Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.
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