More exercise linked to less-severe COVID-19 outcomes

Kaiser Permanente members who were more physically active prior to being diagnosed with COVID-19 had a lower risk of severe outcomes, according to research published Dec. 15, 2022, in the American Journal of Preventive Medicine.

The study of nearly 200,000 adults showed an association between physical activity and improved COVID-19 outcomes across major demographic groups regardless of whether patients had chronic medical conditions. Black, Hispanic, and Asian patients had a greater risk of adverse outcomes compared with white patients, in line with prior research. However, within each racial and ethnic group, more exercise was still associated with less severe COVID-19 outcomes.

"The main message is that every little bit of physical activity counts," said the study's lead author, Deborah Rohm Young, Ph.D., the director of the Division of Behavioral Research for the Kaiser Permanente Southern California Department of Research & Evaluation. "The more exercise the better, no matter a person's race, ethnicity, age, sex, or chronic conditions."

This research builds on earlier studies by closely examining the association between exercise and COVID-19 outcomes across demographic groups and chronic conditions.

In this study, Young and her colleagues analyzed the electronic health records of 194,191 adult patients at Kaiser Permanente in Southern California who were diagnosed with COVID-19 between January 2020 and May 2021, prior to widespread COVID-19 vaccination.

All patients had reported their physical activity levels prior to infection in a routine measure known as the Exercise Vital Sign. Each patient fell into 1 of 5 categories ranging from always inactive—10 minutes of exercise or less per week, to always active—150 minutes of exercise per week.

Statistical analysis showed that the more physical activity a patient reported, the lower the risk of hospitalization or death within 90 days of COVID-19 diagnosis. This trend was consistent across all activity levels, with always-active patients facing the lowest risk.

More exercise was also linked to lower rates of hospitalization or death for patients with certain underlying chronic conditions—such as hypertension, cardiovascular disease, or obesity—that are typically associated with an increased risk of poor COVID-19 outcomes.

"Our findings drive home the need for physicians to emphasize to their patients that getting vaccinated and being more physically active are two of the most important things you can do to prevent severe outcomes of COVID-19," said the study's senior author, Robert E. Sallis, MD, a family and sports medicine physician at the Kaiser Permanente Fontana Medical Center.

Young said, "This is a powerful opportunity to develop stronger policies supporting physical activity as a pandemic-mitigation strategy. Our study provides new evidence to inform appropriate interventions across demographic groups."