PT  - JOURNAL ARTICLE
AU  - Lizelle Steenkamp
AU  - Robin Terence Saggers
AU  - Rossella Bandini
AU  - Saverio Stranges
AU  - Yun-Hee Choi
AU  - Jane S Thornton
AU  - Simon Hendrie
AU  - Deepak Patel
AU  - Shannon Rabinowitz
AU  - Jon Patricios
TI  - Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes
AID  - 10.1136/bjsports-2021-105159
DP  - 2022 May 01
TA  - British Journal of Sports Medicine
PG  - 568--577
VI  - 56
IP  - 10
4099  - http://bjsm.bmj.com/content/56/10/568.short
4100  - http://bjsm.bmj.com/content/56/10/568.full
SO  - Br J Sports Med2022 May 01; 56
AB  - Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with a confirmed diagnosis of COVID-19.Methods Directly measured physical activity data from 65 361 adult patients with a COVID-19 diagnosis from 19 March 2020 to 30 June 2021, were grouped by activity level: low (<60 min/week), moderate (60–149 min/week) and high activity (≥150 min/week). The association of physical activity levels and the risk of adverse outcomes was analysed using modified Poisson regression. We accounted for demographics and comorbidities including conditions known to influence COVID-19 outcomes, as well as patient complexity as measured by the Johns Hopkins Adjusted Clinical Group system. The regression approach was further validated with a Bayesian network model built off a directed acyclic graph.Results High physical activity was associated with lower rates of hospitalisation (risk ratio, RR 0.66, 95% CI 0.63 to 0.70), ICU admission (RR 0.59, 95% CI 0.52 to 0.66), ventilation (RR 0.55, 95% CI 0.47 to 0.64) and death (RR 0.58, 95% CI 0.50 to 0.68) due to COVID-19 than those who engaged in low physical activity. Moderate physical activity also was associated with lower rates of hospitalisation (RR 0.87, 95% CI 0.82 to 0.91), admission to ICU (RR 0.80, 95% CI 0.71 to 0.89), ventilation (RR 0.73, 95% CI 0.62 to 0.84) and death (RR 0.79, 95% CI 0.69 to 0.91).Conclusions Adults with high and moderate physical activity levels had significantly better outcomes than those with low activity when contracting COVID-19. The apparent protective effects of regular physical activity extended to those with concomitant chronic medical conditions.No data are available. Not applicable.