SIB# 436- Exercise Capacity and COVID Hospitalization

The Study: Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019 

 Overview: This is a retrospective observational study which looked at the relationship between measured levels of physical fitness and the likelihood of hospitalization due to COVID-19 disease.

 Key Points: 

  • ·         The study observed 1181 adult patients who had both a recent exercise stress test and a test for SARS-CoV2 plus all other complete data which were to be used in the statistical analysis.

  •  ·         Of these, 246 patients had tested positive for SARS-CoV-2. 

  • ·         89 of these 246 patients (36%) were hospitalized for COV-19 disease.  

  • ·         Median age at time of the SARS-Co-V-2 testing was 59 ½ years. So as a whole, this was a somewhat older population. 

  • ·         Median time between the exercise test and the SARS-CoV-2 testing was 2.1 years.  

  • ·         Patients were also screened for a number of other confounding factors including Race, body Mass Index, history of Hypertension, Diabetes, Asthma, Smoking, Cancer, Coronary Heart Disease, Kidney Disease and COPD. 

  • ·         Physical fitness was divided into Quartiles of “peak metabolic equivalents of task” (METS)   

  • ·        Higher levels of physical fitness (higher METS) were inversely associated with the likelihood of hospitalization.   

  • ·         Each quartile unit higher of peak METS was “independently associated with 13% lower odds of hospitalization.” 

  • ·         This relationship was independent of sex, age and body mass index.  

 

Author’s Conclusions: “In a diverse cohort of patients who tested positive for SARS-CoV-2, we showed an independent and inverse association between maximal exercise capacity and likelihood of hospitalization for COVID-19.”

  

Reviewer's Comments: The authors point out that physical fitness is a direct reflection of “the integrated function of multiple organ systems. As such “it is an important measure of overall health  and the body’s ability to respond” to a wide range physical stressors such as a viral invasion.  They also cite “the importance of allowing individuals to maintain and preferably to increase physical activity levels when normal activities might be restricted by local health authorities in response to a public health crisis.  

 

Reviewer:  Mark R. Payne DC

  

Reference:  Clinton A Brawner 1, Jonathan K Ehrman 2, Shane Bole 3, Dennis J Kerrigan 2, Sachin S Parikh 2, Barry K Lewis 2, Ryan M Gindi 2, Courtland Keteyian 4, Khaled Abdul-Nour 2, Steven J Keteyian 2 Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019. Mayo Clin Proc. 2021 Jan;96(1):32-39. doi: 10.1016/j.mayocp.2020.10.003. Epub 2020 Oct 10.

  

Link to Abstract: https://pubmed.ncbi.nlm.nih.gov/33413833/

Link to Full Text: https://www.mayoclinicproceedings.org/article/S0025-6196(20)31130-7/pdf

 

Mark R. Payne DC