Physical Activity Decreases Prevalence of COVID-19-associated Hospitalization: Brazil EXTRA Study

View ORCID ProfileFrancis Ribeiro Souza, View ORCID ProfileDaisy Motta-Santos, View ORCID ProfileDouglas dos Santos Soares, View ORCID ProfileJuliana Beust Lima, View ORCID ProfileGustavo Goncalves Cardozo, View ORCID ProfileLuciano Santos Pinto Guimaraes, View ORCID ProfileCarlos Eduardo Negrao, View ORCID ProfileMarcelo Rodrigues dos Santos

doi: https://doi.org/10.1101/2020.10.14.20212704

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2020.10.14.20212704v1.full.pdf

Objectives: We compared physical activity levels before the outbreak and quarantine measures with COVID-19-associated hospitalization prevalence in surviving patients infected with SARS-CoV-2. Additionally, we investigated the association of physical activity levels with symptoms of the disease, length of hospital stay, and mechanical ventilation. Methods: Between June 2020 and August 2020, we invited Brazilian survivors and fully recovered patients infected with SARS-CoV-2 to respond to an online questionnaire. We shared the electronic link to the questionnaire on the internet. In this cross-sectional study, we collected data about clinical outcomes (symptoms, medications, hospitalization, and length of hospital stay) and cofactors, such as age, sex, ethnicity, preexisting diseases, socioeconomic and educational, and physical activity levels using the International Physical Activity Questionnaire (IPAQ short version). Results: Out of 938 patients, 91 (9.7%) were hospitalized due to COVID-19. In a univariate analysis, sex, age, and BMI were all associated with hospitalizations due to COVID-19. Men had a higher prevalence of hospitalization (66.6%, P=0.013). Patients older than 65 years, obese, and with preexisting disease had a higher prevalence of COVID-19-related hospitalizations. In a multivariate regression model, performance of at least 150 min/wk (moderate) and/or 75 min/wk (vigorous) physical activity was associated with a lower prevalence of hospitalizations after adjustment for age, sex, BMI, and preexisting diseases (PR=0.657; P=0.046). Conclusions: Sufficient physical activity levels are associated with a lower prevalence of COVID-19-related hospitalizations. Performing at least 150 minutes a week of moderate-intensity, or 75 minutes a week of vigorous-intensity physical activity reduces this prevalence by 34.3%.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

NCT04396353

Funding Statement

D.S.S was supported by Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES), J.B.L by Conselho Nacional de Pesquisa e Desenvolvimento (CNPq), C.E.N by CNPq (303573/2015-5), and M.R.S by Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) (2016/24306-0 and 2019/14938-7).

https://www.medrxiv.org/content/10.1101/2020.10.14.20212704v1