Physical activity may reduce risk of poor COVID-19 outcomes 進行體育鍛煉可以減少COVID-19結果不良的風險

News Release 13-Apr-2021

Editor’s note: Physical exercise can not only boost your immunity against viral infection, but also help mitigate inflammatory response which is the big threat from covid 19.

But do not count on physical exercise alone to help prevent the infection or reduce your risk of death from the illness. Vitamin D, C, B3/B6, omega 3 fatty acids, selenium, and zinc are all important and effective at fighting covid 19. Studies found patients infected with covid 19 rarely die if their blood concentration of vitamin D is high.

Zinc is another at least equally important nutrient you can take. This is critical for your immunity. With sufficient zinc in your system, your immunity is primed to prevent covid 19 infection.

編者註：體育鍛煉不僅可以增強您抵抗病毒感染的免疫力，還可以減輕炎症反應，這是covid 19的最大威脅。 但是，不要僅僅依靠體育鍛煉來幫助預防感染或減少疾病致死的風險。 維生素D，C，B3 / B6，歐米伽3脂肪酸，硒和鋅對於對抗covid 19都是重要且有效的。研究發現，如果covid 19的血液中維生素D含量高，則感染covid 19的患者很少會死亡。 鋅是您可以攝取的另一種至少同樣重要的營養素。 這對您的免疫力至關重要。 如果您的系統中有足夠的鋅，則可以增強免疫力，以預防covid 19感染。

Kaiser Permanente study showed that a history of being consistently active was strongly associated with a reduced risk of hospitalization, ICU admission, and death in those with COVID-19.

Kaiser Permanente

Research News

PASADENA, Calif. — A Kaiser Permanente study of nearly 50,000 people with COVID-19 suggested that regular physical activity provided strong protection from hospitalization, intensive care unit admission, and death. Even exercising inconsistently lowered the odds for severe COVID-19 outcomes when compared to people who were not active at all.

The study, led by investigators in Kaiser Permanente Southern California, was published in the British Journal of Sports Medicine.

“This is a wake-up call for the importance of healthy lifestyles and especially physical activity,” said Robert E. Sallis, MD, a family and sports medicine physician at the Kaiser Permanente Fontana Medical Center. “Kaiser Permanente’s motivation is to keep people healthy, and this study truly shows how important that is during this pandemic and beyond. People who regularly exercise had the best chance of beating COVID-19, while people who were inactive did much worse.”

To study the effect of exercise on COVID-19 outcomes, researchers identified 48,440 adults with a COVID-19 diagnosis from January 1, 2020, to October 21, 2020, who had 2 or more measurements of their Exercise Vital Sign between March of 2018 and March of 2020.

The Exercise Vital Sign measurement has been used at every outpatient encounter within Kaiser Permanente Southern California since 2009. To get the measurement, patients are asked how many days a week they engage in moderate to strenuous exercise and, on average, how many minutes they engage in exercise at that level. The responses are recorded in each patient’s electronic health record.

The patients in this study had a median age of 47, included 61.9% females, and reflected the diverse racial makeup of the Southern California population. Of the total cohort, 6.4% were consistently active and 14.4% were consistently inactive, with the remainder falling in the inconsistently active category.

Among all COVID-19 patients, 8.6% were hospitalized, 2.4% were admitted to the ICU, and 1.6% died.

The results of the study show inactivity is strongly associated with poor COVID-19 outcomes.

• Physical activity provided strong protection from hospitalization, ICU admission, and death among COVID-19 patients.
• Being consistently inactive more than doubled the odds of hospitalization compared with being consistently active.
• Patients who were consistently inactive had 1.73 times greater odds of ICU admission than patients who were consistently active.
• The odds for death were 2.49 times greater for patients who were consistently inactive compared with patients who were consistently active.
• Other than being over age 60 or having a history of organ transplant, being consistently inactive conferred the highest risk for death from COVID-19.
• Even patients who were inconsistently active had lower odds for severe COVID-19 when compared to those who were consistently inactive, suggesting any amount of physical activity has benefit.

“What surprised me the most from this study was the strength of the association between inactivity and poor outcomes from COVID-19,” said study co-author Deborah Rohm Young, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. “Even after we included variables such as obesity and smoking in the analysis, we still saw inactivity was strongly associated with much higher odds of hospitalization, ICU admission, and death compared with moderate physical activity or any activity at all.”

Dr. Sallis said his prescription is straightforward: “Walk 30 minutes a day, 5 days a week at a moderate pace and that will give you a tremendous protective effect against COVID-19.” He added that the way someone can gauge whether they are walking at a moderate pace is that they are too winded to sing but can still talk.

“I continue to believe that exercise is medicine that everyone should take – especially in this era of COVID-19,” Dr. Sallis said.

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About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.4 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health.

News Release 13-Apr-2021

Physical inactivity linked to more severe COVID-19 infection and death 缺乏運動會導致更嚴重的COVID-19感染和死亡

Surpassed only by advanced age and organ transplant as a risk factor, large study shows

BMJ

Research News

Physical inactivity is linked to more severe COVID-19 infection and a heightened risk of dying from the disease, finds a large US study published online in the British Journal of Sports Medicine.

Patients with COVID-19 who were consistently inactive during the 2 years preceding the pandemic were more likely to be admitted to hospital, to require intensive care, and to die than were patients who had consistently met physical activity guidelines, the findings show.

As a risk factor for severe disease, physical inactivity was surpassed only by advanced age and a history of organ transplant.

Several risk factors for severe COVID-19 infection have been identified, including advanced age, male sex, and certain underlying medical conditions, such as diabetes, obesity, and cardiovascular disease.

But physical inactivity is not one of them, even though it is a well known contributory risk factor for several long term conditions, including those associated with severe COVID-19, point out the researchers.

To explore its potential impact on the severity of the infection, including hospital admission rates, need for intensive care, and death, the researchers compared these outcomes in 48,440 adults with confirmed COVID-19 infection between January and October 2020.

The patients’ average age was 47; nearly two thirds were women (62%). Their average weight (BMI) was 31, which is classified as obese.

Around half had no underlying conditions, including diabetes, COPD, cardiovascular disease, kidney disease, and cancer; nearly 1 in 5 (18%) had only one; and almost a third (32%) had two or more.

All of them had reported their level of regular physical activity at least three times between March 2018 and March 2020 at outpatient clinics. This was classified as consistently inactive (0-10 mins/week); some activity (11-149 mins/week); or consistently meeting physical activity guidelines (150+ mins/week).

Some 7% were consistently meeting physical activity guidelines;15% were consistently inactive, with the remainder reporting some activity.

White patients were most likely to consistently meet physical activity guidelines (10%), followed by Asian patients (7%), Hispanic patients (6%) and African-American patients (5%).

Some 9% of the total were admitted to hospital; around 3% required intensive care; and 2% died. Consistently meeting physical activity guidelines was strongly associated with a reduced risk of these outcomes.

After taking account of potentially influential factors, such as race, age, and underlying medical conditions, patients with COVID-19 who were consistently physically inactive were more than twice as likely to be admitted to hospital as those who clocked up 150+ minutes of physical activity every week.

They were also 73% more likely to require intensive care, and 2.5 times more likely to die of the infection.

And patients who were consistently inactive were also 20% more likely to be admitted to hospital, 10% more likely to require intensive care, and 32% more likely to die of their infection than were patients who were doing some physical activity regularly.

This is an observational study, and as such, can’t establish cause. The study also relied on patients’ own assessments of their physical activity. Nor was there any measure of exercise intensity beyond the threshold of ‘moderate to strenuous exercise’ (such as a brisk walk).

But the study was large and ethnically diverse. And the researchers point out: “It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by [The Centers for Disease Control] except for age and a history of organ transplant.

“In fact, physical inactivity was the strongest risk factor across all outcomes, compared with the commonly cited modifiable risk factors, including smoking, obesity, diabetes, hypertension [high blood pressure], cardiovascular disease and cancer.”

They conclude: “We recommend that public health authorities inform all populations that short of vaccination and following public health safety guidelines such as social distancing and mask use, engaging in regular [physical activity] may be the single most important action individuals can take to prevent severe COVID-19 and its complications, including death.

“This message is especially important given the increased barriers to achieving regular [physical activity] during lockdowns and other pandemic restrictions.”

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Externally peer reviewed? Yes
Evidence type: Observational
Subjects: People