Physical inactivity – even more than smoking – determines COVID recovery
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COVID-19 patients who had been physically active were far less likely to be hospitalized, admitted to the intensive care unit or die, according to a Kaiser Permanente study of 48,440 adults published in the British Journal of Sports Medicine in April.
Even those who exercised inconsistently lowered their odds for contracting a severe case of COVID-19, researchers said. They divided patients into three categories: those that said they got less than 10 minutes of physical activity a week; those who reported 11 to 149 minutes; and those who said they did the 150 minutes or more of moderate activity recommended by the U.S. Centers for Disease Control and Prevention. Even patients in the middle category saw a difference, researchers said.
In fact, the study found that physical activity was the third most important risk, topped only by whether a patient was elderly or had been through an organ transplant. The risk of COVID-19 for those who were “consistently inactive” was even higher than for smokers and those who had chronic diseases such as diabetes, they said.
But exercise will protect you against far more than COVID-19, said Cape Cod Hospital physical therapist John Corsino.
“If you’re going to have an illness, whether it’s COVID or another one, the better your fitness, the better off you’re going to be,” he said.
Age, behavior, and germs, like viruses, affect the way our genes work with the DNA that dictates the structure and function of our bodies. These “epigenetics” do not change the DNA sequence itself but they can affect how the gene works and interacts with it, according to the CDC. Starting even a moderate exercise routine, for example, can make a difference in supporting the genes, Corsino said.
“Using the large skeletal muscles in our legs and backs changes our metabolism; it maintains our sensitivity to insulin and other hormones,” Corsino said. “It changes our tissue, which changes how our bodies function.”
Other studies, such as one published in the Journal of Health and Sport Science in 2019, have also found a direct link between physical exercise and an improved immune system. Some healthcare organizations, including Cape Cod Hospital, consider the level of physical activity to be an indicator of health -- a vital sign like blood pressure or weight, Corsino said.
“At Cape Cod Hospital, we have a scale that we use every shift to know how much our patients are moving because it’s such an important indicator of both the care we’re providing and how they’re improving,” he said.
Although it’s good to get moving, many people have difficulty hitting the CDC’s recommended goal of 150 minutes a week, whether it’s due to age, disability or other circumstance, Corsino said. He suggests a different way of thinking about exercise: Do more this week than you did last week.
“For many people the guidelines are unobtainable, yet those people can benefit a lot,” he said. “So instead of saying 150 minutes, we should be saying do 5 percent more this week than you did last week. To me, it’s about continuous improvement.”
Our bodies adapt to the demands we put on them, Corsino said. “So, if you lift 100 pounds and you do that forever, you’re never going to get stronger. You have to continuously change the demand.”
The first step is to get medical clearance to exercise. The next is to find something you like doing. If you’re already exercising, think about how to keep things fresh and increase the frequency, duration or intensity by even 1 or 2 percent each week, he said.
“Say you’re doing intervals and you’re walking really hard for 30 seconds and then slower for a couple of minutes, you just dial down the time in between,” Corsino said.
“The right approach is always going to be finding something people like enough that they’ll continue to do it. And then just building with small, incremental progress.”