Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case–control study

BACKGROUND: Regular physical activity is associated with a low risk of severe community-acquired infections. However, the hypothesis that a physical inactivity pattern is associated with a higher risk for severe COVID-19 has not been completely proven, especially with severe pneumonia. OBJECTIVE: The goal of this study was to confirm the link between physical activity patterns and severe SARS-CoV-2 pneumonia. DESIGN: Case–control study. METHODS: This study involved 307 patients who developed SARS-CoV-2 severe pneumonia and were hospitalized in an intensive care unit. Age- and sex-matched controls (307) were selected from the same population: patients with mild to moderate forms of COVID-19 who were not hospitalized. Physical activity patterns were assessed using the short version of the International Physical Activity Questionnaire. RESULTS: The mean physical activity levels were lower in the SARS-CoV-2 severe pneumonia group as compared to the control group: 1576 ± 2939 vs 2438 ± 2999, metabolic equivalent of task (MET-min/week), p < 0.001. A high or moderate physical activity level was more common in the control group, and a low physical activity level was more observed in the case group (p < 0.001). Obesity was also associated with severe SARS-CoV-2 pneumonia (p < 0.001). Multivariable analysis showed that a low physical activity level was associated with a higher risk for severe SARS-CoV-2 pneumonia, independent of nutritional status (CI 3.7; 2.24–5.99), p < 0.001). CONCLUSION: A higher and moderate level of physical activity is linked to a lower risk of SARS-CoV-2 severe pneumonia.