People who were more physically active before they became infected with COVID-19 had a lower risk of developing severe symptoms, a new study of more than 190,000 adults suggests.

The study, published last week in the American Journal of Preventive Medicine, sought to determine if there is an association between physical activity and less-severe COVID-19 outcomes, regardless of sex, race, or whether patients have chronic health problems.

“The main message is that every little bit of physical activity counts,” said Dr. Deborah Rohm Young, the study’s lead author, in a press release. “The more exercise the better, no matter a person’s race, ethnicity, age, sex, or chronic conditions.”

For the study, researchers at non-profit health group Kaiser Permanente analyzed the records of 194,191 Southern California adult patients who had been diagnosed with COVID-19 between Jan. 1, 2020, and May 31, 2021. All patients had self-reported their physical activity levels in the two years before their infection, and each of them was categorized ranging from “always inactive” for having 10 minutes or less of exercise per week, to “always active” for having 150 or more minutes of exercise per week.

The analysis showed that patients in the lower physical activity categories were more likely to have adverse COVID-19 outcomes, with those classified as “always inactive” having the highest odds of hospitalization, deterioration, or death.

This trend held true for patients of different sexes, races, and those with underlying chronic conditions such as obesity, hypertention, and cardiovascular diseases (CVD), according to the authors.

“Pre-existing chronic conditions, such as obesity, CVD, diabetes, and hypertension, are strongly associated with COVID-19‒related deaths,” the authors noted. “These data indicate that if a person with chronic disease was infected, the odds of hospitalization, inpatient deterioration event, and death were lowered among those who were engaged in some physical activity before COVID-19 diagnosis, compared with those in the always inactive category.”

An important limitation of the study, according to the researchers, is the fact that it relied on self-reported data. With that said, their analysis did lead to a conclusion consistent with previous studies.

One of those studies, published in February by researchers from South Africa, examined the physical activity of more than 65,000 adults who tested positive for COVID-19 from 19 March 2020 to 30 June 2021. The patients’ COVID-19-related outcomes were matched against their physical activity history, which was recorded by smart devices, clocked gym attendance, and participation in mass sporting events in the two years before the South African government imposed a lockdown.

After accounting for demographic factors and other risk factors, patients in the “high activity band,” or those who exercised more than 150 minutes per week, were found to be at a 34 percent lower risk of admission, a 41 percent lower risk of ICU admission, a 45 percent lower risk of requiring ventilation and a 42 percent lower risk of death, compared with those with low levels of activity.

“Adults with high and moderate physical activity levels had significantly better outcomes than those with low activity when contracting COVID-19,” the researchers said. “The apparent protective effects of regular physical activity extended to those with concomitant chronic medical conditions.”