Exercise Makes for Lower Risk of Severe COVID

Physical Inactivity Makes for High Risk of COVID

We all know the CDC research-based risks for severe Covid: advanced age, male gender, and the presence of underlying comorbidities, such as diabetes, obesity, and cardiovascular disease. Now,inactivity is known to be a risk factor for all the COVID risk factors. Being a couch potato helps you gain weight, develop diabetes and earn your heart attack. What no one has ever studied is the effect of activity itself on COVID risk. The COVID pandemic has locked everyone down at home, inactive, watching TV, and gaining weight. Does that make the whole situation worse? Does inactivity make for worse COVID? That's an interesting question.

Physical activity guidelines for Americans have been published in JAMA and call for 150 minutes a week of activity. That is easily achievable for most folks as it only asks for 20 minutes a day. The dilemma is that 20 minutes a day is a bit of a trick if your front door is closed by pandemic strictures. What are the risks?

The authors of this week's paper from the Kaiser Permanente Health System in Southern California (KPSC) looked at just that. KPSC has an electronic medical record that documents activity levels (as self-reported) and covers 4.7 million people. The inclusion criteria for the study was everyone over age 18 who got COVID in the 10-month interval from January to October of 2020. They required all participants to have 3 "exercise vital signs" in the prior three years to ensure their measure of exercise was accurate. An "exercise vital sign" is a query by an intake by a medical assistant: ‘On average, how many days per week do you engage in moderate to strenuous exercise (like a brisk walk)?’ and ‘On average, how many minutes do you engage in exercise at this level?’. Response choices for days are 0–7, and minutes are recorded as 0, 10, 20, 30.........90, 120 and 150 or greater.

They had 103,337 study subjects with COVID of which 48,440 had 3 queries as to exercise. That became the study population. Being consistently inactive increased the odds of hospitalization 2.26-fold. Those with some activity had 1.89 times greater chance of hospitalization than those who were consistently meeting the activity guidelines. Finally, those who were regularly inactive had greater odds of being hospitalized 1.20 times over those patients who were doing some activity. These are major risks because other than age, and a history of organ transplant. Being consistently inactive conferred the highest odds for hospitalization with COVID-19 of any major risk factor.

Let that sink in. Other than age, and organ transplant inactivity is the riskiest thing you can do for COVID. (The study had an interesting statistical blip over pregnancy because a lot of admissions happened with pregnancy, making it look skewed towards risk. They were being admitted to deliver their babies. They, in fact, had a much lower risk of mortality.)

Inactivity is just plain dangerous for you.

www.What will Work for me. Being outdoors with moving air has been shown to produce a much lower risk for COVID. The moist particles COVID needs to survive likely dry out rapidly, and blow away. I must say, I discovered bike riding during COVID and find that that habit has stuck. I am older, male, with lousy genes for diabetes. I can do something about my diabetes by losing weight and avoiding sugar. I can't change the older, and male. But I can get 20 minutes of exercise every day. The dog insists on it.

References: Br Jr Sports Med, CDC, CDC, JAMA, Oxidative Medicine, Frontiers Nutrition,

Pop Quiz

1. What did this study show? Answer: Increased risk of severe COVID and hospitalization for those with the lowest risk of activity.

2. What are the other major risks the study points out for severe COVID? Answer: Male gender, age, organ transplant, diabetes, heart disease, obesity.

3. Why has the COVID pandemic made all the risks worse? Answer: That's simple. Lockdown makes you stuck indoors.

4. How much do I have to exercise to get the risk-lowering effect? Answer: Easy-peasy. 20 minutes of brisk walking.

5. Is there more risk reduction with more rigorous exercise? Answer: It was not studied. But if you want to do a deep dive, there is pretty good evidence that ketosis is helpful for the PDC block in COVID that makes it a lethal disease. So, a ketogenic diet is helpful. Exercise gets you into ketosis, getting you closer to a safer spot. It all flows and makes sense. Hence, the logic of ketone esters for COVID.