Exercise Considerations during Coronavirus Disease 2019 (COVID-19) Outbreak: A Narrative Review

Document Type : Review

Authors

1 Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

2 Department of Biology, College of Basic Sciences, Yadegar-e-Imam Khomeini (RAH) Shahre Rey Branch, Islamic Azad University, Tehran, Iran

Abstract

The widespread outbreak of coronavirus (COVID-19) worldwide has raised concerns about physical activity and exercise. A review of research on physical training and viral infections shows that regular, moderate-intensity aerobic exercise (65-80% VO2max) increases antibody titers, lymphocyte proliferation, gamma interferon, immunoglobulin M, G, and natural killer cells production. It modulates the levels of inflammatory cytokines, chemokines and T cell-mediated immune response to the influenza virus. That is also associated with stronger and longstanding antibody responses to influenza vaccination in adults. Based on the available evidence and similarity of some of the signs and/or symptoms of Covid-19 to the H1N1 virus, it may be recommended toexercise during the outbreak. First, it is reasonable to restrict heavy exercise at this stage, as the open window hypothesis may increase the susceptibility to infection. Second, healthy or asymptomatic individuals can exercise moderately with hygiene guidelines and benefit from improved immune function according to the J-shaped model. Third, people with mild upper respiratory tract symptoms (e.g., runny nose, sinus congestion, mild sore throat) can exercise lightly with precautions. Finally, one suspected of Covid-19 symptoms (e.g., fever, cough, severe sore throat, myalgia, shortness of breath, general fatigue) should avoid exercise.

Keywords

References

1. Casanova LM, Jeon S, Rutala WA, Weber DJ, Sobsey MD. Effects of air temperature and relative humidity on coronavirus survival on surfaces. Appl. Environ. Microbiol. 2010;76(9):2712-7. 2. World Health Organization. Laboratory testing of human suspected cases of novel coronavirus (‎‎‎nCoV)‎‎‎ infection: interim guidance, 10 January 2020. World Health Organization; 2020. 3. Wertheim JO, Chu DK, Peiris JS, Pond SL, Poon LL. A case for the ancient origin of coronaviruses. Journal of Virology. 2013;87(12):7039-45. 4. Manson JE, Greenland P, LaCroix AZ, Stefanick ML, Mouton CP, Oberman A, et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. New England Journal of Medicine. 2002;347(10):716-25. 5. Nieman DC, Nehlsen-Cannarella SL. The immune response to exercise. InSeminars in hematology. 1994;31(2):166-179. 6. Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain, behavior, and immunity. 2005;19(5): 377-80. 7. Brown AS, Davis JM, Murphy EA, Carmichael MD, GHaffar A, Mayer EP. Gender differences in viral infection after repeated exercise stress. Medicine & Science in Sports & Exercise. 2004;36(8):1290-5. 8. Wong CM, Lai HK, Ou CQ, Ho SY, Chan KP, Thach TQ, et al. Is exercise protective against influenza-associated mortality?. PLoS One. 2008;3(5). 9. Woods JA, Keylock KT, Lowder T, Vieira VJ, Zelkovich W, Dumich S, et al. Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. Journal of the American Geriatrics Society. 2009;57(12):2183-91. 10. Williams PT. Reduced total and cause-specific mortality from walking and running in diabetes. Medicine and science in sports and exercise. 2014; 46(5):933. 11. Williams PT. Dose-response relationship between exercise and respiratory disease mortality. Medicine and science in sports and exercise. 2014;46(4):711. 12. Kohut ML, Sim YJ, Yu S, Yoon KJ, Loiacono CM. Chronic exercise reduces illness severity, decreases viral load, and results in greater anti-inflammatory effects than acute exercise during influenza infection. The Journal of infectious diseases. 2009;200(9):1434-42. 13. Warren KJ, Olson MM, Thompson NJ, Cahill ML, Wyatt TA, Yoon KJ, et al. Exercise improves host response to influenza viral infection in obese and non-obese mice through different mechanisms. PloS one. 2015;10(6). 14. Folsom R, Littlefield‐Chabaud MA, French DD, Pourciau SS, Mistric L, Horohov DW. Exercise alters the immune response to equine influenza virus and increases susceptibility to infection. Equine Veterinary Journal. 2001;33(7):664-9. 15. Kohut ML, Arntson BA, Lee W, Rozeboom K, Yoon KJ, Cunnick JE, et al. Moderate exercise improves antibody response to influenza immunization in older adults. Vaccine. 2004;22(17-18):2298-306. 16. de Araújo AL, Silva LC, Fernandes JR, Matias MD, Boas LS, Machado CM, et al. Elderly men with moderate and intense training lifestyle present sustained higher antibody responses to influenza vaccine. Age. 2015;37(6):105. 17. Zhu W. Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods. Journal of Sport and Health Science. 2020;9(2):105 18. Nieman DC, Wentz LM. The compelling link between physical activity and the body's defense system. Journal of sport and health science. 2019;8 (3): 201-17. 19. Dimitrov S, Hulteng E, Hong S. Inflammation and exercise: Inhibition of monocytic intracellular TNF production by acute exercise via β2-adrenergic activation. Brain, behavior, and immunity. 2017;61: 60-8. 20. Campbell JP, Turner JE. Debunking the myth of exercise-induced immune suppression: redefining the impact of exercise on immunological health across the lifespan. Frontiers in immunology. 2018;9:648. 21. Yang Y, Verkuilen J, Rosengren KS, Mariani RA, Reed M, Grubisich SA, et al. Effects of a Taiji and Qigong intervention on the antibody response to influenza vaccine in older adults. The American journal of Chinese medicine. 2007;35(04):597-607. 22. Falkenberg RI, Eising C, Peters ML. Yoga and immune system functioning: a systematic review of randomized controlled trials. Journal of behavioral medicine. 2018;41(4):467-82. 23. Martin SA, Pence BD, Woods JA. Exercise and respiratory tract viral infections. Exercise and sport sciences reviews. 2009;37(4):157.
Journal of Military Medicine
Volume 22, Issue 2 - Serial Number 86
March and April 2020
Pages 161-168

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