Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness, and COVID-19-related mortality in South Korea: a nationwide cohort study

Lee, Seung Won and Lee, Jinhee and Moon, Sung Yong and Jin, Hyun Young and Yang, Jee Myung and Ogino, Shuji and Song, Mingyang and Hong, Sung Hwi and Ghayda, Ramy A. and Kronbichler, Andreas and Koyanagi, Ai and Jacob, Louis and Dragioti, Elena and Smith, Lee and Giovannucci, Edward L. and Lee, I-Min and Lee, Dong Hoon and Lee, Keum Hwa and Shin, Youn Ho and Kim, So Young and Kim, Min Seo and Won, Hong-Hee and Ekelund, Ulf and Shin, Jae Il and Yon, Dong Keon (2021) Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness, and COVID-19-related mortality in South Korea: a nationwide cohort study. British Journal of Sports Medicine. ISSN 1473-0480

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Official URL: http://dx.doi.org/10.1136/bjsports-2021-104203

Abstract

Purpose- To determine the potential associations between physical activity and risk of SARS-CoV-2 infection, severe illness from COVID-19 and COVID-19 related death using a nationwide cohort from South Korea. Methods- Data regarding 212 768 Korean adults (age ≥20 years), who tested for SARS-CoV-2, from 1 January 2020 to 30 May 2020, were obtained from the National Health Insurance Service of South Korea and further linked with the national general health examination from 1 January 2018 to 31 December 2019 to assess physical activity levels. SARS-CoV-2 positivity, severe COVID-19 illness and COVID-19 related death were the main outcomes. The observation period was between 1 January 2020 and 31 July 2020. Results- Out of 76 395 participants who completed the general health examination and were tested for SARS-CoV-2, 2295 (3.0%) were positive for SARS-CoV-2, 446 (0.58%) had severe illness from COVID-19 and 45 (0.059%) died from COVID-19. Adults who engaged in both aerobic and muscle strengthening activities according to the 2018 physical activity guidelines had a lower risk of SARS-CoV-2 infection (2.6% vs 3.1%; adjusted relative risk (aRR), 0.85; 95% CI 0.72 to 0.96), severe COVID-19 illness (0.35% vs 0.66%; aRR 0.42; 95% CI 0.19 to 0.91) and COVID-19 related death (0.02% vs 0.08%; aRR 0.24; 95% CI 0.05 to 0.99) than those who engaged in insufficient aerobic and muscle strengthening activities. Furthermore, the recommended range of metabolic equivalent task (MET; 500–1000 MET min/week) was associated with the maximum beneficial effect size for reduced risk of SARS-CoV-2 infection (aRR 0.78; 95% CI 0.66 to 0.92), severe COVID-19 illness (aRR 0.62; 95% CI 0.43 to 0.90) and COVID-19 related death (aRR 0.17; 95% CI 0.07 to 0.98). Similar patterns of association were observed in different sensitivity analyses. Conclusion- Adults who engaged in the recommended levels of physical activity were associated with a decreased likelihood of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related death. Our findings suggest that engaging in physical activity has substantial public health value and demonstrates potential benefits to combat COVID-19.

Item Type: Journal Article
Keywords: COVID-19, Physical Activity, Mortality
Faculty: COVID-19 Research Collection
Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 01 Jul 2021 10:05
Last Modified: 09 Sep 2021 18:50
URI: https://arro.anglia.ac.uk/id/eprint/706698

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