Remote learning and physical activity in medical students from Latin America: a cross-sectional study during the first wave of the COVID-19 pandemic

Objective: To evaluate the association between remote learning and physical activity levels among medical students in Latin America during the first wave of the COVID-19 pandemic. Methods: Multicenter cross-sectional study conducted via an online survey during 2020, targeting medical students from multiple Latin American countries. Sociodemographic, academic, mental health, and physical activity data were collected using the International Physical Activity Questionnaire (IPAQ-S). Remote learning was the main exposure variable, and low physical activity level was the outcome. Poisson regression models with robust variance were used to estimate adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI). Results: Among 2018 medical students, the prevalence of low physical activity was 54.5% (95% CI: 52.3-56.7). In the multivariable analysis, remote/virtual learning was associated with a lower prevalence of high physical activity (PR = 0.81). Other factors associated with lower prevalence included female sex (PR = 0.89), obesity (PR = 0.69), trust in the government (PR = 0.79), and high-risk tobacco use (PR = 0.80). Factors associated with higher prevalence included perceiving the pandemic as mild/not serious (PR = 1.40), prior COVID-19 diagnosis (PR = 1.21), studying at a private university (PR = 1.17), and having diabetes (PR = 1.59). Conclusions: Remote learning during the pandemic was associated with lower physical activity levels among Latin American medical students. These findings highlight the need for university-based interventions to promote physical activity, particularly in prolonged distance learning contexts.