16th Jul 2020

COVID-19 FAQ: What lifestyle factors can increase the risk of severe illness?

16th Jul 2020

Curated by Endre Szvetnik

Most research into the risk of severe COVID-19 focuses on age and underlying medical conditions, while studies about how lifestyle can affect severity are just emerging.


One of them, using data from over 387,000 UK residents has found that obesity, smoking, physical inactivity and alcohol consumption all increased the risk being admitted to hospital following a SARS-CoV-2 infection. According to their findings, physically inactive and less highly educated older male smokers were at the highest risk, over 4 times that of people with optimal lifestyles. Being overweight or obese were both found to be risk factors. This is explained by links between obesity and immune hyper-reactivity, impaired metabolic responses and its adverse effects on lung function. The researchers concluded that unhealthy behaviours can contribute up to 51% to whether someone ends up in hospital with COVID-19. On the other hand, a more active lifestyle can strengthen the immune system against viral infections. Interestingly, the team has found weak evidence that excessive alcohol intake further increases the risk of severe COVID-19. Other studies highlighted deprivation (a combination of poverty, poor education, low social status) as a risk factor, although people on low incomes don’t have much choice of where they live. University of Glasgow researchers found that people from deprived areas were 1,89 times more likely to fall ill with COVID-19.
What kind of lifestyle changes can lower the risk? The above UK study suggested that even relatively low activity (less than 150 minutes of moderate to vigorous exercise per week could offer some protection against severe COVID-19. The explanation lies in the immunological benefits of exercise, such as anti-inflammatory effects and effects on adaptive immune responses. US researchers have found that surprisingly, having a diverse social network can lower the susceptibility of viral infections. According to their studies ‘social stressors’ (loneliness, loss of employment of familial conflict) can affect immunity through the overproduction of inflammation-boosting chemicals. Severe COVID-19 is linked to an overreaction of the immune system, known as the ‘cytokine storm’. Therefore, leading a socially adjusted life can offer some protection against a severe form of the disease. Additionally, authorities such as the US Centers for Disease Control stress the importance of adjusting our lifestyles to follow social distancing rules. However, ‘front-line’ workers (such as care workers) might not be able to avoid crowded spaces and need protective equipment to lower their risk.

Here is the current state of science on a Sparrho pinboard. NB: The pinboard contains research papers that have not been peer-reviewed yet, meaning that they have not gone through the standard scientific validation process yet.

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Curated by

Endre Szvetnik

Endre Szvetnik is Senior Editor at Sparrho. Endre works with Sparrho Heroes to curate, translate and disseminate scientific research to the wider public.

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