The Influence of Social Distancing Behaviors and Psychosocial Factors on Physical Activity During the COVID-19 Pandemic: Cross-sectional Survey Study

Relationship between physical exercise and COVID-19 (SARS-CoV-2): systematic review

Background

The SARS-CoV virus is a precursor to the SARS-CoV-2 virus (COVID-19) and has caused millions of deaths worldwide. Although exercise can be a non-pharmacological means for the prevention and treatment of various diseases, the effects on COVID-19 patients are not yet completely clear.

Aims

The aim of this study was to investigate the relationship between physical exercise and symptoms caused by COVID-19.

Methods

The present systematic review was sent for evaluation and received the PROSPERO registration protocol-CRD42021257475. The search for studies related to health and physical exercise was carried out in the following databases; the "National Library in Medicine MEDLINE-Ovid", "Embase", "Web of Science", "SportDiscus-Ebsco", and "Scopus".

Results

Ten articles were included in the systematic review and the findings demonstrated the protective effects of physical exercise in patients with COVID-19. These effects were observed both in symptoms and in the period of hospitalization. In addition, the results show that the benefits of physical exercise seem to collaborate both in an individual manner and as an alternative to drug therapy. Finally, it was possible to verify the effect of physical exercise on variables, such as quality of life, cardiorespiratory capacity, and immunological biomarkers, and on the symptoms of the new Coronavirus.

Conclusions

It is possible to conclude that physical exercise can be a component for the treatment of COVID-19. In addition, it could help to reduce the symptoms and severity of COVID-19, and may be considered as an adjunct to drug therapy in patients contaminated with SARS-CoV-2.

Factors associated with meeting physical activity guidelines during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics.

METHODS

Data included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin Leisure-time exercise questionnaire. We used logistic regression models to estimate unadjusted and adjusted odds ratios (aOR) and their 95% confidence intervals (CI) for the associations between independent variables (e.g., demographic variables, neighborhood safety, COVID Stay-at-Home order and length of time) and physical activity levels that did not meet (i.e., < 600 metabolic equivalents of task [MET]-minutes/week) or met guidelines (i.e., ≥ 600 MET-minutes/week). We used R-Studio open-source edition to clean and code data and SAS V9.4 for analyses.

RESULTS

Most participants were 18-45 years old (58%), female (79%), Hispanic (58%), and college/post-graduates (76%). Most (70%) reported meeting physical activity guidelines. In multivariate-adjusted analyses stratified by income, in the highest income bracket (≥ $70,000) pet ownership was associated with higher odds of meeting physical activity guidelines (aOR = 2.37, 95% CI: 1.23, 4.55), but this association did not persist for other income groups. We also found lower  perceived neighborhood safety was associated with significantly lower odds of meeting physical activity guidelines (aOR = 0.15, 95% CI:0.04-0.61), but only among individuals in the lowest income bracket (< $40,000). Within this lowest income bracket, we also found that a lower level of education was associated with reduced odds of meeting physical activity guidelines.

DISCUSSION

We found that perceived neighborhood safety, education and pet ownership were associated with meeting physical activity guidelines during the early months of the COVID-19 pandemic, but associations differed by income. These findings can inform targeted approaches to promoting physical activity during subsequent waves of COVID-19 or future pandemics.

Physical activity lowers the risk for acute respiratory infections: Time for recognition

Physical inactivity is a well-established risk factor for chronic diseases, such as cardiovascular disease, cancer, and diabetes mellitus. There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections (ARIs). ARIs, such as the common cold, influenza, pneumonia, and coronavirus disease 2019 (COVID-19), are among the most pervasive diseases on earth and cause widespread morbidity and mortality. Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the COVID-19 pandemic because of increased scientific scrutiny. Large-scale studies have consistently reported that the risk for severe COVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness, even after adjusting for other risk factors. The lowered risk for severe COVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects, including enhanced surveillance of key immune cells and reduced chronic inflammation. Scientific consensus groups, including those who submitted the Physical Activity Guidelines for Americans, have not yet given this area of research the respect that is due. It is time to add "reduced risk for ARIs" to the "Exercise is Medicine" list of physical activity-related health benefits.

Physical Activity During Lockdowns Associated with the COVID-19 Pandemic: A Systematic Review and Multilevel Meta-analysis of 173 Studies with 320,636 Participants

Background

Many countries have restricted public life in order to contain the spread of the novel coronavirus (SARS-CoV2). As a side effect of related measures, physical activity (PA) levels may have decreased.

Objective

We aimed (1) to quantify changes in PA and (2) to identify variables potentially predicting PA reductions.

Methods

A systematic review with random-effects multilevel meta-analysis was performed, pooling the standardized mean differences in PA measures before and during public life restrictions.

Results

A total of 173 trials with moderate methodological quality (modified Downs and Black checklist) were identified. Compared to pre-pandemic, total PA (SMD − 0.65, 95% CI − 1.10 to − 0.21) and walking (SMD − 0.52, 95% CI − 0.29 to − 0.76) decreased while sedentary behavior increased (SMD 0.91, 95% CI: 0.17 to 1.65). Reductions in PA affected all intensities (light: SMD − 0.35, 95% CI − 0.09 to − 0.61, p = .013; moderate: SMD − 0.33, 95% CI − 0.02 to − 0.6; vigorous: SMD − 0.33, − 0.08 to − 0.58, 95% CI − 0.08 to − 0.58) to a similar degree. Moderator analyses revealed no influence of variables such as sex, age, body mass index, or health status. However, the only continent without a PA reduction was Australia and cross-sectional trials yielded higher effect sizes (p < .05).

Conclusion

Public life restrictions associated with the COVID-19 pandemic resulted in moderate reductions in PA levels and large increases in sedentary behavior. Health professionals and policy makers should therefore join forces to develop strategies counteracting the adverse effects of inactivity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00515-x.

The longitudinal associations of physical activity, time spent outdoors in nature and symptoms of depression and anxiety during COVID-19 quarantine and social distancing in the United States

Stressors associated with COVID-19 pandemic stay-at-home orders are associated with increased depression and anxiety and decreased physical activity. Given that physical activity and time spent outdoors in nature are associated with improved mental health, we examined the longitudinal association of these variables during the pandemic. Over 20,000 adults who participated in the U.S. Kaiser Permanente Research Bank, did not report COVID-19 symptoms, and responded to an online baseline and 3 follow-up surveys over approximately 3 months formed the cohort. Physical activity was assessed from a modified survey, time spent outdoors was assessed from one question, and anxiety and depression scores were assessed from validated instruments. Almost 60% were women, 82.8% were non-Hispanic white, and more than 93% of respondents were over the age of 50. Less in-person contact with friends and visiting crowded places was highly prevalent (>80%) initially and decreased somewhat (>70%). Participants in the lowest physical activity category (no physical activity) had the highest depression and anxiety scores compared to each successive physical activity category (p < 0.001). Spending less time outdoors was associated with higher depression and anxiety scores. This effect was greater for participants in the younger age categories compared with older age categories. The effect of less time spent outdoors on anxiety (p = 0.012) and depression (p < 0.001) scores was smaller for males than females. Results suggest that physical activity and time outdoors is associated with better mental health. People should be encouraged to continue physical activity participation during public health emergencies.

Relationship between Objectively and Subjectively Measured Physical Activity in Adolescents during and after COVID-19 Restrictions

Background: Studying the relationship between subjectively and objectively measured physical activity (PA) can provide viable information on youths’ behaviors. However, the restrictions due to COVID-19 pandemic, which reduced children’s possibilities to be active, may negatively affect it. The aim of this study was to assess the relationship between subjectively and objectively measured PA levels (light, moderate, vigorous, and moderate-to-vigorous) during COVID-19-based restrictions and after they were lifted, and to determine whether such relationships changed in these two periods. Methods: A total of 26 adolescents (58% girls; mean age = 12.4 ± 0.5) wore accelerometers during public restrictions and after they were removed. Participants also completed the International Physical Activity Questionnaire during the same periods. Results: High significant correlations were found at all levels of PA (r = 0.767–0.968) in both time periods, except for moderate PA during restrictions. Comparing the two periods, significantly higher correlations were found for moderate PA (p < 0.001) and moderate-to-vigorous PA (p = 0.003) after restrictions were lifted. Conclusions: In this highly active cohort of adolescents, results emphasize the potential threat of lockdown conditions for youths’ ability to accurately perceive their behaviors, with possible detrimental consequences on the short- and long-term health.