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Erol N, Erol C. Do sports protect us from COVID-19? An evaluation of COVID-19 infection, vaccination status, and cardiac examination findings in children who exercise. Cardiol Young 2024; 34:771-775. [PMID: 37822192 DOI: 10.1017/s1047951123003475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
AIM The COVID-19 pandemic which has devastated the whole world for the past 3 years affects different patient groups differently. This study aims to evaluate the prevalence, symptoms, and severity of COVID-19 infection, vaccination status, and cardiac pathologies of children who exercise. MATERIAL AND METHODS The records of the children and adolescents who applied to our paediatric cardiology outpatient clinic for preparticipation examinations between 01.01.22 and 31.12.2022 were scanned retrospectively, and information about their COVID-19 history, the severity of infection, symptoms during the infection, at the time of the examination, and vaccination status was obtained. The results were analysed using MS Excel 2016 software. RESULTS The study consisted of 240 children [82 (34.17%) girls and 158 (65.83%) boys] whose mean age was 12.64 ± 2.64 years, mean weight was 50.03 ± 15.53 kg, mean height was 157 ± 15.09 cm, and mean body mass index was 19.65 ± 3.59. 129 cases had a COVID-19 history, 74 cases had no COVID-19 history, and 37 only had contact but no polymerase chain reaction positivity. 84 cases were mild, 19 were moderate, and 12 were asymptomatic. The most common symptoms were fatigue, malaise, headache, sore throat, and fever. 51 cases (35.15%) were vaccinated against COVID-19. No significant cardiac pathologies were detected in electrocardiography or echocardiography. CONCLUSIONS This study shows that COVID-19 infections in children who exercise are generally mild and self-limiting. Our findings suggest that exercise may have positive effects on immunity.
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Affiliation(s)
- Nurdan Erol
- Pediatric Clinics, Health Sciences University Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, Istanbul, Turkey
| | - Cigdem Erol
- Istanbul University Informatics Department, Beyazit, Istanbul, Turkey
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Muñoz-Vergara D, Wayne PM, Kim E, Lee IM, Buring JE, Manson JE, Sesso HD. Prepandemic Physical Activity and Risk of COVID-19 Diagnosis and Hospitalization in Older Adults. JAMA Netw Open 2024; 7:e2355808. [PMID: 38349654 PMCID: PMC10865155 DOI: 10.1001/jamanetworkopen.2023.55808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/19/2023] [Indexed: 02/15/2024] Open
Abstract
Importance Higher prepandemic physical activity (PA) levels have been associated with lower risk and severity of COVID-19. Objective To investigate the association between self-reported prepandemic PA levels and the risk and severity of COVID-19 in older US adults. Design, Setting, and Participants This cohort study combined cohorts from 3 ongoing prospective randomized clinical trials of US adults aged 45 years or older who provided prepandemic self-reports of baseline leisure-time PA and risk factors for COVID-19 outcomes using the most recent questionnaire completed as of December 31, 2019, as the baseline PA assessment. In multiple surveys from May 2020 through May 2022, participants indicated whether they had at least 1 positive COVID-19 test result or were diagnosed with or hospitalized for COVID-19. Exposure Prepandemic PA, categorized into 3 groups by metabolic equivalent hours per week: inactive (0-3.5), insufficiently active (>3.5 to <7.5), and sufficiently active (≥7.5). Main Outcome and Measures Primary outcomes were risk of COVID-19 and hospitalization for COVID-19. Multivariable logistic regression was used to estimate odd ratios (ORs) and 95% CIs for the association of COVID-19 diagnosis and/or hospitalization with each of the 2 upper PA categories vs the lowest PA category. Results The pooled cohort included 61 557 participants (mean [SD] age, 75.7 [6.4] years; 70.7% female), 20.2% of whom were inactive; 11.4%, insufficiently active; and 68.5%, sufficiently active. A total of 5890 confirmed incident cases of COVID-19 were reported through May 2022, including 626 hospitalizations. After controlling for demographics, body mass index, lifestyle factors, comorbidities, and medications used, compared with inactive individuals, those insufficiently active had no significant reduction in infection (OR, 0.96; 95% CI, 0.86-1.06) or hospitalization (OR, 0.98; 95% CI, 0.76-1.28), whereas those sufficiently active had a significant reduction in infection (OR, 0.90; 95% CI, 0.84-0.97) and hospitalization (OR, 0.73; 95% CI, 0.60-0.90). In subgroup analyses, the association between PA and SARS-CoV-2 infection differed by sex, with only sufficiently active women having decreased odds (OR, 0.87; 95% CI, 0.79-0.95; P = .04 for interaction). Conclusions and Relevance In this cohort study of adults aged 45 years or older, those who adhered to PA guidelines before the pandemic had lower odds of developing or being hospitalized for COVID-19. Thus, higher prepandemic PA levels may be associated with reduced odds of SARS-CoV-2 infection and hospitalization for COVID-19.
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Affiliation(s)
- Dennis Muñoz-Vergara
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter M. Wayne
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Eunjung Kim
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Julie E. Buring
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Howard D. Sesso
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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3
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Smith KA, Zúñiga TM, Baker FL, Batatinha H, Pedlar CR, Burgess SC, Gustafson MP, Katsanis E, Simpson RJ. COVID-19 vaccination produces exercise-responsive SARS-CoV-2 specific T-cells regardless of infection history. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:99-107. [PMID: 37399887 PMCID: PMC10818112 DOI: 10.1016/j.jshs.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/24/2023] [Accepted: 05/08/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND The mobilization and redistribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific T-cells and neutralizing antibodies (nAbs) during exercise is purported to increase immune surveillance and protect against severe coronavirus disease 2019 (COVID-19). We sought to determine if COVID-19 vaccination would elicit exercise-responsive SARS-CoV-2 T-cells and transiently alter nAb titers. METHODS Eighteen healthy participants completed a 20-min bout of graded cycling exercise before and/or after receiving a COVID-19 vaccine. All major leukocyte subtypes were enumerated before, during, and after exercise by flow cytometry, and immune responses to SARS-CoV-2 were determined using whole blood peptide stimulation assays, T-cell receptor (TCR)-β sequencing, and SARS-CoV-2 nAb serology. RESULTS COVID-19 vaccination had no effect on the mobilization or egress of major leukocyte subsets in response to intensity-controlled graded exercise. However, non-infected participants had a significantly reduced mobilization of CD4+ and CD8+ naive T-cells, as well as CD4+ central memory T-cells, after vaccination (synthetic immunity group); this was not seen after vaccination in those with prior SARS-CoV-2 infection (hybrid immunity group). Acute exercise after vaccination robustly mobilized SARS-CoV-2 specific T-cells to blood in an intensity-dependent manner. Both groups mobilized T-cells that reacted to spike protein; however, only the hybrid immunity group mobilized T-cells that reacted to membrane and nucleocapsid antigens. nAbs increased significantly during exercise only in the hybrid immunity group. CONCLUSION These data indicate that acute exercise mobilizes SARS-CoV-2 specific T-cells that recognize spike protein and increases the redistribution of nAbs in individuals with hybrid immunity.
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Affiliation(s)
- Kyle A Smith
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA
| | - Tiffany M Zúñiga
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA
| | - Forrest L Baker
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA; Department of Pediatrics, The University of Arizona, Tucson, AZ 85724, USA
| | - Helena Batatinha
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA
| | - Charles R Pedlar
- Faculty of Sport, Allied Health and Performance Science, St. Mary's University, Twickenham TW1 4SX, UK; Institute of Sport Exercise and Health, University College London, London WC1E 7HU, UK
| | - Shane C Burgess
- Department of Animal and Comparative Biomedical Sciences, The University of Arizona, Tucson, AZ 85721, USA; The University of Arizona Cancer Center, The University of Arizona, Tucson, AZ 85719, USA
| | - Michael P Gustafson
- Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ 85054, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, The University of Arizona, Tucson, AZ 85724, USA; The University of Arizona Cancer Center, The University of Arizona, Tucson, AZ 85719, USA; Department of Immunobiology, The University of Arizona, Tucson, AZ 85724, USA; Department of Medicine, The University of Arizona, Tucson, AZ 85724, USA; Department of Pathology, The University of Arizona, Tucson, AZ 85724, USA
| | - Richard J Simpson
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA; Department of Pediatrics, The University of Arizona, Tucson, AZ 85724, USA; Department of Immunobiology, The University of Arizona, Tucson, AZ 85724, USA; Department of Medicine, The University of Arizona, Tucson, AZ 85724, USA.
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Wang R, Jia Y, Sun T, Ruan B, Zhou H, Yu L, Hou X. Does Physical Activity Affect Clinical Symptoms and the Quality of Life of Mild-Infected Individuals with COVID-19 in China? A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2163. [PMID: 37570403 PMCID: PMC10418943 DOI: 10.3390/healthcare11152163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/18/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Few studies have identified the links between physical activity (PA), clinical symptoms, and the quality of life (QoL) among mildly infected individuals with COVID-19. This cross-sectional study aims to evaluate how PA levels before infections affect the infectious symptoms and the QoL in mildly infected patients with COVID-19. METHODS An online questionnaire link including participants' sociodemographic and anthropometric characteristics, clinical symptoms during the COVID-19 infectious period, the QoL of the worst symptomatic day, and PA in the last seven days before COVID-19 infections was disclosed. Logistic regression and multiple linear regression analyses were applied to assess the relationships between PA levels in the last seven days before infections and COVID-19-related outcomes. The level of statistical significance was set at p < 0.05. RESULTS Compared to the low-PA-level group, the moderate-PA-level group presented a higher risk of headaches (OR = 1.34, 95% CI = 1.03 to 1.75, and p = 0.03) and the high-PA-level group presented a higher risk of muscle/body aches (OR = 1.42, 95% CI = 1.04 to 1.93, and p = 0.03). The adjusted linear regression analysis showed that no associations were found between PA levels in the last seven days before infections and the QoL index value on the worst symptomatic day (moderate-PA-level group: β = -0.04, and p = 0.08; high-PA-level group: β = -0.04, and p = 0.17). However, for the mobility and usual activities dimensions of EQ-5D-5L, the lower-PA-level group had a lower burden of QoL than the higher-PA-level group did on the worst-symptomatic day. CONCLUSIONS Among mildly infected patients with COVID-19, a higher PA level is associated with a higher risk of experiencing clinical symptoms and a lower QoL.
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Affiliation(s)
- Rong Wang
- School of Sport Science, Beijing Sport University, Beijing 100084, China; (R.W.)
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing 100084, China
| | - Yuanyuan Jia
- School of Sport Science, Beijing Sport University, Beijing 100084, China; (R.W.)
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing 100084, China
| | - Tingting Sun
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing 100084, China
| | - Bing Ruan
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Huixuan Zhou
- School of Sport Science, Beijing Sport University, Beijing 100084, China; (R.W.)
| | - Laikang Yu
- Department of Sports Performance, Beijing Sport University, Beijing 100084, China
| | - Xiao Hou
- School of Sport Science, Beijing Sport University, Beijing 100084, China; (R.W.)
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing 100084, China
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Wang C, Ramasamy A, Verduzco-Gutierrez M, Brode WM, Melamed E. Acute and post-acute sequelae of SARS-CoV-2 infection: a review of risk factors and social determinants. Virol J 2023; 20:124. [PMID: 37328773 PMCID: PMC10276420 DOI: 10.1186/s12985-023-02061-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/02/2023] [Indexed: 06/18/2023] Open
Abstract
SARS-CoV-2 infection leading to Coronavirus Disease 2019 (COVID-19) has caused more than 762 million infections worldwide, with 10-30% of patients suffering from post-acute sequelae of SARS-CoV-2 infections (PASC). Initially thought to primarily affect the respiratory system, it is now known that SARS-CoV-2 infection and PASC can cause dysfunction in multiple organs, both during the acute and chronic stages of infection. There are also multiple risk factors that may predispose patients to worse outcomes from acute SARS-CoV-2 infection and contribute to PASC, including genetics, sex differences, age, reactivation of chronic viruses such as Epstein Barr Virus (EBV), gut microbiome dysbiosis, and behavioral and lifestyle factors, including patients' diet, alcohol use, smoking, exercise, and sleep patterns. In addition, there are important social determinants of health, such as race and ethnicity, barriers to health equity, differential cultural perspectives and biases that influence patients' access to health services and disease outcomes from acute COVID-19 and PASC. Here, we review risk factors in acute SARS-CoV-2 infection and PASC and highlight social determinants of health and their impact on patients affected with acute and chronic sequelae of COVID-19.
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Affiliation(s)
- Chumeng Wang
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Akshara Ramasamy
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Monica Verduzco-Gutierrez
- Department of Physical Medicine and Rehabilitation, University of Texas at San Antonio, San Antonio, TX, USA
| | - W Michael Brode
- Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Esther Melamed
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
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HALABCHI FARZIN, MAHDAVIANI BEHNAZ, TAZESH BEHNAZ, SHAB-BIDAR SAKINEH, SELK-GHAFFARI MARYAM. Association between physical activity and risk of COVID-19 infection or clinical outcomes of the patients with COVID-19: A systematic review and meta-analysis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E123-E136. [PMID: 37654858 PMCID: PMC10468187 DOI: 10.15167/2421-4248/jpmh2023.64.2.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 05/05/2023] [Indexed: 09/02/2023]
Abstract
Objective The COVID-19 pandemic has caused serious consequences for global health and economy. The important question is whether the level of physical activity might influence the risk of COVID-19 incidence or clinical outcomes, including the severity or mortality of infected patients. The objective of this systematic review and meta-analysis is to evaluate the association between sufficient physical activity and incidence, hospitalization, severity, recovery, and mortality of COVID-19. Methods A systematic search of Web of Sciences, PubMed, and Scopus between December 2019 and November 2021 was conducted. Studies were screened based on the inclusion criteria, i.e. observational studies (case-control, prospective or retrospective longitudinal designs, and cross-sectional studies) which have determined the association of physical activity, exercise, sports participation, or sedentary behavior with COVID-19 incidence or outcomes, including mortality, severity, recovery and hospitalization in healthy population or population with any specific comorbidity. Results Based on eligibility criteria, 27 articles were finally included in the qualitative synthesis. The meta-analysis of five studies evaluating the association of physical activity and COVID-19 mortality showed a weighted OR of OR of 0.61 (CI 95%: 0.50-0.75) with heterogeneity (I2 = 45.8%, P < 0.001) and in seven studies regarding physical activity and COVID-19 hospitalization, weighted OR was 0.541 (CI 95%: 0.491-0.595) with heterogeneity (I2 = 81.7%, P < 0.001). Conclusion Participating in sufficient physical activity might decrease COVID-19 related COVID-19-related hospitalization and mortality. Developing programs to increase physical activity during the COVID-19 pandemic might be an appropriate health strategy.
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Affiliation(s)
- FARZIN HALABCHI
- Department of Sports and Exercise Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - BEHNAZ MAHDAVIANI
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - BEHNAZ TAZESH
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - SAKINEH SHAB-BIDAR
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - MARYAM SELK-GHAFFARI
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Bolesławska I, Jagielski P, Błaszczyk-Bębenek E, Jagielska A, Przysławski J. Lifestyle Changes during the SARS-CoV-2 Pandemic as Predictors of BMI Changes among Men and Women in Poland. Nutrients 2023; 15:nu15112427. [PMID: 37299391 DOI: 10.3390/nu15112427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Social isolation during the SARS-CoV-2 pandemic affected people's body weight, therefore, this study was designed to evaluate the association between lifestyle elements and the change in BMI during lockdown. METHODS This retrospective observational study involved 290 questionnaires completed by adult participants divided into three groups according to BMI change during isolation. The structured questionnaire included a general description of the study objective and collected data regarding sociodemographics, anthropometrics, physical activity, sedentary behaviour, sleep duration, and food intake pre- and during COVID-19 lockdown. RESULTS A decrease or increase in BMI was found in 23.6% and 47.8% of women and 18.5% and 42.6% of men, respectively. Among those who lost weight, 46.5% of women and 40% of men followed a diet of their own choice, 30.2% of women and 25% of men changed their product mix and reduced their intake, 40% of men stopped eating outside the home. An increase in BMI was associated with increased food intake (32.2% of women and 28.3% of men), increased sleep duration on weekdays (49.2% of women and 43.5% of men) and, in more than 50% of subjects, decreased physical activity. In women, increased BMI was associated with the highest frequency of snacking (p = 0.0003), the highest intake of sweets (p = 0.0021), and in men with the highest intake of alcohol (p = 0.0017). CONCLUSIONS The observed changes in BMI during social isolation were the result of lifestyle modifications including dietary behaviour and differed by gender.
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Affiliation(s)
- Izabela Bolesławska
- Department of Bromatology, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznan, Poland
| | - Paweł Jagielski
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska Street, 31-066 Kraków, Poland
| | - Ewa Błaszczyk-Bębenek
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska Street, 31-066 Kraków, Poland
| | - Anna Jagielska
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland
| | - Juliusz Przysławski
- Department of Bromatology, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznan, Poland
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Ferguson M, Vel J, Phan V, Ali R, Mabe L, Cherner A, Doan T, Manakatt B, Jose M, Powell AR, McKinney K, Serag H, Sallam HS. Coronavirus Disease 2019, Diabetes, and Inflammation: A Systemic Review. Metab Syndr Relat Disord 2023; 21:177-187. [PMID: 37130311 DOI: 10.1089/met.2022.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
People with cardiometabolic diseases [namely type 2 diabetes (T2D), obesity, or metabolic syndrome] are more susceptible to coronavirus disease 2019 (COVID-19) infection and endure more severe illness and poorer outcomes. Hyperinflammation has been suggested as a common pathway for both diseases. To examine the role of inflammatory biomarkers shared between COVID-19 and cardiometabolic diseases, we reviewed and evaluated published data using PubMed, SCOPUS, and World Health Organization COVID-19 databases for English articles from December 2019 to February 2022. Of 248 identified articles, 50 were selected and included. We found that people with diabetes or obesity have (i) increased risk of COVID-19 infection; (ii) increased risk of hospitalization (those with diabetes have a higher risk of intensive care unit admissions) and death; and (iii) heightened inflammatory and stress responses (hyperinflammation) to COVID-19, which worsen their prognosis. In addition, COVID-19-infected patients have a higher risk of developing T2D, especially if they have other comorbidities. Treatments controlling blood glucose levels and or ameliorating the inflammatory response may be valuable for improving clinical outcomes in these patient populations. In conclusion, it is critical for health care providers to clinically evaluate hyperinflammatory states to drive clinical decisions for COVID-19 patients.
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Affiliation(s)
- Monique Ferguson
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jaysonn Vel
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Vincent Phan
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Roshaneh Ali
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Lainie Mabe
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Annie Cherner
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Thao Doan
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Bushra Manakatt
- School of Nursing, University of Texas Medical Branch, Galveston, Texas, USA
| | - Mini Jose
- School of Nursing, University of Texas Medical Branch, Galveston, Texas, USA
| | - Audrey Ross Powell
- University of Texas Medical Branch Alumni, Galveston, Texas, USA
- Madrigal Pharmaceuticals, Conshohocken, Pennsylvania, USA
| | - Kevin McKinney
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Hani Serag
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Hanaa S Sallam
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Physiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Rejeki PS, Witarto BS, Witarto AP, Rifdah SN, Wafa IA, Utami DM, Izzatunnisa N, Kencono Wungu CD, Khaerunnisa S, Sakina, Fazleen Mohd Fathil NE. Importance of moderate-to-vigorous physical activity during the COVID-19 pandemic: a systematic review and meta-analysis. J Basic Clin Physiol Pharmacol 2023; 34:311-320. [PMID: 36957989 DOI: 10.1515/jbcpp-2023-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/25/2023]
Abstract
Moderate-to-vigorous physical activity (MVPA) has been shown to have a favorable effect on many diseases as a complementary therapy and is a critical component of healthy living. During the pandemic era, physical activity has been promoted for resistance against coronavirus disease 2019 (COVID-19). However, there is scarce evidence on whether MVPA could reduce the infectivity and susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The objective of this meta-analysis was to determine the effect of MVPA on morbidity, mortality, and duration of hospitalization in COVID-19 patients. We performed a comprehensive search of five online databases for eligible studies up to September 9, 2021. Meta-analyses were conducted to determine the association between MVPA and COVID-19-related morbidity, hospitalization, and mortality. The odds ratio (OR) was applied as the summary statistic for the primary outcomes. Secondary analyses were conducted to evaluate the difference in the metabolic equivalent of tasks (METs) between the outcome and non-outcome groups with the mean difference as the pooled effect. This meta-analysis included eight observational studies. We found that MVPA significantly reduced the odds of contracting SARS-CoV-2 infection (OR=0.88; 95% confidence interval [CI] = 0.85-0.92), hospitalization (OR=0.56; 95% CI=0.35-0.92), and mortality (OR=0.42; 95% CI=0.21-0.81) due to COVID-19 compared to no physical activity. METs≥500 min/week were linked to decreased morbidity and mortality of COVID-19 (OR=0.94 [95% CI=0.90-0.98]; OR=0.56 [95% CI=0.38-0.83]). COVID-19 patients with MVPA demonstrated a lower risk of COVID-19-related morbidity, hospitalization, and mortality compared to those who were less active, highlighting the importance of an active lifestyle despite the pandemic situation where such activities are limited.
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Affiliation(s)
- Purwo Sri Rejeki
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bendix Samarta Witarto
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Andro Pramana Witarto
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | | | - Ifan Ali Wafa
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Dita Mega Utami
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Nabilah Izzatunnisa
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Siti Khaerunnisa
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Sakina
- Department of Anatomy, Histology and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Hilbold E, Bär C, Thum T. COVID-19: Insights into long-term manifestations and lockdown impacts. JOURNAL OF SPORT AND HEALTH SCIENCE 2023:S2095-2546(23)00019-4. [PMID: 36868374 PMCID: PMC9977467 DOI: 10.1016/j.jshs.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Coronaviruses are pathogens thought to primarily affect the respiratory tracts of humans. The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 was also marked mainly by its symptoms of respiratory illness, which were named coronavirus disease 2019 (COVID-19). Since its initial discovery, many other symptoms have been linked to acute SARS-CoV-2 infections as well as to the long-term outcomes of COVID-19 patients. Among these symptoms are different categories of cardiovascular diseases (CVDs), which continue to be the main cause of death worldwide. The World Health Organization estimates that 17.9 million people die from CVDs each year, accounting for ∼32% of all deaths globally. Physical inactivity is one of the most important behavioral risk factors for CVDs. The COVID-19 pandemic has affected CVDs as well as the physical activity in different ways. Here, we provide an overview of the current status as well as future challenges and possible solutions.
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Affiliation(s)
- Erika Hilbold
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover 30625, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover 30625, Germany; Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hannover 30625, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover 30625, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover 30625, Germany; Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hannover 30625, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover 30625, Germany.
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11
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Bostancı Ö, Karaduman E, Çolak Y, Yılmaz AK, Kabadayı M, Bilgiç S. Respiratory muscle strength and pulmonary function in unvaccinated athletes before and after COVID-19 infection: A prospective cohort study. Respir Physiol Neurobiol 2023; 308:103983. [PMID: 36343877 PMCID: PMC9635222 DOI: 10.1016/j.resp.2022.103983] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/21/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE We investigated abnormalities and recovery in respiratory function after COVID-19 infection in an unvaccinated elite athlete population. METHODS Measurements included maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF). RESULTS The most frequent reported symptoms were fatigue with 80% and muscle/joint pain and headache with 50%, whereas only 10% reported dyspnoea and 30% cough. During follow-up, MIP was up to 13% and MEP up to 8% lower following COVID-19 infection. Likewise, FEV1 was up to 2% and FVC up to 5% lower. While MEP and FEV1 rapidly normalised, MIP and FVC still remained abnormal after 52 days of COVID-19 infection, thereby leading to a restrictive ventilatory pattern. PEF seemed unaffected during follow-up. CONCLUSIONS COVID-19 decreases respiratory function in unvaccinated athletes despite reporting few respiratory symptoms and having mild disease. An initiative aimed at reducing the long-term adverse effects following COVID-19 infection seems warranted, which perhaps may be avoided through vaccination.
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Affiliation(s)
- Özgür Bostancı
- Faculty of Sport Sciences, University of Ondokuz Mayıs, Samsun, Türkiye
| | - Emre Karaduman
- Faculty of Sport Sciences, University of Ondokuz Mayıs, Samsun, Türkiye.
| | - Yunus Çolak
- Department of Respiratory Medicine and the Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark
| | - Ali Kerim Yılmaz
- Faculty of Sport Sciences, University of Ondokuz Mayıs, Samsun, Türkiye
| | - Menderes Kabadayı
- Faculty of Sport Sciences, University of Ondokuz Mayıs, Samsun, Türkiye
| | - Sait Bilgiç
- Faculty of Medicine, University of Ondokuz Mayıs, Samsun, Türkiye
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12
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Li D, Jin S, He Z, Lu S. Association of physical activity and the risk of COVID-19 hospitalization: A dose-response meta-analysis. Medicine (Baltimore) 2023; 102:e32814. [PMID: 36705385 PMCID: PMC9876000 DOI: 10.1097/md.0000000000032814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Many people have experienced a high burden due to the spread of the coronavirus disease (COVID-19) and its serious consequences for health and everyday life. Prior studies have reported that physical activity (PA) may lower the risk of COVID-19 hospitalization. The present meta-analysis explored the dose-response relationship between PA and the risk of COVID-19 hospitalization. METHODS Epidemiological observational studies on the relationship between PA and the risk of COVID-19 hospitalization were included. Categorical dose-response relationships between PA and the risk of COVID-19 hospitalization were assessed using random effect models. Robust error meta-regression models assessed the continuous relationship between PA (metabolic equivalent [Met]-h/wk) and COVID-19 hospitalization risk across studies reporting quantitative PA estimates. RESULTS Seventeen observational studies (cohort\case-control\cross-section) met the criteria for inclusion in the meta-analysis. Categorical dose-relationship analysis showed a 40% (risk ratio [RR] 0.60, 95% confidence interval [CI]: 0.48-0.71) reduction in the risk of COVID-19 hospitalization compared to the lowest dose of PA. The results of the continuous dose-response relationship showed a non-linear inverse relationship (Pnon-linearity < .05) between PA and the risk of COVID-19 hospitalization. When total PA was < or >10 Met-h/wk, an increase of 4 Met-h/wk was associated with a 14% (RR = 0.83, 95% CI: 0.85-0.87) and 11% (RR = 0.89, 95% CI: 0.87-0.90) reduction in the risk of COVID-19 hospitalization, respectively. CONCLUSIONS There was an inverse non-linear dose-response relationship between PA level and the risk of COVID-19 hospitalization. Doses of the guideline-recommended minimum PA levels by the World Health Organization may be required for more substantial reductions in the COVID-19 hospitalization risk.
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Affiliation(s)
- Dan Li
- School of Sports, Wuhan University of Science and Technology, Wuhan, China
| | - Shengzhen Jin
- Tennis College, Wuhan sports university, Wuhan, China
| | - Ziying He
- Graduate School, Wuhan Institute of Physical Education, Wuhan, China
- School of Physical Education, Jianghan University, Wuhan, China
| | - Songtao Lu
- School of Sports, Wuhan University of Science and Technology, Wuhan, China
- * Correspondence: Songtao Lu, School of sports, Wuhan University of Science and Technology, No.16, Huangjiahu West Road, Hongshan District, Wuhan 430065, Hubei Province, China (e-mail: )
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13
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Tartibian B, Khayat SMA, Maleki BH, Chehrazi M. The Effects of Exercise Training on Recovery of Biochemical and Hematological Outcomes in Patients Surviving COVID-19: A Randomized Controlled Assessor-Blinded Trial. SPORTS MEDICINE - OPEN 2022; 8:152. [PMID: 36562867 PMCID: PMC9782268 DOI: 10.1186/s40798-022-00546-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND No previous research has investigated the direct effects of exercise interventions on COVID-19 outcomes. The aim is to investigate the effect of 8 weeks of home-based moderate-intensity continuous training (MICT), resistance training (RT), and combined aerobic and resistance training (CET) on biochemical and hematologic markers associated with COVID-19 symptoms and severity in COVID-19 survivors. METHODS A total of 547 male and female COVID-19 survivors were screened, and 296 (aged 20-93 years) were randomly assigned in a 1:1:1:1 ratio to one of four groups: MICT (n = 74), RT (n = 74), CET (n = 74), or non-exercise (NON-EX, n = 74). Blood samples were taken at baseline, at week 4, and week 8 after training. RESULTS After the intervention, compared with the NON-EX group, all 3 MICT, RT, and CET interventions caused significant improvements in the levels of creatine kinase (CK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, d-dimer, creatinine, urea, potassium (K), sodium (Na), white blood cell (WBC), neutrophils, lymphocytes, red blood cells (RBC), platelets, hemoglobin, and hematocrit concentrations (P < 0.05). CET was effectively superior to MICT and RT in the improvements in the biochemical and hematological variables studied (P < 0.05). CONCLUSIONS Overall, the present study demonstrates that long-term MICT plus RT interventions have a synergistic effect in accelerating and enhancing the recovery in patients surviving COVID-19. Trial registration IRCT20160605028270N3, 6 September 2020.
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Affiliation(s)
- Bakhtyar Tartibian
- grid.444893.60000 0001 0701 9423Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran
| | - Sirwan Mohammad Amini Khayat
- grid.412763.50000 0004 0442 8645Department of Exercise Physiology, Faculty of Physical Education and Sport Science, Urmia University, Urmia, Iran
| | - Behzad Hajizadeh Maleki
- grid.8664.c0000 0001 2165 8627Department of Exercise Physiology and Sports Therapy, Justus-Liebig-University, Kugelberg 62, Giessen, Germany
| | - Mohammad Chehrazi
- grid.411495.c0000 0004 0421 4102Department of Biostatistics and Epidemiology School of Public Health, Babol University of Medical Sciences, Babol, Iran
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Gomide EBG, Mazzonetto LF, Cordeiro JFC, Cordeiro DC, Oliveira ADS, Fioco EM, Venturini ACR, Abdalla PP, Da Silva LSL, Tasinafo Júnior MF, De Andrade D, Bohn L, Machado DRL, Dos Santos AP. Being Physically Active Leads to Better Recovery Prognosis for People Diagnosed with COVID-19: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14908. [PMID: 36429628 PMCID: PMC9690567 DOI: 10.3390/ijerph192214908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.
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Affiliation(s)
- Euripedes Barsanulfo Gonçalves Gomide
- Claretiano-University Center, São Paulo 14300-900, Brazil
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Lisa Fernanda Mazzonetto
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | | | | | - Alcivandro de Sousa Oliveira
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | | | - Ana Claudia Rossini Venturini
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Pedro Pugliesi Abdalla
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Leonardo Santos Lopes Da Silva
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Márcio Fernando Tasinafo Júnior
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Denise De Andrade
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Human Exposome and Infectious Diseases Network (HEID), Ribeirao Preto, Sao Paulo 14040-902, Brazil
| | - Lucimere Bohn
- Faculty of Psychology, Education and Sport, University Lusófona of Porto, 4000-098 Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Education and Communication, Algarve University, 8005-139 Faro, Portugal
| | - André Pereira Dos Santos
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- Human Exposome and Infectious Diseases Network (HEID), Ribeirao Preto, Sao Paulo 14040-902, Brazil
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15
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Gomide EBG, Abdalla PP, Pisa MF, Schneider G, Vieira LG, Mazzonetto LF, de Sousa Oliveira A, Sebastião E, Dos Santos AP. The role of physical activity in the clinical outcomes of people diagnosed with Covid-19: A systematic review. JSAMS PLUS 2022; 1:100007. [PMID: 36415823 PMCID: PMC9672901 DOI: 10.1016/j.jsampl.2022.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/22/2022] [Accepted: 10/01/2022] [Indexed: 11/16/2022]
Abstract
Objective This review aimed to compile the evidence on PA and clinical outcomes of people receiving a positive diagnosis of covid-19. Design Systematic review. Methods The search was performed in five databases: EMBASE, MEDLINE via PubMed portal, Scopus, SPORTDiscus via EBSCO platform, and Web of Science. In addition, the "gray" literature was searched through Google Scholar and medRxiv published between January 2020 and July 2022. Studies were assessed for risk of bias, with the extraction of relevant data. Our search revealed a total of 10,028 studies. Results After applying the eligibility criteria 32 studies were included. Thirty-one studies were at low to moderate risk of bias. Physically active individuals, who were diagnosed with covid-19, presented attenuation of clinical outcomes, such as decreased risk of hospitalization, recovery time, number of symptoms, severity, and ICU and death when compared to individuals with low levels of PA or classified as sedentary. Conclusions Physically active individuals when diagnosed with covid-19 may have decreased risk of several clinical outcomes related to covid-19, including but not limited to hospitalization and number of symptoms. Public health authorities should develop strategies and initiatives that promote safe PA environments to improve the clinical prognosis of people diagnosed with covid-19. Study registration Open Science Framework (OSF), DOI registry 10.17605/OSF.IO/PV6NF. It can be consulted through the access link: https://doi.org/10.17605/OSF.IO/PV6NF, October 07, 2021.
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Affiliation(s)
- Euripedes Barsanulfo Gonçalves Gomide
- Claretiano - University Center, São Paulo, Brazil
- Ribeirão Preto College of Nursing, University of São Paulo, Brazil
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Pedro Pugliesi Abdalla
- Ribeirão Preto College of Nursing, University of São Paulo, Brazil
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- School of Sports (FADEUP), University of Porto, Portugal
| | - Marcel Frezza Pisa
- Claretiano - University Center, São Paulo, Brazil
- Ribeirão Preto College of Medicine, University of São Paulo, Brazil
| | | | | | - Lisa Fernanda Mazzonetto
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, Brazil
| | - Alcivandro de Sousa Oliveira
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, Brazil
| | - Emerson Sebastião
- Health and Exercise Research Group. Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, United States
| | - André Pereira Dos Santos
- Ribeirão Preto College of Nursing, University of São Paulo, Brazil
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, Brazil
- Human Exposome and Infectious Diseases Network (HEID), Brazil
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16
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Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, Garcia-Hermoso A. Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose-response meta-analysis of data from 1 853 610 adults. Br J Sports Med 2022; 56:bjsports-2022-105733. [PMID: 35995587 DOI: 10.1136/bjsports-2022-105733] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To quantify the association between physical activity and risk of SARS-CoV-2 infection, COVID-19-associated hospitalisation, severe illness and death due to COVID-19 in adults. DESIGN A systematic review and meta-analysis. DATA SOURCES Three databases were systematically searched through March 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Peer-reviewed articles reporting the association between regular physical activity and at least one COVID-19 outcome in adults were included. Risk estimates (ORs, relative risk (RR) ratios or HRs) were extracted and pooled using a random-effects inverse-variance model. RESULTS Sixteen studies were included (n=1 853 610). Overall, those who engaged in regular physical activity had a lower risk of infection (RR=0.89; 95% CI 0.84 to 0.95; I2=0%), hospitalisation (RR=0.64; 95% CI 0.54 to 0.76; I2=48.01%), severe COVID-19 illness (RR=0.66; 95% CI 0.58 to 0.77; I2=50.93%) and COVID-19-related death (RR=0.57; 95% CI 0.46 to 0.71; I2=26.63%) as compared with their inactive peers. The results indicated a non-linear dose-response relationship between physical activity presented in metabolic equivalent of task (MET)-min per week and severe COVID-19 illness and death (p for non-linearity <0.001) with a flattening of the dose-response curve at around 500 MET-min per week. CONCLUSIONS Regular physical activity seems to be related to a lower likelihood of adverse COVID-19 outcomes. Our findings highlight the protective effects of engaging in sufficient physical activity as a public health strategy, with potential benefits to reduce the risk of severe COVID-19. Given the heterogeneity and risk of publication bias, further studies with standardised methodology and outcome reporting are now needed. PROSPERO REGISTRATION NUMBER CRD42022313629.
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Affiliation(s)
- Yasmin Ezzatvar
- Departamento de Enfermería, Universitat de València, Valencia, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
- CIBER de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
- CIBER de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Garcia-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
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The influence of physical activity level on the length of stay in hospital in older men survivors of COVID-19. SPORT SCIENCES FOR HEALTH 2022; 18:1483-1490. [PMID: 35730029 PMCID: PMC9187887 DOI: 10.1007/s11332-022-00948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/06/2022] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to verify the influence of physical activity level on the length of hospital stay in older men recovered from COVID-19. In total, 126 older men diagnosed with COVID-19 were admitted to the hospital between September and December 2020. Among them, 70 survived, of which 39 older men were included in the study. Within 30 days after discharge, patients answered the International Physical Activity Questionnaire to measure their physical activity level through phone contact, with questions corresponding to the week before symptom onset. Clinical and laboratorial data from admission, days between onset of symptoms and admission, length of stay, computed tomography abnormalities, and the need for the intensive care unit were collected. The groups (active × sedentary) were compared using the Student t test or Mann-Whitney test for quantitative data and chi-square test was used for categorical data. There is no difference between the groups in characteristics of admission (p > 0.05), except by potassium level. Active older men had a shorter length of stay (6.50 ± 3.46 vs 11.48 ± 7.63 days; p = 0.03), disease duration (15.71 ± 4.84 vs 21.09 ± 7.69 days; p = 0.02), and lower frequency of lung damage when compared to their sedentary counterparts. In conclusion, being physically active prior to infection can attenuate length of hospital stay in older men with COVID-19.
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18
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Gentil P, de Lira CAB, Vieira CA, Ramirez-Campillo R, Haghighi AH, Clemente FM, Souza D. Resistance Training before, during, and after COVID-19 Infection: What Have We Learned So Far? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6323. [PMID: 35627861 PMCID: PMC9141848 DOI: 10.3390/ijerph19106323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 02/05/2023]
Abstract
At the end of 2019, a severe acute respiratory syndrome caused by SARS-CoV-2 started a pandemic, leading to millions of deaths and many important political and social changes. Even in the absence of contamination, the mobility reduction, social distancing and closing of exercise facilities negatively affected physical activity and conditioning, which is associated with muscle atrophy, loss of muscle strength, and reductions in functional capacity. In cases of infection, it has been shown that increased physical capacity is associated with decreased hospitalization and mortality risk. Although millions of people have died from COVID-19, most contaminated individuals survived the infection, but carried different sequelae, such as the severe loss of physical function and a reduced quality of life. Among different physical exercise models that might help to prevent and treat COVID-19-related conditions, resistance training (RT) might be particularly relevant. Among its benefits, RT can be adapted to be performed in many different situations, even with limited space and equipment, and is easily adapted to an individual's characteristics and health status. The current narrative review aims to provide insights into how RT can be used in different scenarios to counteract the negative effects of COVID-19. By doing this, the authors expect to provide insights to help deal with the current pandemic and similar events the world may face in the future.
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Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
- Hypertension League Federal University of Goias, Goiânia 74605-050, Brazil
- Instituto VIDA, Brasilia 70.000, Brazil
| | - Claudio Andre Barbosa de Lira
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
| | - Carlos Alexandre Vieira
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile;
| | - Amir Hossein Haghighi
- Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar 9617976487, Iran;
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, 4900-347 Viana do Castelo, Portugal;
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
| | - Daniel Souza
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
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19
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Malisoux L, Backes A, Fischer A, Aguayo G, Ollert M, Fagherazzi G. Associations between physical activity prior to infection and COVID-19 disease severity and symptoms: results from the prospective Predi-COVID cohort study. BMJ Open 2022; 12:e057863. [PMID: 35487745 PMCID: PMC9058293 DOI: 10.1136/bmjopen-2021-057863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To investigate if the physical activity (PA) prior to infection is associated with the severity of the disease in patients positively tested for COVID-19, as well as with the most common symptoms. DESIGN A cross-sectional study using baseline data from a prospective, hybrid cohort study (Predi-COVID) in Luxembourg. Data were collected from May 2020 to June 2021. SETTING Real-life setting (at home) and hospitalised patients. PARTICIPANTS All volunteers aged >18 years with confirmed SARS-CoV-2 infection, as determined by reverse transcription-PCR, and having completed the PA questionnaire (n=452). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was disease severity (asymptomatic, mild illness and moderate illness). The secondary outcomes were self-reported symptoms. RESULTS From the 452 patients included, 216 (48%) were female, the median (IQR) age was 42 (31-51) years, 59 (13%) were classified as asymptomatic, 287 (63%) as mild illness and 106 (24%) as moderate illness. The most prevalent symptoms were fatigue (n=294; 65%), headache (n=281; 62%) and dry cough (n=241; 53%). After adjustment, the highest PA level was associated with a lower risk of moderate illness (OR 0.37; 95% CI 0.14 to 0.98, p=0.045), fatigue (OR 0.54; 95% CI 0.30 to 0.97, p=0.040), dry cough (OR 0.55; 95% CI 0.32 to 0.96, p=0.034) and chest pain (OR 0.32; 95% CI 0.14 to 0.77, p=0.010). CONCLUSIONS PA before COVID-19 infection was associated with a reduced risk of moderate illness severity and a reduced risk of experiencing fatigue, dry cough and chest pain, suggesting that engaging in PA may be an effective approach to minimise the severity of COVID-19. TRIAL REGISTRATION NUMBER NCT04380987.
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Affiliation(s)
- Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anne Backes
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Aurélie Fischer
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Gloria Aguayo
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Markus Ollert
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, University of Southern, Odense, Denmark
| | - Guy Fagherazzi
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
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20
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Can Previous Levels of Physical Activity Affect Risk Factors for Cardiorespiratory Diseases and Functional Capacity after COVID-19 Hospitalization? A Prospective Cohort Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7854303. [PMID: 35496055 PMCID: PMC9041158 DOI: 10.1155/2022/7854303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/03/2022] [Accepted: 04/09/2022] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the influence of previous levels of physical activity on hemodynamic, vascular, ventilatory, and functional outcomes after coronavirus disease 2019 (COVID-19) hospitalization. Methods Sixty-three individuals with COVID-19 had their clinical status and previous levels (12 month) of physical activity (Baecke Questionnaire of Habitual Physical Activity) assessed at hospital admission. Individuals were then allocated to lower levels of physical activity (ACTLOWER; N = 22), intermediate levels of physical activity (ACTINTERMEDIATE; N = 22), or higher levels of physical activity (ACTHIGHER; N = 19) groups, according to tertiles of physical activity. Resting hemodynamic (heart rate and brachial/central blood pressures) and vascular (carotid-femoral pulse wave velocity, augmentation index, and brachial artery flow-mediated dilation) variables, pulmonary function (spirometry), respiratory muscle strength (maximal respiratory pressures), and functional capacity (handgrip strength, five-time sit-to-stand, timed-up and go, and six-minute walking tests) were measured at 30 to 45 days after hospital discharge. Results ACTLOWER showed lower levels (P < 0.05) of forced vital capacity, forced expiratory volume in the first second, maximal voluntary ventilation, and maximal expiratory pressure than ACTHIGHER. ACTLOWER also had lower (P = 0.023) walking distance (~21%,) and lower percentage of predicted walking distance (~20%) at six-minute walking test during follow-up than ACTINTERMEDIATE. However, hemodynamic and vascular variables, handgrip strength, five-time sit-to-stand, and timed-up and go were not different among groups. Conclusion ACTLOWER showed impaired ventilatory parameters and walking performance when compared with ACTHIGHER and ACTINTERMEDIATE, respectively. These results suggest that previous levels of physical activity may impact ventilatory and exercise capacity outcomes 30 to 45 days after COVID-19 hospitalization discharge.
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21
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Freire APCF, Lira FS, Morano AEVA, Pereira T, Coelho-E-Silva MJ, Caseiro A, Christofaro DGD, Marchioto Júnior O, Dorneles GP, Minuzzi LG, Pinho RA, Silva BSDA. Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2457. [PMID: 35206647 PMCID: PMC8875183 DOI: 10.3390/ijerph19042457] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 02/06/2023]
Abstract
The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with SARS-CoV-2 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with SARS-CoV-2 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken, and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in the post-COVID-19 group was increased (stress index; p = 0.0273). They also presented lower values of parasympathetic activity (p < 0.05). Overweight/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p < 0.05). Physically inactive subjects in the post-COVID-19 group presented significantly higher sympathetic activity than active subjects in the control group. Parasympathetic activity was significantly increased in physically active subjects in the control group compared to the physically inactive post-COVID-19 group (p < 0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by overweight/obesity and physical activity levels.
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Affiliation(s)
- Ana Paula Coelho Figueira Freire
- Department of Health Sciences, Central Washington University Ellensburg, Ellensburg, WA 98926, USA
- Physiotherapy Department, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil
| | - Fabio Santos Lira
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil; (A.E.v.A.M.); (O.M.J.); (L.G.M.); (B.S.d.A.S.)
| | - Ana Elisa von Ah Morano
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil; (A.E.v.A.M.); (O.M.J.); (L.G.M.); (B.S.d.A.S.)
| | - Telmo Pereira
- Polytechnic of Coimbra, ESTESC, Laboratory Biomedical Sciences, 3046-854 Coimbra, Portugal; (T.P.); (A.C.)
- Molecular Physical-Chemistry R & D Unit, Faculty of Science and Technology, University of Coimbra, 3004-535 Coimbra, Portugal
- Laboratory for Applied Health Research (LabinSaúde), 3046-854 Coimbra, Portugal
| | - Manuel-João Coelho-E-Silva
- Faculty of Sport Science and Physiucal Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal;
| | - Armando Caseiro
- Polytechnic of Coimbra, ESTESC, Laboratory Biomedical Sciences, 3046-854 Coimbra, Portugal; (T.P.); (A.C.)
- Molecular Physical-Chemistry R & D Unit, Faculty of Science and Technology, University of Coimbra, 3004-535 Coimbra, Portugal
- Laboratory for Applied Health Research (LabinSaúde), 3046-854 Coimbra, Portugal
| | - Diego Giulliano Destro Christofaro
- Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil;
| | - Osmar Marchioto Júnior
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil; (A.E.v.A.M.); (O.M.J.); (L.G.M.); (B.S.d.A.S.)
| | - Gilson Pires Dorneles
- Cellular and Molecular Immunology Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, Brazil;
| | - Luciele Guerra Minuzzi
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil; (A.E.v.A.M.); (O.M.J.); (L.G.M.); (B.S.d.A.S.)
| | - Ricardo Aurino Pinho
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba 80215-901, Brazil;
| | - Bruna Spolador de Alencar Silva
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil; (A.E.v.A.M.); (O.M.J.); (L.G.M.); (B.S.d.A.S.)
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22
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Steenkamp L, Saggers RT, Bandini R, Stranges S, Choi YH, Thornton JS, Hendrie S, Patel D, Rabinowitz S, Patricios J. Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes. Br J Sports Med 2022; 56:568-576. [PMID: 35140062 PMCID: PMC8844956 DOI: 10.1136/bjsports-2021-105159] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 02/03/2023]
Abstract
Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with a confirmed diagnosis of COVID-19. Methods Directly measured physical activity data from 65 361 adult patients with a COVID-19 diagnosis from 19 March 2020 to 30 June 2021, were grouped by activity level: low (<60 min/week), moderate (60–149 min/week) and high activity (≥150 min/week). The association of physical activity levels and the risk of adverse outcomes was analysed using modified Poisson regression. We accounted for demographics and comorbidities including conditions known to influence COVID-19 outcomes, as well as patient complexity as measured by the Johns Hopkins Adjusted Clinical Group system. The regression approach was further validated with a Bayesian network model built off a directed acyclic graph. Results High physical activity was associated with lower rates of hospitalisation (risk ratio, RR 0.66, 95% CI 0.63 to 0.70), ICU admission (RR 0.59, 95% CI 0.52 to 0.66), ventilation (RR 0.55, 95% CI 0.47 to 0.64) and death (RR 0.58, 95% CI 0.50 to 0.68) due to COVID-19 than those who engaged in low physical activity. Moderate physical activity also was associated with lower rates of hospitalisation (RR 0.87, 95% CI 0.82 to 0.91), admission to ICU (RR 0.80, 95% CI 0.71 to 0.89), ventilation (RR 0.73, 95% CI 0.62 to 0.84) and death (RR 0.79, 95% CI 0.69 to 0.91). Conclusions Adults with high and moderate physical activity levels had significantly better outcomes than those with low activity when contracting COVID-19. The apparent protective effects of regular physical activity extended to those with concomitant chronic medical conditions.
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Affiliation(s)
| | - Robin Terence Saggers
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.,Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Rossella Bandini
- PRINCE: Project to Improve Neonatal Care, School of Clinical Medicine, Faculty of Health Sciences, Wits University, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Saverio Stranges
- University of Western Ontario Faculty of Health Sciences, London, Ontario, Canada.,Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Yun-Hee Choi
- Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Jane S Thornton
- Public Health and Family Medicine, University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | | | | | | | - Jon Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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23
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Alves HR, Lomba GSB, Gonçalves-de-Albuquerque CF, Burth P. Irisin, Exercise, and COVID-19. Front Endocrinol (Lausanne) 2022; 13:879066. [PMID: 35784579 PMCID: PMC9248970 DOI: 10.3389/fendo.2022.879066] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/28/2022] [Indexed: 12/12/2022] Open
Abstract
Muscle and adipose tissue produce irisin during exercise. Irisin is thermogenic adipomyokine, improves glucose and lipid metabolism, and ameliorates the effects of obesity-driven inflammation, metabolic syndrome, and diabetes. In addition, exercise-induced irisin activates anti-inflammatory pathways and may play an essential role in improving the outcomes of inflammatory conditions, such as coronavirus disease (COVID-19). COVID-19 infection can activate different intracellular receptors and modulate various pathways during the course of the disease. The cytokine release storm (CRS) produced is significant because it promotes the context for systemic inflammation, which increases the risk of mortality in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). In addition, viral infection and the resulting organ damage may stimulate the mitogen-activated protein kinase(MAPK) and toll-like receptor 4 (TLR4)/toll interleukin receptor (TIR)-domain-containing adaptor (MyD88) pathways while negatively modulating the AMP-activated protein kinase (AMPK) pathway, leading to increased inflammatory cytokine production. Exercise-induced irisin may counteract this inflammatory modulation by decreasing cytokine production. Consequently, increased irisin levels, as found in healthy patients, may favor a better prognosis in patients with SARS-CoV2. This review aims to explore the molecular mechanisms underlying the anti-inflammatory properties of irisin in mitigating CRS and preventing severe outcomes due to infection with SARS-CoV2.
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Affiliation(s)
- Hugo Rodrigues Alves
- Department of Cell and Molecular Biology, Fluminense Federal University, Niterói, Brazil
| | | | - Cassiano Felippe Gonçalves-de-Albuquerque
- Laboratory of Immunopharmacology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- Postgraduate Program in Biotechnology, Fluminense Federal University, Rio de Janeiro, Brazil
- *Correspondence: Patricia Burth, ; Cassiano Felippe Gonçalves-de-Albuquerque,
| | - Patricia Burth
- Department of Cell and Molecular Biology, Fluminense Federal University, Niterói, Brazil
- Postgraduate Program in Biotechnology, Fluminense Federal University, Rio de Janeiro, Brazil
- *Correspondence: Patricia Burth, ; Cassiano Felippe Gonçalves-de-Albuquerque,
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24
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Pinto AJ, Goessler KF, Fernandes AL, Murai IH, Sales LP, Reis BZ, Santos MD, Roschel H, Pereira RMR, Gualano B. No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:690-696. [PMID: 34391961 PMCID: PMC8358114 DOI: 10.1016/j.jshs.2021.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/22/2021] [Accepted: 07/16/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Regular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19. METHODS Hospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement. RESULTS The median hospital length of stay was 7.0 ± 4.0 days, median ± IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: β = -0.57 (95% confidence interval (95%CI): -1.80 to 0.65), p = 0.355; sport index: β = 0.43 (95%CI: -0.94 to 1.80), p = 0.536; leisure-time index: β = 1.18 (95%CI: -0.22 to 2.59), p = 0.099; and total activity index: β = 0.20 (95%CI: -0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050). CONCLUSION Among hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.
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Affiliation(s)
- Ana J Pinto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Karla F Goessler
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Alan L Fernandes
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Igor H Murai
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Lucas P Sales
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Bruna Z Reis
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Mayara Diniz Santos
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Rosa M R Pereira
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil; Food Research Center, University of Sao Paulo, Sao Paulo, SP 05508080, Brazil.
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25
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Baker FL, Smith KA, Zúñiga TM, Batatinha H, Niemiro GM, Pedlar CR, Burgess SC, Katsanis E, Simpson RJ. Acute exercise increases immune responses to SARS CoV-2 in a previously infected man. Brain Behav Immun Health 2021; 18:100343. [PMID: 34514439 PMCID: PMC8423674 DOI: 10.1016/j.bbih.2021.100343] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022] Open
Abstract
Evidence is emerging that exercise and physical activity provides protection against severe COVID-19 disease in patients infected with SARS-CoV-2, but it is not known how exercise affects immune responses to the virus. A healthy man completed a graded cycling ergometer test prior to and after SARS-CoV-2 infection, then again after receiving an adenovirus vector-based COVID-19 vaccine. Using whole blood SARS-CoV-2 peptide stimulation assays, IFN-γ ELISPOT assays, flow cytometry, ex vivo viral-specific T-cell expansion assays and deep T-cell receptor (TCR) β sequencing, we found that exercise robustly mobilized highly functional SARS-CoV-2 specific T-cells to the blood compartment that recognized spike protein, membrane protein, nucleocapsid antigen and the B.1.1.7 α-variant, and consisted mostly of CD3+/CD8+ T-cells and double-negative (CD4-/CD8-) CD3+ T-cells. The magnitude of SARS-CoV-2 T-cell mobilization with exercise was intensity dependent and robust when compared to T-cells recognizing other viruses (e.g. CMV, EBV, influenza). Vaccination enhanced the number of exercise-mobilized SARS-CoV-2 T-cells recognizing spike protein and the α-variant only. Exercise-mobilized SARS-CoV-2 specific T-cells proliferated more vigorously to ex vivo peptide stimulation and maintained broad TCR-β diversity against SARS-CoV-2 antigens both before and after ex vivo expansion. Neutralizing antibodies to SARS-CoV-2 were transiently elevated during exercise after both infection and vaccination. Finally, infection was associated with an increased metabolic demand to defined exercise workloads, which was restored to pre-infection levels after vaccination. This case study provides impetus for larger studies to determine if these immune responses to exercise can facilitate viral clearance, ameliorate symptoms of long COVID syndrome, and/or restore functional exercise capacity following SARS-CoV-2 infection.
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Affiliation(s)
- Forrest L. Baker
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Kyle A. Smith
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Tiffany M. Zúñiga
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Helena Batatinha
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Grace M. Niemiro
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Charles R. Pedlar
- Faculty of Sport, Health and Applied Performance Science, St. Mary's University, London, United Kingdom
| | - Shane C. Burgess
- Department of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Pathology, University of Arizona, Tucson, AZ, United States
| | - Richard J. Simpson
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
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26
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Ceravolo MG, Andrenelli E, Arienti C, Côté P, de Sire A, Iannicelli V, Lazzarini SG, Negrini F, Patrini M, Negrini S. Rehabilitation and COVID-19: rapid living systematic review by Cochrane Rehabilitation Field - third edition. Update as of June 30th, 2021. Eur J Phys Rehabil Med 2021; 57:850-857. [PMID: 34749491 DOI: 10.23736/s1973-9087.21.07301-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION This paper updates and summarizes the current evidence informing rehabilitation of patients with COVID-19 and/or describing the consequences of the disease and its treatment. EVIDENCE ACQUISITION Studies published from May 1st to June 30th, 2021 were selected, excluding descriptive studies and expert opinions. Papers were categorized according to study design, research question, COVID-19 phase, limitations of functioning of rehabilitation interest, and type of rehabilitation service involved. From this edition, we improved the quality assessment using the Joanna Briggs Institute checklists for observational studies and the Cochrane Risk of Bias Tool for randomized-controlled clinical trials (RCTs). EVIDENCE SYNTHESIS Twenty-five, out of 3699 papers, were included. They were three RCTs, 13 cross-sectional studies and nine cohort studies. Twenty studies reported data on symptom prevalence (N.=13) or disease natural history (N.=7); and five studies reported intervention effectiveness at the individual level. All study participants were COVID survivors and 48% of studies collected information on participants 6 months or longer after COVID-19 onset. The most frequent risks of bias for RCTs concerned weaknesses in allocation concealment, blinding of therapists, and lack of intention-to-treat analysis. Most analytical studies failed to identify or deal with confounders, describe or deal with dropouts or eventually perform an appropriate statistical analysis. CONCLUSIONS Most studies in this updated review targeted the prevalence of limitations of functioning of rehabilitation interest in COVID-19 survivors. This is similar to past review findings; however, data in the new studies was collected at longer follow-up periods (up to one year after symptom onset) and in larger samples of participants. More RCTs and analytical observational studies are available, but the methodological quality of recently published studies is low. There is a need for good quality intervention efficacy and effectiveness studies to complement the rapidly expanding evidence from observational studies.
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Affiliation(s)
- Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
| | | | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Magna Graecia, Catanzaro, Italy -
| | | | | | | | | | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
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