Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
PLoS One. 2021 May 5;16(5):e0250508. doi: 10.1371/journal.pone.0250508. eCollection 2021.
BACKGROUND: It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID-19. METHODS: This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16th, 2020 to July 26th, 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20th percentile), moderate (20th to 80th percentile) and high (≥80th percentile) within sex and ten-year age groups (e.g. 50-60 years). Participants were classified as having COVID-19 if they tested positive (primarily PCR tests) at an in-patient or out-patient setting as of July 26, 2020. Participants were classified as having died from COVID-19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30th, 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. FINDINGS: There was no significant association between eCRF and testing positive for COVID-19. Conversely, individuals with moderate (aRR = 0.43, 95% CI: 0.25, 0.75) and high fitness (aRR = 0.37, 95% CI: 0.16, 0.85) had a significantly lower risk of dying from COVID-19 than those with low fitness. CONCLUSIONS: While eCRF was not significantly associated with testing positive for COVID-19, we observed a significant dose-response between having higher eCRF and a decreased risk of dying from COVID-19. This suggests that prior gains in CRF could be protective against dying from COVID-19 should someone develop the virus.
背景:有人认为心肺适能(CRF)可用于识别患严重 COVID-19 疾病风险最高的人群。然而,迄今为止尚无研究探讨 CRF 与 COVID-19 之间的关联。本研究的目的是确定 CRF 是否与 COVID-19 检测呈阳性或死于 COVID-19 独立相关。
方法:这是一项针对英国生物库研究中 2690 名成年人的前瞻性队列研究,随访时间为 2020 年 3 月 16 日至 2020 年 7 月 26 日。研究对象为接受 COVID-19 检测且进行 CRF 评估的人群。CRF 采用估计值(eCRF),并根据性别和十年年龄组(例如,50-60 岁)分为低(<20 百分位)、中(20-80 百分位)和高(≥80 百分位)。如果截至 2020 年 7 月 26 日,研究对象在住院或门诊环境中 PCR 检测呈阳性(主要为 PCR 检测),则被归类为 COVID-19 阳性。如果 2020 年 6 月 30 日之前主要或根本死因被列为 ICD-10 代码 U071 或 U072,则将研究对象归类为死于 COVID-19。使用调整后的风险比(aRR)和 95%置信区间(CI)进行估计,并采用向前模型构建方法确定协变量。
结果:eCRF 与 COVID-19 检测呈阳性之间无显著关联。相反,中(aRR=0.43,95%CI:0.25,0.75)和高健身(aRR=0.37,95%CI:0.16,0.85)水平的个体死于 COVID-19 的风险明显低于低健身水平的个体。
结论:虽然 eCRF 与 COVID-19 检测呈阳性无显著关联,但我们观察到 eCRF 较高与 COVID-19 死亡风险降低之间存在显著的剂量-反应关系。这表明,如果有人感染了该病毒,先前获得的 CRF 增益可能有助于预防 COVID-19 死亡。
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