the coronavirus disease (COVID-19) and its serious consequences for health and everyday life. Prior studies have reported that physical activity (PA) may lower the risk of COVID-19 hospitalization. The present meta-analysis (PROSPERO registration number: CRD42022339672) explored the doseresponse relationship between PA and the risk of COVID-19 hospitalization.
Methods Epidemiological observational studies on the relationship between PA and the risk of COVID-19 hospitalization were included. Categorical dose-response relationships between PA and the risk of COVID-19 hospitalization were assessed using random effect models. Robust error meta-regression models assessed the continuous relationship between PA (metabolic equivalent [MET]-h/week) and COVID-19 hospitalization risk across studies reporting quantitative PA estimates.
Results Seventeen observational studies (cohort\case-control\cross-section) met the criteria for inclusion in the meta-analysis. Categorical dose-relationship analysis showed a 40% (risk ratio (RR) 0.60, 95% confidence intervals (CI): 0.48-0.71) reduction in the risk of COVID-19 hospitalization compared to the lowest dose of PA. The results of the continuous dose-response . NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
/ 14 relationship showed a non-linear inverse relationship (Pnon-linearity < 0.05) between PA and the risk of COVID-19 hospitalization. When total PA was less than or greater than 10 Met-h/week, an increase of 4 Met-h/week was associated with a 14% (RR = 0.83, 95%CI: 0.85-0.87) and 11% (RR = 0.89, 95%CI: 0.87-0.90) reduction in the risk of COVID-19 hospitalization, respectively.
Conclusions There was an inverse non-linear dose-response relationship between PA level and the risk of COVID-19 hospitalization. Doses of the guideline-recommended minimum PA levels by WTO may be required for more substantial reductions in the COVID-19 hospitalization risk.
Author Contributions
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