Association between physical activity and risk of COVID-19 infection or clinical outcomes of the patients with COVID-19; A systematic review and meta-analysis


Exercise, COVID-19, SARS-CoV-2, Systematic Review, Meta-Analysis


Objective:  Nowadays, the COVID-19 pandemic has caused serious consequences for global health and economy. The important question is whether the level of physical activity might influence the risk of COVID-19 incidence or clinical outcomes, including the severity or mortality of infected patients. The objective of this systematic review and meta-analysis is to evaluate the association between sufficient physical activity and incidence, hospitalization, severity, recovery, and mortality of COVID-19.

Methods: A systematic search of Web of Sciences, PubMed, and Scopus between December 2019 and November 2021 in English language was conducted. Studies were screened based on the inclusion criteria, i.e. observational studies (case-control, prospective or retrospective longitudinal designs, and cross-sectional studies) which have determined the association of physical activity, exercise, sports participation, or sedentary behavior with COVID-19 incidence or outcomes, including mortality, severity, recovery and hospitalization in healthy population or population with any specific comorbidity.

Results: Based on eligibility criteria, 27 articles were finally included in the qualitative synthesis. The meta-analysis of five studies evaluating association of physical activity and COVID-19 mortality showed weighted OR of OR of 0.61 (CI 95%: 0.50- 0.75) with heterogeneity (I2= 45.8%, P<0.001) and in seven studies regarding physical activity and COVID-19 hospitalization, weighted OR was 0.541 (CI 95% :0.491 -0.595) with heterogeneity (I2=81.7%, P<0.001).

Conclusion: Participating in sufficient physical activity might decrease COVID-19 related hospitalization and mortality. Developing programs to increase physical activity during the COVID-19 pandemic might be an appropriate health strategy.


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