INACTIVITY LINKED TO SEVERE COVID-19

Starting March 2020, near the beginning of the pandemic, exercise

scientists and clinicians published blogs about the mechanisms by which

physical activity could likely reduce harm from COVID-19.

There was strong evidence that physical activity improves immune function, reduces inflammation, prevents and treats most common chronic diseases, decreases the psychological and physiological burden of stress, and improves immune responses to vaccinations among older adults.

Though these blogs gained attention in the exercise science community, they had no impact on the public response to the pandemic in the United States. We did not see coverage in the mainstream press on how physical activity could benefit people during the pandemic. Instead, we saw many of the venues where people are physically active (gyms, parks, trails) closed during lockdowns. The CDC did not list physical inactivity as a risk factor for severe COVID-19, but the World Health Organization did.

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The study showed those who reported being physically inactive before diagnosis were 2.49 times more likely to die of COVID-19 than those who regularly met physical activity guidelines of 150 minutes per week.

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Perhaps US public health leaders were waiting for direct evidence about physical activity benefits specific to COVID-19? Now we have just such evidence. A study of 48,440 Covid-19 patients was published in April. These patients were diagnosed with COVID-19 and had reported their physical activity at least 3 times during outpatient visits over the prior 2 years. The study showed those who reported being physically inactive before diagnosis were 2.49 times more likely to die of COVID-19 than those who regularly met physical activity guidelines of 150 minutes per week. Similar benefits of physical activity were seen for hospital and ICU admissions. Most notably, physical inactivity was a stronger risk factor for severe COVID-19 than heart disease, cancer, diabetes, hypertension, smoking, and obesity. Physical inactivity should be considered a major risk factor for severe COVID-19 cases and death. The documented benefits of physical activity have been neglected for the first year of the pandemic, missing an opportunity to reduce suffering and death. People are still getting sick and dying of COVID-19, so it is not too late to take action to

help people be more active.