INACTIVITY IS THE #1 RISK FACTOR FOR SEVERE COVID-19
                     INACTIVITY IS THE 
#1 RISK FACTOR 
FOR SEVERE 
COVID-19
http://www.virtualphysicaltherapists.com/
Being physically active has been shown to improve health and longevity. Exercise 
increases muscle and bone strength, improves your immune system, lungs, and heart, 
and prevents many cancers and chronic illnesses. Not surprisingly, physical activity is 
now linked to COVID-19 outcomes and inactivity is the #1 Risk Factor for Severe COVID-
19.
Physical inactivity is more of a risk factor for severe COVID-19 than heart disease, 
cancer, diabetes, hypertension, smoking, and obesity.
A study of 48,440 COVID-19 patients from Kaiser Permanente in southern California 
found that physical activity was a critical risk factor for severe COVID-19 outcomes. 
Kaiser Permanente tracked patients diagnosed with COVID-19 who had also reported 
their physical activity thrice during outpatient visits over the prior two years. Those who 
were inactive had a significantly higher risk of hospitalization, ICU admission, and death. 
Being consistently inactive was a stronger risk factor for severe COVID-19 outcomes 
than any of the underlying medical conditions or risk factors identified by the CDC, 
except for age and a history of organ transplant. Even being active for only 10 minutes 
per week had some protection against severe illness or death from COVID.
The study showed that those who reported being physically inactive before diagnosis 
were 2.49 times more likely to die of COVID-19 than those who regularly met the U.S. 
physical activity guidelines of 150 minutes per week. 
Engaging in regular P.A. may be individuals’ most important action to prevent severe 
COVID-19 and its complications, including death.
 Patients with COVID-19 who were consistently inactive during the two years 
preceding the pandemic were more likely to be hospitalized, admitted to the 
intensive care unit, and die than patients who consistently met physical activity 
guidelines.
 Other than advanced age and a history of organ transplant, physical inactivity was 
the strongest risk factor for severe COVID-19 outcomes.
 Meeting U.S. Physical Activity Guidelines was associated with substantial benefits. 
Still, even those doing some physical activity had lower risks for severe COVID-19 
outcomes, including death, than those who were consistently inactive.
Mechanisms and reasons why regular physical activity plays a critical role in 
mitigating the severity of the COVID-19 pandemic:
It is well known that immune function improves with regular physical activity. Exercise 
benefits cardiovascular health increases lung capacity and muscle strength, and also 
improves mental health. Those who are regularly active have a lower incidence, 
intensity of symptoms, and death from various viral infections. Regular activity 
reduces the risk of systemic inflammation, which is the main contributor to lung 
damage caused by COVID-19. 
The U.S. Physical Activity Guidelines call for adults to engage in at least 150 
min/week of moderate to vigorous physical activity.
Despite the health benefits of regular physical activity and the consequences of a 
sedentary lifestyle, 36 percent of adults engage in NO leisure-time physical activity 
at all. Globally, only 23 percent of adults and 80 percent of adolescents are 
insufficiently active. According to the U.S. 2016 National Health Interview Survey, 48 
percent of adults are NOT meeting the Physical Activity Guidelines for aerobic 
activity, and 78 percent of adults are NOT meeting aerobic and strength training 
guidelines.
U.S. adolescents and adults spend almost eight hours a day in sedentary behaviors. 
Devastating Effects of Inactivity:
During the pandemic, every country advised to stay at home and avoid contact with 
individuals outside of one’s household. Lockdowns were put in place, as were 
restricted access to gyms, parks, playgrounds, beaches, swimming pools, and other 
venues where people can be active. These restrictions cause isolation and reduced 
public access to physical activity opportunities. Lack of physical activity causes insulin 
resistance (a warning sign for the development of type 2 diabetes), reduced muscle 
mass, increased body fat, weight gain, reduced cardiovascular and issues with 
inactivity such as poor sleep quality, poor mental health, cognitive sluggishness and 
increased risk of chronic illness. The health effects of inactivity start piling up within 
days.
Physical inactivity and sedentary behavior posed a significant economic burden 
worldwide before COVID-19. In 2013 the global economic cost of physical inactivity 
was estimated at around $54 billion. Inactivity also resulted in $13.7 billion in 
productivity losses due to physical-inactivity-related deaths.
Everyone is aware of the loss of strength from inactivity, but the devastating health 
effects are much more damaging and expensive.
Two weeks of inactivity (similar to being housebound during this pandemic) results 
in lowered muscle protein synthesis rates and the onset of insulin resistance. For 
those over 65, the adverse effects are much more significant. During the same 
period of inactivity, those over age 65 lose four percent of their leg muscle and one-
third of their insulin sensitivity. Younger adults can recover when they return to 
daily walking, but those over 65 have a more challenging time restoring muscle and 
glycemic control when they return to their daily routines; they do not regain their 
lost muscle. Effectively, older individuals don’t have the same ability to bounce back 
as younger people do. 
Regaining muscle requires deliberate effort – if you don’t use it, you lose it.
The most effective way to maintain muscle is to perform resistance exercises or 
strength training. And it doesn’t have to be complicated. If you don’t have access to a 
gym to use free weights, there are many valuable alternatives you can easily do at 
home. Body-weight exercises such as push-ups, squats, sit to stand with no hands, 
lunges, and elastic bands are excellent for strength training and walking, stair-
climbing, and even dancing are the best for aerobic conditioning.
The good news is that doing exercise does not have to be complicated. You can 
simply go for a long walk, and if it is raining, find a free exercise routine on YouTube. 
The most important thing is consistency. You should devote 30 minutes a day to 
exercise. Remember the important benefits of exercise -it will help you to get 
stronger and prevent muscle loss, 
The World Health Organization (WHO) classified physical inactivity as the fourth 
leading risk factor accounting for 6% of global mortality, following hypertension 
(13%), smoking (9%), and diabetes (6%). And now inactivity is the #1 Risk Factor for 
Severe COVID-19!
Exercise is the BEST Medicine
The documented benefits of physical activity have been neglected for the first year of 
the pandemic, missing an opportunity to reduce suffering and death. People are still 
getting sick and dying of COVID-19, so it is not too late to take action to help people 
be more active.  Reducing inactivity – the #1 Risk Factor for Severe COVID-19 is easy 
– more emphasis must be placed on the importance of regular exercise!
VIRTUAL 
PHYSICAL 
THERAPISTS
[email protected]
HTTP://WWW.VIRTUALPHYSICALTHERAPISTS.COM/
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