Article Text

Download PDFPDF
Evidence-based physical activity for COVID-19: what do we know and what do we need to know?
  1. Bruno Gualano
  1. Applied Physiology & Nutrition Research Group; Laboratory of Assessment and Conditioning in Rheumatology; Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
  1. Correspondence to Professor Bruno Gualano, University of Sao Paulo, Sao Paulo 01246-903, Brazil; gualano{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Since the WHO declared COVID-19 a pandemic in March 2020, scientists have put great effort into increasing our understanding of the linkages between this new disease and the multiple factors that potentially affect its prognosis. Evidence began to accumulate that COVID-19 can be more lethal in individuals with clinical conditions that weaken immune function. As regular physical activity (PA) knowingly improves immunity,1 a growing number of studies have investigated whether PA could change the natural course of COVID-19.

PA and COVID-19 outcomes in the general population

The first indication that PA could be a predictor of severity of COVID-19 outcomes derived from a community-based cohort study of 387 109 adults in the UK, showing that physical inactivity increased the relative risk (RR) of COVID-19 hospital admission by 32%.2 Supporting these data, another population-based study of 48 440 individuals in the USA showed participants who were consistently inactive had a greater risk of hospitalisation (adjusted OR (aOR): 2.26), admission to the intensive care unit (ICU) (aOR: 1.73) and death (aOR: 2.49) than those who were consistently meeting PA guidelines.3 Similar findings were obtained by a nationwide cohort study of 12 768 adults in South Korea, in which participants who adhered to recommendations for both aerobic and strengthening activities had a lower risk of SARS-CoV-2 infection (adjusted RR (aRR): 0.85), severe COVID-19 outcomes (aRR: 0.42) and COVID-19-related death (aRR: 0.24) than …

View Full Text


  • Correction notice This article has been corrected since it published Online First. A typographical error in the last sentence has been corrected.

  • Contributors BG is the sole author responsible for the content of this article.

  • Funding The author’s work on COVID-19 is supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (grant: 2017/13552–2).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.