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Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalization, and death

Author

Listed:
  • Yunhe Wang

    (University of Oxford)

  • Binbin Su

    (Chinese Academy of Medical Sciences/Peking Union Medical College)

  • Marta Alcalde-Herraiz

    (NDORMS, University of Oxford)

  • Nicola L. Barclay

    (NDORMS, University of Oxford)

  • Yaohua Tian

    (Huazhong University of Science and Technology)

  • Chunxiao Li

    (University of Cambridge)

  • Nicholas J. Wareham

    (University of Cambridge)

  • Roger Paredes

    (Hospital Universitari Germans Trias i Pujol
    Case Western Reserve University School of Medicine)

  • Junqing Xie

    (NDORMS, University of Oxford)

  • Daniel Prieto-Alhambra

    (NDORMS, University of Oxford
    Erasmus Medical Center University)

Abstract

Effective prevention strategies for post-COVID complications are crucial for patients, clinicians, and policy makers to mitigate their cumulative burden. This study evaluated the association of modifiable lifestyle factors (smoking, alcohol intake, BMI, physical activity, sedentary time, sleep duration, and dietary habits) with COVID-19 multisystem sequelae, death, and hospitalization in the UK Biobank cohort (n = 68,896). A favorable lifestyle (6-10 healthy factors; 46.4%) was associated with a 36% lower risk of multisystem sequelae (HR, 0.64; 95% CI, 0.58-0.69; ARR at 210 days, 7.08%; 95% CI, 5.98-8.09) compared to an unfavorable lifestyle (0-4 factors; 12.3%). Risk reductions spanned all 10 organ systems, including cardiovascular, coagulation, metabolic, gastrointestinal, kidney, mental health, musculoskeletal, respiratory disorders, and fatigue. This beneficial effect was largely attributable to direct lifestyle impacts independent of corresponding pre-infection comorbidities (71% for any sequelae). A favorable lifestyle was also related to the risk of post-COVID death (HR 0.59, 0.52-0.66) and hospitalization (HR 0.78, 0.73-0.84). These associations persisted across acute and post-acute infection phases, irrespective of hospitalization status, vaccination, or SARS-CoV-2 variant. These findings underscore the clinical and public health importance of adhering to a healthy lifestyle in mitigating long-term COVID-19 adverse impacts and enhancing future pandemic preparedness.

Suggested Citation

  • Yunhe Wang & Binbin Su & Marta Alcalde-Herraiz & Nicola L. Barclay & Yaohua Tian & Chunxiao Li & Nicholas J. Wareham & Roger Paredes & Junqing Xie & Daniel Prieto-Alhambra, 2024. "Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalization, and death," Nature Communications, Nature, vol. 15(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-50495-7
    DOI: 10.1038/s41467-024-50495-7
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    References listed on IDEAS

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