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Before and After: Exercise Is Key to Covid Recovery

Am Journal of Preventative Medicine logo

Patients who were more physically active before catching COVID-19 experienced a reduced risk of severe outcomes, according to a study in the American Journal of Preventive Medicine. And the positive benefits of exercise were observed in patients both with and without chronic medical conditions.

The trial, which involved close to 200,000 adults, showed a link between physical activity and improved COVID-19 outcomes across major demographic groups; black, Hispanic, and Asian subjects 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, PhD, 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.

Study Details

Young and her colleagues analyzed the electronic health records of 194,191 adult patients who were diagnosed with COVID-19 between January 2020 and May 2021, before widespread vaccination.

Prior to infection, all patients were asked to report their physical activity levels in a routine measure known as the Exercise Vital Sign. The patients 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 more physical activity was associated with a lower 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, including hypertension, cardiovascular disease, and obesity.

“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,” Young said.


In CDC review of the protective effects of physical activity or fitness on severe COVID-19 outcomes, consistent and conclusive evidence of benefits was found.5 This study showed stepwise higher odds of adverse COVID- 19 outcomes with each increment in physical inactivity. It examined the critical question of the amount of physical inactivity among patients with COVID-19 with the highest risk for severe outcomes; those with common chronic diseases; older individuals; and Asian or Pacific Islander, Black, and Hispanic persons. Across virtually all subgroups, substantial deleterious effects of higher amounts of physical inactivity were found. The cumulative evidence of less physical inactivity’s benefits for people with COVID-19, even those in the highest risk categories, has public health significance. Adults, regardless of demographic category or chronic disease status, should be encouraged to reduce their physical inactivity as another COVID-19 mitigation strategy.



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