Covid and Exercise: Does Exercise Protect Against Severe COVID? 

By  Dr. Mike Hansen

Covid and Exercise: Until now, there really haven’t been any good studies directly looking at the link between exercise and the severity of COVID illness. There is a new, large study in the BMJ of Sports Medicine that did exactly that.

We already have a ton of research that shows us that exercise helps us feel better, mentally and physically. It prevents or improves many medical conditions, like heart disease, type 2 diabetes, high blood pressure, obesity, certain types of cancer, dementia, and can extend our lives. That’s why the US physical activity guidelines and the American Heart Association recommend at least 150 minutes of moderate physical activity weekly. So now let’s get to the study that was just done at Kaiser Permanente in California.

Covid and Exercise

To understand this study, you have to know about something they were already doing before the pandemic. Health care workers there routinely asked all of their patients two simple questions about their physical activity. They would refer to this as the “Exercise Vital Sign.” On average, the questions were how many days per week do you engage in moderate to strenuous exercise (like a brisk walk)? The answer choices are 0 to 7 days. The second question was, on average, how many minutes do you engage in exercise at this level? The answer choices are 0, 10, 20, 30, 40, 50, 60, 90, 120, 150 or greater minutes.

Based on research, it turns out that these questions are a good measure of people’s activity levels. Not only that, but these 2 questions predict some medical problems, such as high blood pressure and high blood sugar. Most people already know that many health conditions are strongly correlated with a lack of physical activity — like the ones I just mentioned. Many of them are also risk factors for severe illness and death if they get COVID. Like obesity, high blood pressure, and diabetes.

The researchers also looked at other important characteristics of these 48,000+ patients. How old were they? Were they male or female? Did they smoke? or have emphysema? Did they have obesity, diabetes, high blood pressure, cardiovascular disease, or kidney disease? And more. They collected and analyzed a ton of data, then calculated the risk correlated with different outcomes. The big takeaways from this study are that consistently inactive people had a significantly higher risk of hospitalization, ICU admission, and death after getting COVID compared with those who were active for at least 150 minutes per week.

Also, what they found was that those who were active for over 10 minutes per week, meaning group B, did have some protection against severe illness or death from COVID, but not as much as group A. Now, this was one study, looking at the direct correlation between exercise and severity of COVID illness. More studies would be needed to confirm these findings. Still, it’s one more reason to encourage and promote physical activity for everyone based on what we have—ideally, a minimum of 150 minutes per week.

Certain types of exercise can give more health benefits than others. For example, resistance training, or strength training, which includes lifting weights and calisthenics, is especially great not just for adding muscle and staying strong but to prevent osteoporosis. Then you have HITT, which is especially great for shedding fat. Then you have aerobic training, or cardio, which is especially great for shedding fat and increasing stamina. All of these types of exercises have overlap when it comes to benefits. Now I know. Some people are going to bring up this question. How does exercise, along with healthy eating, and getting good sleep, etc., how does compare to the covid vaccine?

Let’s say you exercise more than 150 minutes per week. And you don’t have the vaccine. Does that give you the same level of protection? Well, we don’t have any studies comparing the two head-ons. All I can tell you is that the mRNA vaccines made by Pfizer and Moderna are 95% effective against severe COVID. And I seriously doubt that exercising 150 plus minutes per week will get you that same level of protection. To do that study, you would need to do a randomized clinical trial comparing those that head-on. On that note, this new Delta variant of COVID, which is the worst COVID strain yet, is rising in the US and will soon be the dominant strain.

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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