Oxford University-led study A healthy lifestyle before infection is associated with a 36% lower risk of long-term COVID-19, a 41% lower chance of death, and a 22% lower chance of hospitalization.
Researchers assessed the association between modifiable lifestyle factors (including smoking, alcohol consumption, BMI, physical activity, time spent in sedentary activities, sleep duration, and diet) and long COVID, death, and hospitalization in 68,896 adults from the UK Biobank cohort who tested positive for COVID-19 between March 2020 and March 2022.
Participants’ mean age was 66.6 years, 53.4% were male, and 82.1% were white. A total of 12.3% practiced an unfavorable lifestyle (0-4 healthy habits), 41.3% practiced a moderate lifestyle (5 healthy habits), and 46.4% practiced a favorable lifestyle (6-10). Participants practiced an average of 7 healthy lifestyle factors.
The results were published today in the journal Nature Communications.
71% of benefits are due to lifestyle
A total of 5.5% and 7.8% of people had signs or symptoms of long COVID in at least one studied organ system during and after infection, respectively. A healthy lifestyle was associated with a 36% lower risk of long COVID compared with an unhealthy lifestyle (absolute risk reduction (ARR), 7.1% at 210 days). An intermediate lifestyle was associated with a 20% lower risk of long COVID compared with an unhealthy lifestyle (ARR, 3.9%). The number of favorable lifestyle factors was associated with risk of long COVID in a dose-dependent manner.
Adherence to a healthy lifestyle before the pandemic was associated with a significantly lower risk of sequelae across organ systems, death, and hospitalization after COVID-19, regardless of stage of infection, vaccination status, testing setting, SARS-CoV-2 variant, or associated comorbidities.
Risk reduction affected all organ systems studied (cardiovascular, coagulation, metabolic, gastrointestinal, renal, mental health, musculoskeletal, respiratory, fatigue).Benefits were primarily lifestyle-driven and unrelated to pre-infection disease (percentage direct effect on signs and symptoms, 71%).
A healthy lifestyle was associated with a 41% lower risk of death and a 22% lower odds of hospitalization after COVID-19 infection. These associations were observed regardless of pre- or post-infection status, hospitalization status, vaccination status, or SARS-CoV-2 variant. Pre-COVID medical conditions, particularly cardiovascular disease, diabetes and psychiatric illness, were associated with a significantly increased risk of long COVID-19.
The study authors said a healthy lifestyle may lower the risk of severe COVID-19 and death by preventing inflammation, abnormal immune responses (autoimmunity) and abnormal clotting.
“Adherence to a healthy lifestyle before the pandemic was associated with a significantly lower risk of sequelae, death, and hospitalization across organ systems after COVID-19, regardless of stage of infection, vaccination status, testing setting, SARS-CoV-2 variant, or associated comorbidities,” the study authors wrote. “These findings suggest that people’s adherence to a healthy lifestyle may help reduce the long-term adverse health effects of COVID-19.”