한빛사 논문
Seung Won Lee,1,* Jinhee Lee,2 Sung Yong Moon,1 Hyun Young Jin,1 Jee Myung Yang,3 Shuji Ogino,4,5 Mingyang Song,4 Sung Hwi Hong,6 Ramy Abou Ghayda,7 Andreas Kronbichler,8 Ai Koyanagi,9,10 Louis Jacob,9,11,12 Elena Dragioti,13 Lee Smith,14 Edward Giovannucci,4,15,16 I-Min Lee,4,17 Dong Hoon Lee,16 Keum Hwa Lee,18 Youn Ho Shin,19 So Young Kim,20 Min Seo Kim,21 Hong-Hee Won,21 Ulf Ekelund,22,23 Jae Il Shin,18,* Dong Keon Yon24,*
1Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea (the Republic of)
2Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
3Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
4Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
5Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
6Yonsei University College of Medicine, Seoul, Korea (the Republic of)
7Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
8Deparment of Medicine, University of Cambridge, Cambridge, UK
9Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain
10Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
11Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
12Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montignyle-Bretonneux, France
13Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
14The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Chelmsford, UK
15Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
16Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
17Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
18Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
19Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea (the Republic of)
20Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea (the Republic of)
21Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Korea (the Republic of)
22Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
23Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
24Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Correspondence to
Dr Dong Keon Yon, Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 08826, Korea (the Republic of);
Professor Seung Won Lee, Department of Data Science, Sejong University College of Software Convergence, Seoul 03722, Korea (the Republic of);
and Professor Jae Il Shin, Department of Pediatrics, Yonsei University College of Medicine,
Seoul 03722, Korea (the Republic of);
SWL and DKY are joint first authors
Abstract
Purpose
To determine the potential associations between physical activity and risk of SARS-CoV-2 infection, severe illness from COVID-19 and COVID-19 related death using a nationwide cohort from South Korea.
Methods
Data regarding 212 768 Korean adults (age ≥20 years), who tested for SARS-CoV-2, from 1 January 2020 to 30 May 2020, were obtained from the National Health Insurance Service of South Korea and further linked with the national general health examination from 1 January 2018 to 31 December 2019 to assess physical activity levels. SARS-CoV-2 positivity, severe COVID-19 illness and COVID-19 related death were the main outcomes. The observation period was between 1 January 2020 and 31 July 2020.
Results
Out of 76 395 participants who completed the general health examination and were tested for SARS-CoV-2, 2295 (3.0%) were positive for SARS-CoV-2, 446 (0.58%) had severe illness from COVID-19 and 45 (0.059%) died from COVID-19. Adults who engaged in both aerobic and muscle strengthening activities according to the 2018 physical activity guidelines had a lower risk of SARS-CoV-2 infection (2.6% vs 3.1%; adjusted relative risk (aRR), 0.85; 95% CI 0.72 to 0.96), severe COVID-19 illness (0.35% vs 0.66%; aRR 0.42; 95% CI 0.19 to 0.91) and COVID-19 related death (0.02% vs 0.08%; aRR 0.24; 95% CI 0.05 to 0.99) than those who engaged in insufficient aerobic and muscle strengthening activities. Furthermore, the recommended range of metabolic equivalent task (MET; 500–1000 MET min/week) was associated with the maximum beneficial effect size for reduced risk of SARS-CoV-2 infection (aRR 0.78; 95% CI 0.66 to 0.92), severe COVID-19 illness (aRR 0.62; 95% CI 0.43 to 0.90) and COVID-19 related death (aRR 0.17; 95% CI 0.07 to 0.98). Similar patterns of association were observed in different sensitivity analyses.
Conclusion
Adults who engaged in the recommended levels of physical activity were associated with a decreased likelihood of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related death. Our findings suggest that engaging in physical activity has substantial public health value and demonstrates potential benefits to combat COVID-19.
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