According to findings from a prospective cohort study published in the Journal of the American Medical Association Internal Medicine, adherence to healthy lifestyle habits preceding COVID-19 infection was inversely correlated with risk of post-COVID-19 condition (PCC).

The researchers sought to examine the correlation between healthy lifestyle factors prior to SARS-CoV-2 infection and the risk of PCC.

Data were compiled and reviewed from 32,249 women in the Nurses’ Health Study II cohort who reported preinfection lifestyle habits in 2015 and 2017 and a history of COVID-19 from April 2020 to November 2021.

Among participants with SARS-CoV-2 infection, the relative risk of PCC in association with the number of healthy lifestyle factors (0-6) was calculated utilizing Poisson regression and modifying for demographic characteristics and comorbidities.

The healthy lifestyle factors evaluated in this study included the following: healthy BMI (18.5-24.9 kg/m2), history of never smoking, obtaining at least 150 minutes of moderate-to-vigorous physical activity per week, moderate alcohol intake (5-15 g/day), high diet quality (upper 40% of Alternate Healthy Eating Index–2010 score), and obtaining an adequate amount of sleep (7-9 hours per night).

The results revealed that a total of 1,981 women with a positive SARS-CoV-2 test over 19 months of follow-up were recorded, with an average age of 64.7 years (age range: 55-75 years). Of those, 97.4% (n = 1,929) were Caucasian and 42.8% (n = 848) were active healthcare workers.

Among these, 871 (44.0%) developed PCC. Healthy lifestyle was associated with a lower risk of PCC in a dose-dependent manner. Compared with women without any healthy lifestyle factors, those with five to six healthy lifestyle factors had a 49% lower risk of developing PCC. Moreover, these associations were primarily propelled by healthy body weight and obtaining adequate sleep.

The authors indicated that the population-attributable risk percentage for all six healthy lifestyle factors in combination was 36.0%, signifying that if these associations were causal, 36.0% of PCC cases would have been prevented if all participants had five or six healthy lifestyle factors before the pandemic.

The authors also indicated that prior research found an unhealthy lifestyle is correlated with expanded risk of chronic inflammation and immune dysregulation, which also boosts one’s risk of PCC.

They also noted that while their findings imply that each of the six healthy lifestyle factors measured were largely correlated with a lower risk of PCC, in analyses mutually adjusted for all lifestyle factors and comorbidities, BMI and sleep were most robustly correlated with lower risk of PCC.

The authors concluded that in this study, preinfection healthy lifestyle was linked with a considerably lower risk of developing PCC. Additionally, if the correlations discovered were causal, among healthy lifestyle factors, maintaining a healthy weight and obtaining adequate duration of sleep each night may bestow the greatest benefit for deterrence of PCC. However, more research is warranted to examine whether lifestyle interventions may diminish risk of developing PCC or lessen symptoms for those with PCC or possibly other postinfection syndromes.

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