Living a Healthy Lifestyle May Prevent Long COVID

People who live a healthy lifestyle prior to COVID-19 infection have a significantly lower risk of post-COVID-19 condition (PCC), informally known as long COVID, according to a new study published in JAMA Internal Medicine.

Long COVID is defined as COVID symptoms that persist beyond 4 weeks after initial infection. The condition comprises a broad range of respiratory, cardiovascular, metabolic, neurological, and psychiatric manifestations, and affects up to 40% of individuals with COVID-19, with the prevalence being higher among the unvaccinated. Prior data have found that people with a healthy body mass index (BMI) have a lower risk of long COVID, but the link between healthy lifestyle factors prior to infection and the risk of long COVID has been less elucidated.

In this prospective cohort study, researchers documented 1,981 women (mean age, ~65, 97.4% white) who reported a positive COVID-19 test from April 2020 to November 2021. The healthy lifestyle factors that were analyzed included healthy BMI, never smoking, only moderate alcohol intake, a healthy diet, and adequate sleep (7-9 hours per night). Long COVID symptoms were self-reported, and relative risk was estimated using Poisson regression, while adjusting for demographic factors, and comorbidities.

Healthy Living May Confer Protection Against Long COVID

According to the results, a healthy lifestyle was linked with lower risk of PCC in a dose-dependent manner. The researchers noted that compared with women without any healthy lifestyle factors, those with 5 to 6 healthy lifestyle factors had 49% lower risk (RR, 0.51; 95% CI, 0.33-0.78) of PCC. The investigators observed that BMI and sleep were independently associated with risk of PCC (BMI, 18.5-24.9 vs others, RR, 0.85; 95% CI, 0.73-1.00, P = .046; sleep, 7-9 h/d vs others, RR, 0.83; 95% CI, 0.72-0.95, P = .008). “If these associations were causal, 36.0% of PCC cases would have been prevented if all participants had 5 to 6 healthy lifestyle factors (population attributable risk percentage, 36.0%; 95% CI, 14.1%-52.7%),” the researchers said of the results.

“The findings of this prospective cohort study indicate that adherence to a healthy lifestyle was associated with substantially reduced risk of developing PCC among individuals subsequently infected with SARS-CoV-2,” the researchers concluded. “If the associations we found were causal, among healthy lifestyle factors, maintaining a healthy weight and having adequate sleep duration may confer the greatest benefit for prevention of PCC.”