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 infec-tions. 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 hos-pitalized 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 activ-ity 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 com-pared 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.