Objective To quantify the association between physical activity and risk of SARS-CoV-2 infection, COVID-19-associated hospitalisation, severe illness and death due to COVID-19 in adults. Design A systematic review and meta-analysis. Data sources Three databases were systematically searched through March 2022. Eligibility criteria for selecting studies Peer-reviewed articles reporting the association between regular physical activity and at least one COVID-19 outcome in adults were included. Risk estimates (ORs, relative risk (RR) ratios or HRs) were extracted and pooled using a random-effects inverse-variance model. Results Sixteen studies were included (n=1 853 610). Overall, those who engaged in regular physical activity had a lower risk of infection (RR=0.89; 95% CI 0.84 to 0.95; I2=0%), hospitalisation (RR=0.64; 95% CI 0.54 to 0.76; I2=48.01%), severe COVID-19 illness (RR=0.66; 95% CI 0.58 to 0.77; I2=50.93%) and COVID-19-related death (RR=0.57; 95% CI 0.46 to 0.71; I2=26.63%) as compared with their inactive peers. The results indicated a non-linear dose–response relationship between physical activity presented in metabolic equivalent of task (MET)-min per week and severe COVID-19 illness and death (p for non-linearity <0.001) with a flattening of the dose–response curve at around 500 MET-min per week. Conclusions Regular physical activity seems to be related to a lower likelihood of adverse COVID-19 outcomes. Our findings highlight the protective effects of engaging in sufficient physical activity as a public health strategy, with potential benefits to reduce the risk of severe COVID-19. Given the heterogeneity and risk of publication bias, further studies with standardised methodology and outcome reporting are now needed. PROSPERO registration number CRD42022313629.

中文翻译：

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COVID-19 的体力活动和感染风险、严重程度和死亡率：对 1 853 610 名成年人的数据进行系统回顾和非线性剂量反应荟萃分析


目的 量化成人体力活动与 SARS-CoV-2 感染、与 COVID-19 相关的住院治疗、重症和因 COVID-19 死亡的风险之间的关联。设计系统回顾和荟萃分析。数据来源 系统检索了截至 2022 年 3 月的三个数据库。选择研究的资格标准纳入了报告定期体力活动与成人至少一种 COVID-19 结果之间关联的同行评审文章。使用随机效应逆方差模型提取并汇总风险估计（OR、相对风险 (RR) 比或 HR）。结果 纳入 16 项研究（n=1 853 610）。总体而言，经常进行体力活动的人感染（RR=0.89；95% CI 0.84至0.95；I2=0%）、住院（RR=0.64；95% CI 0.54至0.76；I2=48.01%）的风险较低。 ）、严重 COVID-19 疾病（RR=0.66；95% CI 0.58 至 0.77；I2=50.93%）和 COVID-19 相关死亡（RR=0.57；95% CI 0.46 至 0.71；I2=26.63%）进行比较与不活跃的同龄人。结果表明，以每周代谢当量 (MET) 分钟表示的体力活动与严重的 COVID-19 疾病和死亡之间存在非线性剂量反应关系（非线性 p <0.001），且剂量趋于平坦– 反应曲线约为每周 500 MET-min。结论 定期进行体力活动似乎与降低发生 COVID-19 不良后果的可能性有关。我们的研究结果强调了充分体育活动作为公共卫生策略的保护作用，并具有降低严重 COVID-19 风险的潜在益处。鉴于异质性和发表偏倚的风险，现在需要采用标准化方法和结果报告进行进一步研究。 PROSPERO 注册号 CRD42022313629。