Influence of Baseline Physical Activity as a Modifying Factor on COVID-19 Mortality: A Single-Center, Retrospective Study
Ricardo Salgado-Aranda, Nicasio Pérez-Castellano, Ivan Núñez-Gil, A Josué Orozco, Norberto Torres-Esquivel, Jesús Flores-Soler, Ahmed Chamaisse-Akari, Angela Mclnerney, Carlos Vergara-Uzcategui, Lin Wang, Juan J González-Ferrer, David Filgueiras-Rama, Victoria Cañadas-Godoy, Carlos Macaya-Miguel, Julián Pérez-Villacastín
Infectious Diseases and Therapy, doi:10.1007/s40121-021-00418-6
Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes a severe respiratory disease with a 3% global mortality. In the absence of effective treatment, controlling of risk factors that predispose to severe disease is essential to reduce coronavirus disease 2019 (COVID-19) mortality. Large observational studies suggest that exercise can reduce the risk of all-cause and disease-specific mortality. The aim of this study was to analyze the influence of the baseline physical activity level on COVID-19 mortality Methods: This is a retrospective cohort study that included patients between 18 and 70 years old, diagnosed with COVID-19 and hospitalized in our center between February 15 and April 15, 2020. After discharge all the patients included in the study were contacted by telephone. Baseline physical activity level was estimated using the Rapid Assessment of Physical Activity Scale questionnaire and patients were divided into two groups for comparison: sedentary patients (group 1) and active patients (group 2). Results: During the study period 552 patients were admitted to our hospital and met the inclusion criteria. Global mortality in group 1 was significantly higher than in group 2 (13.8% vs 1.8%; p \ 0.001). Patients with a sedentary lifestyle had increased COVID-19 mortality independently of other risk factors previously described (hazard ratio 5.91 (1.80-19.41); p = 0.003). Conclusion: A baseline sedentary lifestyle increases the mortality of hospitalized patients with COVID-19. This finding may be of great utility in the prevention of severe COVID-19 disease.
Authorship. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Disclosures. Ricardo Salgado-Aranda, Nicasio Pe ´rez-Castellano, Ivan Nu ´n ˜ez-Gil, A. Josue Órozco, Norberto Torres-Esquivel, Jesu ´s Flores-Soler, Ahmed Chamaisse-Akari, Angela Mclnerney, Carlos Vergara-Uzcategui, Lin Wang, Juan Jose ´Gonza ´lez-Ferrer, David Filgueiras-Rama, Victoria Can ˜adas-Godoy, Carlos Macaya-Miguel, and Julia ´n Pe ´rez-Villacastı ´n declare that they have no conflicts of interest associated with this manuscript. Compliance with Ethics Guidelines. This study has received approval from Clinical Research Ethics Committee of Clinico San Carlos Hospital under registry number ''20/374-E_COVID'' on 11 May 2020; and it was performed in accordance with the Helsinki Declaration of 1964, and its later amendments. All subjects provided informed consent to participate in the study and their consent for publication. Data Availability. The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. Open Access. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you..
References
Aggio, Papachristou, Papacosta, Association between 20-year trajectories of non-occupational physical activity from midlife to old age and biomarkers of cardiovascular disease: a 20-year longitudinal study of British men, Am J Epidemiol
Chow, Fleming-Dutra, Gierke, Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019-United States, February 12, MMWR Morb Mortal Wkly Rep
Hamer, Sabia, Batty, Physical activity and inflammatory markers over 10 years: follow-up in men and women from the Whitehall II cohort study, Circulation
Henschke, Infections in the elderly, Med J Aust
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Katzmarzyk, Church, Craig, Bouchard, Sitting time and mortality from all causes, cardiovascular disease, and cancer, Med Sci Sports Exerc
Kodama, Saito, Tanaka, Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis, JAMA
Kushi, Doyle, Mccullough, American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity, CA Cancer J Clin
Kyu, Bachman, Alexander, Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study, BMJ
Li, Moore, Vasilieva, Angiotensinconverting enzyme 2 is a functional receptor for the SARS coronavirus, Nature
Li, Yang, Zhao, Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China, Clin Res Cardiol
Liang, Guan, Chen, Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China, Lancet Oncol
Lighter, Phillips, Hochman, Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission, Clin Infect Dis
Lobelo, Young, Routine assessment and promotion of physical activity in healthcare settings: a scientific statement from the American Heart Association, Circulation
Michaud, Giovannucci, Willett, Colditz, Stampfer et al., Physical activity, obesity, height, and the risk of pancreatic cancer, J Am Med Assoc
Moreira, Wohlwend, Wisløff, Exercise and cardiac health: physiological and molecular insights, Nat Metab
Nieman, Henson, Austin, Upper respiratory tract infection is reduced in physically fit and active adults, Br J Sports Med
Nieman, Wentz, The compelling link between physical activity and the body's defense system, J Sport Health Sci
Nyberg, Singh-Manoux, Pentti, Association of healthy lifestyle with years lived without major chronic diseases, JAMA Intern Med
Parsons, Sartini, Welsh, Physical activity, sedentary behavior, and inflammatory and hemostatic markers in men, Med Sci Sports Exerc
Petrilli, Jones, Yang, Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study, BMJ
Shanely, Nieman, Henson, Knab, Inflammation and oxidative stress are lower in physically fit and active adults, Scand J Med Sci Sports
Shiroma, Lee, Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity, Circulation
South, Tomlinson, Edmonston, Hiremath, Sparks, Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic, Nat Rev Nephrol
Tartof, Qian, Hong, Obesity and mortality among patients diagnosed with COVID-19: results from an integrated health care organization, Ann Intern Med
Topolski, Logerfo, Patrick, Williams, Walwick et al., The Rapid Assessment of Physical Activity (RAPA) among older adults, Prev Chronic Dis
Warren, Barry, Hooker, Sui, Church et al., Sedentary behaviors increase risk of cardiovascular disease mortality in men, Med Sci Sports Exerc
Wedell-Neergaard, Krogh-Madsen, Petersen, Cardiorespiratory fitness and the metabolic syndrome: roles of inflammation and abdominal obesity, PLoS One
Williamson, Walker, Bhaskaran, Factors associated with COVID-19-related death using OpenSAFELY, Nature
Wilmot, Edwardson, Achana, Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis, Diabetologia
Zheng, Ma, Zhang, Xie, COVID-19 and the cardiovascular system, Nat Rev Cardiol
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
