# Physical activity is associated with a lower risk of contracting and dying in infection and sepsis: a Swedish population-based cohort study

## TL;DR

Regular physical activity is linked to lower risks of infection/sepsis and death from these conditions in a large Swedish cohort.

## Contribution

This study is the first to show a dose-response relationship between physical activity and reduced sepsis risk in a population-based cohort.

## Key findings

- Exercising one hour per week was associated with 7% lower risk of infection/sepsis compared to no exercise.
- Higher physical activity levels correlated with even lower risks of contracting and dying from infection/sepsis.
- Population-attributable risks for not exercising were 2.6% for infection/sepsis and 4.5% for death from these conditions.

## Abstract

Sepsis is a condition where the immune response to infection becomes dysregulated and life-threatening. It is not known whether lifestyle factors influence the risk of sepsis. The aim of the present study is to investigate the association between physical activity and the risk of acquiring and dying in infection or sepsis.

The population-based Swedish Mammography Cohort and Cohort of Swedish Men sent participants lifestyle questionnaires in 1997 and have subsequently followed participants in national Swedish registers, including the National Patient Register, the Swedish Intensive Care Registry and the Cause of Death Register. The risk of contracting infection and sepsis, the risk of intensive care unit admission and the risk of death were estimated using multivariable Cox regression.

Among 64,850 cohort participants, 26,124 individuals suffered at least one episode of infection or sepsis and 4708 individuals died of infection or sepsis during the study period. In adjusted analyses, compared to exercising less than one hour per week, stated exercise one hour per week was associated with lower risk of contracting infection or sepsis, hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.90–0.97), and lower risk of dying in infection or sepsis, HR 0.87 (95% CI 0.80–0.96). Further exercise was associated with even lower risk, and similar patterns were observed for walking. The population-attributable risks of contracting and dying in infection or sepsis for not exercising were 2.6% and 4.5%, respectively.

Exercise and walking demonstrate inverse dose–response associations with both the risk of contracting and dying in infection and sepsis, presenting possible preventative interventions for this critical condition.

The online version contains supplementary material available at 10.1186/s13054-024-04881-8.