No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19

Author(s)

Pinto, Ana J. ^[1] ; Goessler, Karla F. ^[1] ; Fernandes, Alan L. ^[2] ; Murai, Igor H. ^[2] ; Sales, Lucas P. ^[2] ; Reis, Bruna Z. ^[2] ; Santos, Mayara Diniz ^[2] ; Roschel, Hamilton ^[1] ; Pereira, Rosa M. R. ^[2] ; Gualano, Bruno ^{[3, 1]}

Affiliation

^[1] Univ Sao Paulo, Sch Med FMUSP, Clin Hosp HCFMUSP, Appl Physiol & Nutr Res Grp, Sch Phys Educ & Sport, BR-01246903 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Sch Med FMUSP, Clin Hosp HCFMUSP, Rheumatol Div, BR-01246903 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Food Res Ctr, BR-05508080 Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: JOURNAL OF SPORT AND HEALTH SCIENCE; v. 10, n. 6, p. 690-696, DEC 2021.
• Web of Science Citations: 0

Abstract

Background: Regular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19. Methods: Hospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement. Results: The median hospital length of stay was 7.0 +/- 4.0 days, median +/- IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: b = -0.57 (95% confidence interval (95%CI): -1.80 to 0.65), p = 0.355; sport index: b = 0.43 (95%CI: -0.94 to 1.80), p = 0.536; leisure-time index: b = 1.18 (95%CI: -0.22 to 2.59), p = 0.099; and total activity index: b = 0.20 (95%CI: -0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050). Conclusion: Among hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease. (AU)

• FAPESP's process: 16/00006-7 - Evaluation of bone metabolism parameters by HR-pQCT and histomorphometry in rheumatoid arthritis and juvenile idiopathic arthritis patients: association with clinical and genetic variables
• Grantee: Eduardo Ferreira Borba Neto
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 20/05752-4 - Vitamin D supplementation in patients with COVID-19: randomized, double-blind and placebo controlled clinical trial
• Grantee: Rosa Maria Rodrigues Pereira
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/26937-4 - Studies on physical (in)activity in patients with rheumatoid arthritis: characterization, associations with disease and effects of breaking up sedentary time
• Grantee: Ana Jéssica Pinto
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 19/18039-7 - Reducing sedentary time in bariatric patients: a randomized controlled trial
• Grantee: Karla Fabiana Goessler
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 19/24782-4 - Comparison of mechanisms of bone loss in patients undergoing Roux-en-Y gastric bypass or sleeve gastrectomy
• Grantee: Igor Hisashi Murai
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study
• Grantee: Bruno Gualano
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 20/11102-2 - Vitamin D supplementation in patients with COVID-19: randomized, double-blind and placebo controlled clinical trial
• Grantee: Alan Lins Fernandes
• Support Opportunities: Scholarships in Brazil - Post-Doctoral