The COVID-19 pandemic: how to maintain a healthy immune system during the lockdown - a multidisciplinary approach with special focus on athletes

Training strategies of 10,074 athletes from 121 countries based on human development index in early COVID-19 lockdown

The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.

Neuropsychiatric Systemic Lupus Erythematosus: Molecules Involved in Its Imunopathogenesis, Clinical Features, and Treatment

Systemic lupus erythematosus (SLE) is an idiopathic chronic autoimmune disease that can affect any organ in the body, including the neurological system. Multiple factors, such as environmental (infections), genetic (many HLA alleles including DR2 and DR3, and genes including C4), and immunological influences on self-antigens, such as nuclear antigens, lead to the formation of multiple autoantibodies that cause deleterious damage to bodily tissues and organs. The production of autoantibodies, such as anti-dsDNA, anti-SS(A), anti-SS(B), anti-Smith, and anti-neuronal DNA are characteristic features of this disease. This autoimmune disease results from a failure of the mechanisms responsible for maintaining self-tolerance in T cells, B cells, or both. Immune complexes, circulating antibodies, cytokines, and autoreactive T lymphocytes are responsible for tissue injury in this autoimmune disease. The diagnosis of SLE is a rheumatological challenge despite the availability of clinical criteria. NPSLE was previously referred to as lupus cerebritis or lupus sclerosis. However, these terms are no longer recommended because there is no definitive pathological cause for the neuropsychiatric manifestations of SLE. Currently, the treatment options are primarily based on symptomatic presentations. These include the use of antipsychotics, antidepressants, and anxiolytic medications for the treatment of psychiatric and mood disorders. Antiepileptic drugs to treat seizures, and immunosuppressants (e.g., corticosteroids, azathioprine, and mycophenolate mofetil), are directed against inflammatory responses along with non-pharmacological interventions.

Comparison of geological clusters between influenza and COVID-19 in Thailand with unsupervised clustering analysis

The coronavirus disease (COVID-19) pandemic has considerably impacted public health, including the transmission patterns of other respiratory pathogens, such as the 2009 pandemic influenza (H1N1). COVID-19 and influenza are both respiratory infections that started with a lack of vaccination-based immunity in the population. However, vaccinations have been administered over time, resulting in a transition of the status of both diseases from a pandemic to an endemic. In this study, unsupervised clustering techniques were used to identify clusters of disease trends in Thailand. The analysis incorporated three distinct surveillance datasets: the pandemic influenza outbreak, influenza in the endemic stage, and the early stages of COVID-19. The analysis demonstrated a significant difference in the distribution of provinces between Cluster -1, representing those with unique transmission patterns, and the other clusters, indicating provinces with similar transmission patterns among their members. Specifically, for Pandemic Influenza, the ratio was 61:16, while for Pandemic COVID-19, it was 65:12. In contrast, Endemic Influenza exhibited a ratio of 46:31, with a notable emergence of more clustered provinces in the southern, western, and central regions. Furthermore, a pair of provinces with highly similar spreading patterns were identified during the pandemic stages of both influenza and COVID-19. Although the similarity decreased slightly for endemic influenza, they still belonged to the same cluster. Our objective was to identify the transmission patterns of influenza and COVID-19, with the aim of providing quantitative and spatial information to aid public health management in preparing for future pandemics or transitioning into an endemic phase.

Dietary vitamin D: growth, physiological and health consequences in broiler production

Vitamins are needed in trace amounts in dietary formulations for poultry; however, they are critical for the health, maintenance, and performance of important body organs. Broilers have a lot of leg issues because of their rapid development and lack of exercise. Because of commercial broilers have limited access to direct sunlight, vitamin D supplementation in the feed is critical to reducing the risk of bone deformation and maximizing development. Vitamin D deficiency causes skeletal abnormalities, which may lead also to financial problems. The latest scientific findings on the source, metabolism, mechanisms of action, and functions of vitamin D in broilers are the subject of this review paper.

Association of Sociodemographic Factors with Physical Activity and Sleep Quality in Arab and Non-Arab Individuals of Both Sexes during the COVID-19 Pandemic

We explored the association of sociodemographic and anthropometric factors with self-reported physical activity (PA) and sleep quality in Arab and non-Arab individuals of both sexes during the COVID-19 pandemic. In this cross-sectional study, 638 participants (those recovered from COVID-19 = 149, and non-infected = 489) of both sexes aged 18-55 years were recruited. Their sociodemographic and anthropometric information, PA (self-reported using the International Physical Activity Questionnaire Short-form [IPAQ-SF)]) and sleep quality (self-reported using the Pittsburgh Sleep Quality Index [PSQI]) were documented. The association between participants' characteristics, PA levels, and sleep quality were determined using the chi-squared test. Variables significantly associated with IPAQ and PSQI in bivariate analyses were included in a multivariate binary logistic regression model. Men were more active than women (odds ratio [OR] = 1.66, p = 0.010), and non-Arab participants were more active than Arab ones (OR = 1.49, p = 0.037). Participants ≥40 years, men, non-Arab participants, and those who were working were more likely to have a good sleep quality than those ≤40 years (OR 1.70, p = 0.048), women (OR 1.10, p = 0.725), Arab individuals (OR 1.95, p = 0.002), and unemployed people (OR 2.76, p = 0.007). Male and non-Arab participants seemed to have a better self-reported PA and sleep quality compared to female and Arab participants, during the pandemic.

Changes in dietary habits during Covid-19 lockdown in Egypt: the Egyptian COVIDiet study

PURPOSE

COVID-19 lockdown changed social habits and lifestyle, including dietary habits, of people worldwide. However, limited information is available about these changes in Egypt. This cross-sectional study investigates the effects of COVID-19 lockdown on dietary habits among the Egyptian populations.

METHODS

An online questionnaire, based on sociodemographic data and dietary adherence in accordance with the validated PREDIMED MedDiet Adherence Screener (MEDAS), was used all over the Egyptian governorates. The dietary changes were statistically evaluated for significance in relation to age, gender, body mass index (BMI), education level and governorates.

RESULTS

A total of 1010 participants (76% aged below 36 years, 77% female, 22% obese, and 62% university-level education) answered the questionnaire. Respondents ≤ 20 years had a significant increase in weight and consumption of carbonated beverages, commercial pastries, fried and fast food. Egyptians > 50 years old had a significant decrease in physical activity. Underweight people (less than 3% of participants) increased their fast food intake with a prominent rise in weight. However, obese people increased cooking frequency and increased eating times with a decrease in physical activity. Male participants reported increased intake of carbonated beverages and fast food, while female participants increased the intake of homemade pastries with a significant decrease in physical activity. Approximately 50% of participants with postgraduate education reported decreased intake of fast food and carbonated beverages as well as decreased body weight. Residents of Cairo showed a significant increase in vegetable intake, and fried food intake with a decrease in seafood consumption. Participants from the Delta region had a significant increase in pastries intake.

CONCLUSION

The findings of this study explored the need for increasing awareness about healthy lifestyle in future lockdown periods.

COVID-19: Insights into long-term manifestations and lockdown impacts

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.

Influence of quarantine during the coronavirus disease 2019 (COVID-19) pandemic on physical and psychosocial aspects: perceptions of 214 Brazilian athletes

Background

Social distancing may affect athletes' training, causing negative effects on mental and physical health.

Objective

This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects, sleep quality and coping strategies during the quarantine of the coronavirus disease 2019 (COVID-19) pandemic.

Methods

This was a cross-sectional study with online survey, performed with Brazilian athletes (amateur and professional) over 18 years. The main outcomes measures assessed were physical and psychosocial aspects, sleep quality and coping strategies.

Results

A total of 214 athletes were included. The average weekly hours of training during the quarantine was 4.71 ± 3.71 h, of which 64.5% athletes (138/214) were oriented by medical staff during training. For 52.8% (113/214) of athletes, training intensity during the quarantine was different/very different from the intensity before the quarantine. 79.4% athletes (170/214) reported moderate to extreme difficulties in keeping the same level of training during the quarantine. 77.1% athletes (165/214) had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future, including return to the sport. 72.9% athletes (156/214) reported change in sleep schedule during the quarantine period.

Conclusion

The quarantine period during COVID-19 pandemic negatively affected the athlete's perception about training routine, since athletes reported reduction in training hours and training intensity. Overall, the athletes reported that they were moderately to extremely anxious. They also had concerns about their career in the future, as well as concerns regarding return to sport.

Impact and control of the COVID pandemic in an elite sports club: Real Madrid

The incidence and risk factors for poor outcome in patients with COVID are well known, as are the protective measures in high-risk populations. In contrast, the epidemiological and clinical behavior of this disease in the population of elite athletes who are the paradigm of good health is poorly understood. Data on COVID in athletes are scarce and have focused preferentially on the consequences on sports performance of confinement measures and on the pathophysiological risks of infected athletes. Real Madrid is a large elite sports institution with facilities in the City of Madrid where 600 athletes train daily. The incidence of COVID during a study period of 671 days of observation in athletes, professional or amateur, working in the institution has been 0,74 per 1,000 days of exposure. The disease has been asymptomatic or oligosymptomatic in all athletes and did not require any hospital admissions. The different teams did not have to suspend any of its sportive commitments for COVID during the study period and there was no evidence of outbreaks of internal transmission between members of the different teams.

Athlete level, sport-type, and gender influences on training, mental health, and sleep during the early COVID-19 lockdown in Malaysia

Purpose: We evaluated the extent of changes in training practices, recovery, mental health, and sleep patterns of athletes during the early COVID-19 lockdown in a single country-cohort. Methods: A total of 686 athletes (59% male, 41% female; 9% World Class, 28% International, 29% National, 26% State, 8% Recreational) from 50 sports (45% individual, 55% team) in Malaysia completed an online, survey-based questionnaire study. The questions were related to training practices (including recovery and injury), mental health, and sleep patterns. Results: Relative to pre-lockdown, training intensity (-34%), frequency (-20%, except World-Class), and duration (-24%-59%, especially International/World-Class) were compromised, by the mandated lockdown. During the lockdown, more space/access (69%) and equipment (69%) were available for cardiorespiratory training, than technical and strength; and these resources favoured World-Class athletes. Most athletes trained for general strength/health (88%) and muscular endurance (71%); and some used innovative/digital training tools (World-Class 48% vs. lower classification-levels ≤34%). More World-Class, International, and National athletes performed strength training, plyometrics, and sport-specific technical skills with proper equipment, than State/Recreational athletes. More females (42%) sourced training materials from social media than males (29%). Some athletes (38%) performed injury prevention exercises; 18% had mild injuries (knees 29%, ankles 26%), and 18% received a medical diagnosis (International 31%). Lower-level athletes (e.g., State 44%) disclosed that they were mentally more vulnerable; and felt more anxious (36% vs. higher-levels 14%-21%). Sleep quality and quantity were "normal" (49% for both), "improved" (35% and 27%), and only 16% and 14% (respectively) stated "worsened" sleep. Conclusion: Lockdown compromised training-related practices, especially in lower-level athletes. Athletes are in need of assistance with training, and tools to cope with anxiety that should be tailored to individual country requirements during lockdown situations. In particular, goal-driven (even if it is at home) fitness training, psychological, financial, and lifestyle support can be provided to reduce the difficulties associated with lockdowns. Policies and guidelines that facilitate athletes (of all levels) to train regularly during the lockdown should be developed.

COVID-19 modifications of offseason and preseason training for NFL athletes are associated with increased risk of regular season injuries

OBJECTIVES

COVID-19 altered National Football League (NFL) player and team training during the 2020 offseason. All preseason games were cancelled resulting in absence of game play before the first week of the regular season. Thus, concerns exist regarding injury susceptibility of players during regular season games. The purpose of this study was to evaluate and compare injury rates during the 2020 NFL season versus injury rates from the unaffected 2017-2019 seasons. We hypothesized there would be an increased injury rate and an increased rate of season ending injuries during the modified 2020 season.

METHODS

The NFL's public injury database was queried to identify players placed on the injury lists throughout the 2017-2020 seasons. All players listed as "out" and on the injured reserve due to physical injury were included in the data set. For further stratification, injury incidence was separated based on position. Time missed due to COVID-19 illness was not included. Injury rates were expressed as injuries per 1000 athlete exposures (AE).

RESULTS

Overall, 893 individual players missed games due to injury during the 2020 NFL regular season compared to an average of 743 over the 2017-2019 seasons. Defensive players at all positions had a statistically significant increase in injury incidence from an average of 7.54 to 10.20 injuries per 1000 AE. Defensive backs were most affected with a 46% increase in players injured. There was no statistically significant difference in season ending injuries for any position.

CONCLUSIONS

The COVID-19 stricken 2020 NFL regular season saw an increased rate and incidence of injuries. Specifically, defensive players had a higher incidence of injury overall with defensive backs experiencing the greatest increase in injury rates.

The Influence of COVID-19 on University Students' Well-Being, Physical Activity, Body Composition, and Strength Endurance

BACKGROUND

Very few scientific studies have simultaneously evaluated changes in well-being (WB), physical activity (PA), and strength endurance (SE) based on results from before and during the COVID-19 pandemic.

AIM

The aim of the study was to assess WB, PA, and SE levels, as well as body composition parameters in university students before and during the pandemic.

METHODS

The study included 30 males and 30 females (mean age: 21.7 ± 2.51 and 21.6 ± 2.34 years, respectively). Well-being using the Self-Perception Questionnaire (POMS), PA from the Polish regular version of the International Physical Activity Questionnaire (IPAQ), body composition parameters using the InBody 270 analyzer, and SE based on the results of a 12 min test involving a Concept 2PM-5 rowing ergometer were assessed before and during the pandemic.

RESULTS

An assessment of university students' WB revealed a significant increase in variables such as tension, depression, anger, confusion, and a significant decline in vigor (p < 0.05). In both sexes, PA and SE decreased significantly-from 2115.4 to 1822.8 METs-min/week and from 2184.5 to 2035 m, respectively, in males, and from 1793.5 to 1699.8 METs-min/week and from 2021.5 to 1943.8 m, respectively, in females. At the same time, body mass and BMI values increased significantly (p < 0.001) in both females and males.

CONCLUSIONS

The COVID-19 pandemic caused a significant decrease in WB, PA and SE levels in young females and males, and led to a significant increase in their body mass and BMI.

Impact of Physical Activity on COVID-19

INTRODUCTION

The coronavirus disease 2019 (COVID-19) pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is seriously endangering human health worldwide. This study finds effective intervention modalities of physical activity on COVID-19 through a narrative review.

METHODS

In this study, 41 papers were selected for a narrative literature review after a comprehensive database search from 20 December 2019, to 30 August 2022.

RESULTS

41 articles meet the established criteria, and in this review, we comprehensively describe recent studies on exercise and COVID-19, including the impact and recommendations of exercise on COVID-19 prevention, patients with COVID-19, and noninfected populations.

CONCLUSIONS

The literature suggests that physical activity (PA) contributes to the prevention and treatment of COVID-19, can promote recovery of physical function, alleviate post-acute COVID-19 syndrome, and improve patients' psychological well-being. It is recommended to develop appropriate exercise prescriptions for different populations under the guidance of a physician.

The effect of caffeine, nap opportunity and their combination on biomarkers of muscle damage and antioxidant defence during repeated sprint exercise

To investigate the effect of 20 min nap opportunity (N20), 5 mg · kg-1 of caffeine (CAF) and their combination (CAF+N20) on the biochemical response (energetic biomarkers, biomarkers of muscle damage and enzymatic antioxidants) to the running-based anaerobic sprint test. Fourteen highly trained male athletes completed in a double-blind, counterbalanced and randomized order four test sessions: no nap with placebo (PLA), N20, CAF and CAF+N20. Compared to PLA, all treatments enhanced maximum and mean powers. Minimum power was higher [(mean difference) 58.6 (95% confidence interval = 1.31-116) Watts] after CAF and [102 (29.9-175) Watts] after CAF+N20 compared to N20. Also, plasma glucose was higher after CAF [0.81 (0.18-1.45) mmol · l-1] and CAF+N20 [1.03 (0.39-1.64) mmol · l-1] compared to N20. However, plasma lactate was higher [1.64 (0.23-3.03) mmol · l-1] only after N20 compared to pre-exercise, suggesting a higher anaerobic glycolysis during N20 compared to PLA, CAF and CAF+N20. Caffeine ingestion increased post-exercise creatine kinase with [54.3 (16.7-91.1) IU · l-1] or without napping [58.9 (21.3-96.5) IU · l-1] compared to PLA. However, superoxide dismutase was higher after napping with [339 (123-554) U · gHB-1] or without caffeine [410 (195-625) U · gHB-1] compared to PLA. Probably because of the higher aerobic glycolysis contribution in energy synthesis, caffeine ingestion resulted in better repeated sprint performance during CAF and CAF+N20 sessions compared to N20 and PLA. Caffeine ingestion resulted in higher muscle damage, and the short nap enhanced antioxidant defence with or without caffeine ingestion.

Physical exercise, immune response, and susceptibility to infections-current knowledge and growing research areas

This review presents state-of-the-art knowledge and identifies knowledge gaps for future research in the area of exercise-associated modifications of infection susceptibility. Regular moderate-intensity exercise is believed to have beneficial effects on immune health through lowering inflammation intensity and reducing susceptibility to respiratory infections. However, strenuous exercise, as performed by professional athletes, may promote infection: in about half of athletes presenting respiratory symptoms, no causative pathogen can be identified. Acute bouts of exercise enhance the release of pro-inflammatory mediators, which may induce infection-like respiratory symptoms. Relatively few studies have assessed the influence of regularly repeated exercise on the immune response and systemic inflammation compared to the effects of acute exercise. Additionally, ambient and environmental conditions may modify the systemic inflammatory response and infection susceptibility, particularly in outdoor athletes. Both acute and chronic regular exercise influence humoral and cellular immune response mechanisms, resulting in decreased specific and non-specific response in competitive athletes. The most promising areas of further research in exercise immunology include detailed immunological characterization of infection-prone and infection-resistant athletes, examining the efficacy of nutritional and pharmaceutical interventions as countermeasures to infection symptoms, and determining the influence of various exercise loads on susceptibility to infections with respiratory viruses, including SARS-CoV-2. By establishing a uniform definition of an "elite athlete," it will be possible to make a comparable and straightforward interpretation of data from different studies and settings.

Perception Towards COVID-19 Related Symptoms and Traditional Medicine Used for Their Management Among Patients and Their Attendants in Ethiopian Comprehensive Specialized Hospitals: A Cross-Sectional Study

Background

Methods

Results

Conclusion

Behavioral activation / inhibition systems and lifestyle as predictors of mental disorders in adolescent athletes during Covid19 pandemic

The following study investigates the correlational relationship between behavioral activation/inhibition systems, lifestyle and mental disorders in Adolescent Athletes during the Covid-19 pandemic. Methods: Research methods are descriptive and correlational; “Of the eligible participants who were available during a COVID-19 quarantine period from June through August 2020 (N = 180), the Krejcie and Morgan Sampling Method was used to simplify the process of determining the sample size for a finite population [46], resulting in a calculation of N = 130 sample participants. to respond to Carver & White’s Behavioral activation/inhibition systems Scale (BIS/BAS), Mille’s Lifestyle Questionnaire and Goldberg & Williams’s General Health Questionnaire (GHQ-12). Data was analyzed using linear regression analysis and Pearson’s correlation coefficient. Results: Findings showed a positive correlation of statistical significance between behavioral inhibition systems (BIS) and mental disorders in Adolescent Athletes at the 0.01 level and a negative correlation of statistical significance between scaling components of the behavioral activation systems (BAS), lifestyle and mental disorders in Adolescent Athletes at the 0.05 level. Conclusions: Analyzing the data, it can thus be concluded that whilst behavioral inhibition and activation systems seem to work together to significantly predict mental disorders, lifestyle cannot.

COVID-19 Lockdown: A Global Study Investigating the Effect of Athletes' Sport Classification and Sex on Training Practices

PURPOSE

To investigate differences in athletes' knowledge, beliefs, and training practices during COVID-19 lockdowns with reference to sport classification and sex. This work extends an initial descriptive evaluation focusing on athlete classification.

METHODS

Athletes (12,526; 66% male; 142 countries) completed an online survey (May-July 2020) assessing knowledge, beliefs, and practices toward training. Sports were classified as team sports (45%), endurance (20%), power/technical (10%), combat (9%), aquatic (6%), recreational (4%), racquet (3%), precision (2%), parasports (1%), and others (1%). Further analysis by sex was performed.

RESULTS

During lockdown, athletes practiced body-weight-based exercises routinely (67% females and 64% males), ranging from 50% (precision) to 78% (parasports). More sport-specific technical skills were performed in combat, parasports, and precision (∼50%) than other sports (∼35%). Most athletes (range: 50% [parasports] to 75% [endurance]) performed cardiorespiratory training (trivial sex differences). Compared to prelockdown, perceived training intensity was reduced by 29% to 41%, depending on sport (largest decline: ∼38% in team sports, unaffected by sex). Some athletes (range: 7%-49%) maintained their training intensity for strength, endurance, speed, plyometric, change-of-direction, and technical training. Athletes who previously trained ≥5 sessions per week reduced their volume (range: 18%-28%) during lockdown. The proportion of athletes (81%) training ≥60 min/session reduced by 31% to 43% during lockdown. Males and females had comparable moderate levels of training knowledge (56% vs 58%) and beliefs/attitudes (54% vs 56%).

CONCLUSIONS

Changes in athletes' training practices were sport-specific, with few or no sex differences. Team-based sports were generally more susceptible to changes than individual sports. Policy makers should provide athletes with specific training arrangements and educational resources to facilitate remote and/or home-based training during lockdown-type events.

Changes in Upper-Body Muscular Strength and Power in Paralympic Swimmers: Effects of Training Confinement during the COVID-19 Pandemic

The aim of this case series was to evaluate the effectiveness of a dry-land home-training program conducted during the COVID-19 pandemic period in Paralympic swimmers. Previous evidence showed the importance of muscular strength and power training for Paralympic swimmers due to the positive relationship between severity of impairment, swimming technique and biomechanics parameters. Specifically, we aimed to analyze: (i) the effects of a customized training regime conducted pre, during and post restrictions on upper-body muscular strength and power (one repetition maximum, mean propulsive velocity, and mean relative propulsive power) compared to a regular gym-based program; (ii) the associations between mean propulsive velocity and load during two upper body exercises in order to estimate the one repetition maximum. Four elite Paralympic swimmers were retrospectively analyzed in upper-body muscular strength, mean propulsive velocity and mean relative propulsive power in bench press and lat pull-down exercises at three time points: T0 (prior the Lockdown period), T1 (immediately after the Lockdown confinement), T2 (sixteen weeks after returning to gym training). Our findings suggest a very likely decrement in one repetition maximum, mean propulsive velocity, and mean relative propulsive power during the Lockdown period compared with the T0 period with a subsequent very likely increment in one repetition maximum after returning to gym training (T2) compared with the lockdown period (T0). Conversely, mean relative propulsive power showed an unclear improvement in all athletes in T2 compared with T1. These results were also corroborated by the Friedman’s test followed by the Dunn’s pairwise comparison that mainly showed a decrement from T0 to T1 (p < 0.05). At the same time, it appears that muscle strength and power could be rapidly restored close to the pre-lockdown levels following an adequate training program in the gym, albeit without significance (p > 0.05). Finally, the close relationship between mean propulsive velocity and load in bench press and lat pull-down exercises was also confirmed in para swimming, making a possible estimation of one repetition maximum.

Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic

The Coronavirus Disease 2019 (COVID-19) pandemic has shocked world health authorities generating a global health crisis. The present study aimed to analyze the different factors associated with physical activity that could have an impact in the COVID-19, providing a practical recommendation based on actual scientific knowledge. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding physical activity and physical activity related factors during the COVID-19 pandemic. The main online database used in the present research were PubMed, SciELO, and Google Scholar. COVID-19 has negatively influenced motor behavior, levels of regular exercise practice, eating and nutritional patterns, and the psychological status of citizens. These factors feed into each other, worsening COVID-19 symptoms, the risk of death from SARS-CoV-2, and the symptoms and effectiveness of the vaccine. The characteristics and symptoms related with the actual COVID-19 pandemic made the physical activity interventions a valuable prevention and treatment factor. Physical activity improves body composition, the cardiorespiratory, metabolic, and mental health of patients and enhancing antibody responses in vaccination.

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey

PURPOSE

The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored.

PATIENTS AND METHODS

For this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: ≥1-2 nights/week; low: <1-2 nights/week). A total of 9100 participants were excluded if answers on variables of interest were missing or receiving rewards for participation. Chi-square tests identified changes of nightmare frequency. Predictors of high nightmare frequency were assessed using logistic regression and presented as Odds Ratios. Post-hoc mediation models were used to investigate the role of post-traumatic stress symptoms (PTSS).

RESULTS

The mean age was 41.63 (SD=16.55) with 64.05% females. High nightmare frequency increased significantly from 13.24% to 22.35% during the pandemic. Factors associated with it included self-reported PTSS (OR=2.11), other mental disorders and various sleep disorders or problems. Financial burden due to the pandemic, confinement, having had COVID-19, and work situation during the pandemic were associated with nightmare frequency, those relations were partly mediated through PTSS.

CONCLUSION

Our results display the pandemic influence on nightmare frequency, which in turn connects to multiple mental health and sleep factors. These relations were partly mediated through PTSS. The COVID-19 pandemic appears to have caused traumatization of a substantial proportion of society. Health care workers should consider nightmares in their screening routines, as it might indicate PTSS and/or other mental and sleep disorders.

The impact of dawn to sunset fasting on immune system and its clinical significance in Covid-19 pandemic

Dawn to sunset fasting, a type of intermittent fasting commonly practiced in the month of Ramadan, requires fasting from dawn to sunset without food or liquid intake. Dawn and dusk are two transition time zones of the day that play a critical role in the human circadian rhythm. Practicing dawn to sunset fasting requires the alignment of mealtimes and wake-sleep times with the human biological dawn and dusk. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impairs immune cell responses at multiple levels and leads to severe Coronavirus Disease 2019 (COVID-19). It generates high levels of pro-inflammatory cytokines and chemokines, also known as a cytokine storm, leads to mitochondrial dysfunction and generation of excessive amounts of mitochondrial reactive oxygen species, downregulates autophagy to escape detection for unchecked replication, and alters gut microbiome composition. Severe cases of COVID-19 have been associated with several comorbidities that impair immune responses (e.g., obesity, diabetes, malignancy) and blood laboratory abnormalities (e.g., elevated procalcitonin, C-reactive protein, interleukin-6 (IL-6), leukocytosis, lymphopenia). Several studies of dawn to sunset fasting showed anti-inflammatory effect by suppressing several pro-inflammatory cytokines, reducing oxidative stress, inducing a proteome response associated with increased autophagy, remodeling the gut microbiome, and improving the components of metabolic syndrome (e.g., obesity, blood glucose levels, blood pressure, lipids). In conclusion, dawn to sunset fasting has the potential to optimize the immune system function against SARS-CoV-2 during the COVID-19 pandemic as it suppresses chronic inflammation and oxidative stress, improves metabolic profile, and remodels the gut microbiome. This review presents scientific literature related to the effects of dawn to sunset fasting on the immune system. Studies are needed to assess and confirm the potential benefits of dawn to sunset fasting against SARS-CoV-2.

Are elite track and field athletes on track? The impact of COVID-19 outbreak on sleep behavior and training characteristics

The Covid-19 outbreak forced many governments to enter a nationwide lockdown. The aim of this study was to evaluate, by means of a survey, changes in sleep parameters and physical activity characteristics of elite track and field athletes in three periods: before the lockdown (T0), during the lockdown (09th March – 03rd May 2020, T1) and the first month after the lockdown (T2). This study was conducted from May 2020 to June 2020 and data were collected using an offline survey with 89 elite track and field athletes (mean age: 24.7 ± 5.4; n = 43 males; n = 46 females). The survey consisted of demographic data and questions on physical activity and sleep behavior at T0, T1 and T2. Athletes reported lower sleep quality scores at T1 compared to T0 and T2 (p < 0.0001) and registered delayed bedtime, wake-up time and longer sleep latency during the lockdown compared to pre-lockdown and post-lockdown whereas no changes in total sleep time were reported. No inter-group differences were detected in sleep characteristics between short- and long-term disciplines and between genders. The weekly training volume decreased from 16.1 ± 5.7 hours at T0 to 10.7 ± 5.7 hours at T1 (p < 0.0001) whereas no significant differences were detected in training volume during the lockdown in relation to the square footage of the house (p = 0.309). Alcohol (p = 0.136) and caffeine intake (p = 0.990) and use of electronic devices (p = 0.317) were similar pre-, during, and post-lockdown. The unprecedented circumstances of the Covid-19 pandemic had negative impacts on the Italian track and field athletes’ sleep and training volumes.

Organising football matches with spectators during the COVID-19 pandemic: What can we learn from the Amir Cup Football Final of Qatar 2020? A call for action

The COVID-19 pandemic is a potential threat to professional sporting events when they eventually return to their usual calendar with spectators’ capacity of football stadiums usually exceeding 40,000 seats for important events. Hence, a strategy for safe return to sporting events is needed in the COVID-19 pandemic to pave the way towards a new normalcy. We reviewed the guidelines and policies implemented in organising the Amir Cup Football Final of Qatar, which hosted about 20,000 fans. The authors evaluated the publicly available information on the official websites of the various organizations involved and highlight the importance and usefulness of the Covid-19 Rapid Antigen Assay-Kit as a tool for screening sports spectators as well as the importance of a rigorous spectator pathway, including their accurate traceability thanks to a specific mobile phone application. Despite the surging of COVID-19 all over the world, a big football event with around 20,000 spectators in the same stadium has been hosted under strongly controlled preventative measures. These preventative measures show that it is possible to organize a major football match held outdoors, with the presence of thousands of supporters. This article is a call for action for the organisers of such events where the supporters’ health status is traceable to provide the scientific community with actual data of post-event infection rates. Therefore, it is suggested to consider using procedures like the ones described in the present article as a potential model in the process of organizing big sporting events with spectators in times of COVID-19.

The effects of COVID-19 lockdown on jumping performance and aerobic capacity in elite handball players

The aim of this research was to analyse the capacity of a home-based training programme to preserve aerobic capacity and jumping performance in top-level handball players during the COVID-19 lockdown. Eleven top-level male handball players from the same team participated in the study. A submaximal shuttle run test and a counter-movement jump test were used to measure the players’ aerobic fitness and lower limb explosive strength, respectively. A 9-week home-based training programme was followed during lockdown. Pre-test measurements were assessed before the pandemic on 29 January 2020 and ended on 18 May 2020. Moderate significant mean heart rate increases were found in the late stages of the submaximal shuttle run test after the lockdown (stage 5, 8.6%, P = 0.015; ES = 0.873; stage 6, 7.7%, P = 0.020; ES = 0.886; stage 7, 6.4%, P = 0.019; ES = 0.827). Moderate significant blood lactate increases were observed immediately after the submaximal shuttle run test following the lockdown (30.1%, P = 0.016; ES = 0.670). In contrast, no changes were found in jump performance. A structured home-based training programme during the COVID-19 lockdown preserved lower limb explosive strength but was an insufficient stimulus to maintain aerobic capacity in top-level handball players.

Influence of COVID-19 Restrictions on Training and Physiological Characteristics in U23 Elite Cyclists

PURPOSE

The COVID-19 pandemic and its associated mobility restrictions caused many athletes to adjust or reduce their usual training load. The aim of this study was to investigate how the COVID-19 restrictions affected training and performance physiology measures in U23 elite cyclists.

METHODS

Twelve U23 elite cyclists (n = 12) participated in this study (mean ± SD: Age 21.2 ± 1.2 years; height 182.9 ± 4.7 cm; body mass 71.4 ± 6.5 kg). Training characteristics were assessed between 30 days pre, during, and post COVID-19 restrictions, respectively. The physiological assessment in the laboratory was 30 days pre and post COVID-19 restrictions and included maximum oxygen uptake (V̇O_2max), peak power output for sprint (Sprint_Pmax), and ramp incremental graded exercise (GXT_Pmax), as well as power output at ventilatory threshold (VT) and respiratory compensation point (RCP).

RESULTS

Training load characteristics before, during, and after the lockdown remained statistically unchanged (p > 0.05) despite large effects (>0.8) with mean reductions of 4.7 to 25.0% during COVID-19 restrictions. There were no significant differences in maximal and submaximal power outputs, as well as relative and absolute V̇O_2max between pre and post COVID-19 restrictions (p > 0.05) with small to moderate effects.

DISCUSSION

These results indicate that COVID-19 restrictions did not negatively affect training characteristics and physiological performance measures in U23 elite cyclists for a period of <30 days. In contrast with recent reports on professional cyclists and other elite level athletes, these findings reveal that as long as athletes are able to maintain and/or slightly adapt their training routine, physiological performance variables remain stable.

COVID-19 Lockdowns: A Worldwide Survey of Circadian Rhythms and Sleep Quality in 3911 Athletes from 49 Countries, with Data-Driven Recommendations

Objective

In a convenience sample of athletes, we conducted a survey of COVID-19-mediated lockdown (termed ‘lockdown’ from this point forward) effects on: (i) circadian rhythms; (ii) sleep; (iii) eating; and (iv) training behaviors.

Methods

In total, 3911 athletes [mean age: 25.1 (range 18–61) years, 1764 female (45%), 2427 team-sport (63%) and 1442 elite (37%) athletes] from 49 countries completed a multilingual cross-sectional survey including the Pittsburgh Sleep Quality Index and Insomnia Severity Index questionnaires, alongside bespoke questions about napping, training, and nutrition behaviors.

Results

Pittsburgh Sleep Quality Index (4.3 ± 2.4 to 5.8 ± 3.1) and Insomnia Severity Index (4.8 ± 4.7 to 7.2 ± 6.4) scores increased from pre- to during lockdown (p < 0.001). Pittsburgh Sleep Quality Index was predominantly influenced by sleep-onset latency (p < 0.001; + 29.8%), sleep efficiency (p < 0.001; − 21.1%), and total sleep time (p < 0.001; − 20.1%), whilst Insomnia Severity Index was affected by sleep-onset latency (p < 0.001; + 21.4%), bedtime (p < 0.001; + 9.4%), and eating after midnight (p < 0.001; + 9.1%). During lockdown, athletes reported fewer training sessions per week (− 29.1%; d = 0.99). Athletes went to bed (+ 75 min; 5.4%; d = 1.14) and woke up (+ 150 min; 34.5%; d = 1.71) later during lockdown with an increased total sleep time (+ 48 min; 10.6%; d = 0.83). Lockdown-mediated circadian disruption had more deleterious effects on the sleep quality of individual-sport athletes compared with team-sport athletes (p < 0.001; d = 0.41), elite compared with non-elite athletes (p = 0.028; d = 0.44) and older compared with younger (p = 0.008; d = 0.46) athletes.

Conclusions

These lockdown-induced behavioral changes reduced sleep quality and increased insomnia in athletes. Data-driven and evidence-based recommendations to counter these include, but are not limited to: (i) early outdoor training; (ii) regular meal scheduling (whilst avoiding meals prior to bedtime and caffeine in the evening) with appropriate composition; (iii) regular bedtimes and wake-up times; and (iv) avoidance of long and/or late naps.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01601-y.

Training During the COVID-19 Lockdown: Knowledge, Beliefs, and Practices of 12,526 Athletes from 142 Countries and Six Continents

Objective

Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020).

Results

Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], plyometric exercise [30%]) at pre-lockdown levels (higher among world-class, international, and national athletes), with most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification.

Conclusions

COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01573-z.

The COVID-19 pandemic and physical activity during intermittent fasting, is it safe? A call for action

Intermittent fasting (IF) has recently gained popularity, and has been used for centuries in many religious practices. The Ramadan fasting is a mandatory form of IF practiced by millions of healthy adult Muslims globally for a whole lunar month every year. In Islam, the "Sunna" also encourages Muslims to practice IF all along the year (e.g.; two days a week). The 2019-Coronavirus disease (COVID-19) pandemic in the context of Ramadan has raised the question whether fasting is safe practice during the COVID-19 pandemic health crisis, and what would be the healthy lifestyle behaviors while fasting that would minimize the risk of infection. As COVID-19 lacks a specific therapy, IF and physical activity could help promote human immunity and be part of holistic preventive strategy against COVID-19. In this commentary, the authors focus on this dilemma and provide recommendations to the fasting communities for safely practicing physical activity in time of COVID-19 pandemic.

Physical Activity and Attitudes Toward Social Media Use of Active Individuals During the COVID-19 Pandemic in Saudi Arabia: Cross-Sectional Survey

Background: Social media became an integral part of the lives of people because it encourages social relations and shares interests, activities, and real-life connections. As quarantine and lockdown orders are prolonged, many people, as well as those physically active individuals, typically responded to this stressful condition by using social media platforms. Objective: This study aimed to examine the level of physical activity of physically active individuals and their attitudes toward social media use during the COVID-19 pandemic. Methods: A descriptive cross-sectional survey was conducted among physically active individuals in Saudi Arabia between June 2020 and July 2020. An online survey was employed among eligible participants who completed a self-administered questionnaire that covered reasons for physical activity and attitudes toward social media platforms during the COVID-19 pandemic. Results: Of these 323 participants, 29.1% were in the age group of 18-24 years, 66.6% were women, and 67.8% were single. The proportion of participants whose metabolic equivalent of tasks-min/week from vigorous activity <1,680 was 31.9%, and all of the participants follow people or pages in social media related to sports teams and fitness models. The average number of hours spent on social media per day was 2.95 ± 0.90 h. The majority of the participants showed positive attitudes toward social media used for exercise and physical activity. Of the eight variables, age, level of physical activity, and the average of hours spent on social media emerged as significant predictors of attitudes toward the use of social media (P < 0.05). Conclusions: The present survey results indicate adverse consequences of home quarantine as reflected by a small proportion of participants who had differences in levels of vigorous activities during the COVID-19 pandemic in Saudi Arabia. Social media appears to be a key avenue to promote and disseminate health interventions to promote physical activity during this COVID-19 pandemic.

Different Effects of the COVID-19 Pandemic on Exercise Indexes and Mood States Based on Sport Types, Exercise Dependency and Individual Characteristics

Exercise indexes have been affected by the coronavirus disease 2019 (COVID-19) pandemic and its related restrictions among athletes. In the present study, we investigated the exercise frequency and intensity before and during the COVID-19 pandemic, and also current exercise dependency and mood state among non-contact individual, contact individual, and team sports athletes. A total of 1353 athletes from non-contact individual sports athletes (NCISA), contact individual sports athletes (CISA) and team sport athletes (TSA) participated; 45.4% of them were females that completed a series of self-rating questionnaires covering sociodemographic information, former and current exercise patterns, exercise dependency and mood states. NCISA had less exercise frequency than CISA, both before and during the COVID-19 pandemic, and NCISA had less exercise frequency than TSA during the COVID-19 pandemic. Regarding exercise intensity, CISA had higher scores than NCISA and TSA before the COVID-19 pandemic, and CISA had more exercise intensity than TSA during the COVID-19 pandemic. Frequency and intensity were reduced from before to during the COVID-19 pandemic in the three groups, except for TSA intensity. In addition, positive and negative mood states were correlated with exercise dependency. CISA were more discouraged and vigorous than NCISA and TSA, respectively. For NCISA, CISA, and TSA, ordinal regressions separately showed that adherence to quarantine and exercise dependency were better predictors of exercise indexes. Finally, exercise dependency subscales were different among sports, but it was not in exercise dependency itself. Although the decrease in exercise indexes was noticeable, there was no consistent pattern of change in exercise behavior in all sports. Additionally, during the COVID-19 pandemic, negative moods were predominant among all athletes. The results discussed are based on exercise nonparticipating, sport type, and affect regulation hypothesis.

Implications of Vitamin D Research in Chickens can Advance Human Nutrition and Perspectives for the Future

The risk of vitamin D insufficiency in humans is a global problem that requires improving ways to increase vitamin D intake. Supplements are a primary means for increasing vitamin D intake, but without a clear consensus on what constitutes vitamin D sufficiency, there is toxicity risk with taking supplements. Chickens have been used in many vitamin-D-related research studies, especially studies involving vitamin D supplementation. Our state-of-the-art review evaluates vitamin D metabolism and how the different hydroxylated forms are synthesized. We provide an overview of how vitamin D is absorbed, transported, excreted, and what tissues in the body store vitamin D metabolites. We also discuss a number of studies involving vitamin D supplementation with broilers and laying hens. Vitamin D deficiency and toxicity are also described and how they can be caused. The vitamin D receptor (VDR) is important for vitamin D metabolism; however, there is much more to understand about VDR in chickens. Potential research aims involving vitamin D and chickens should explore VDR mechanisms that could lead to newer insights into VDR. Utilizing chickens in future research to help elucidate vitamin D mechanisms has great potential to advance human nutrition. Finding ways to increase vitamin D intake will be necessary because the coronavirus disease 2019 (COVID-19) pandemic is leading to increased risk of vitamin D deficiency in many populations. Chickens can provide a dual purpose with addressing pandemic-caused vitamin D deficiency: 1) vitamin D supplementation gives chickens added-value with the possibility of leading to vitamin-D-enriched meat and egg products; and 2) using chickens in research provides data for translational research. We believe expanding vitamin-D-related research in chickens to include more nutritional aims in vitamin D status has great implications for developing better strategies to improve human health.

Impact of COVID-19 on Swimming Training: Practical Recommendations during Home Confinement/Isolation

The COVID-19 pandemic has had severe effects on communities globally, leading to significant restrictions on all aspects of society, including in sports. Several significant decisions were made to postpone or cancel major swimming events by FINA (Fédération Internationale de Natation). Swimmers were no longer allowed to continue their usual training in swimming pools and were confined to their homes. These unusual circumstances may represent a good opportunity to strengthen different areas of swimmer preparation and potentially enhance performance when resuming regular aquatic training. We searched major databases for relevant information, and the present article provides practical information on home-based training for swimmers of all ages. The COVID-19 crisis and its consequences on the swimming community have created a myriad of challenges for swimmers around the world, including maintaining their fitness level and preparing to return optimally and safely to pool training and competitions. Unfortunately, the mental consequences that might arise after the pandemic may also have an impact. We strongly recommend encouraging the swimmers to consider quarantine as an opportunity for development in specific areas of preparation and learn how to best cope with this special situation of self-isolation and/or "physical distancing" for their mental health and in case a similar situation is faced again in the future.

Lifestyle and rehabilitation during the COVID-19 pandemic: guidance for health professionals and support for exercise and rehabilitation programs

Introduction: The coronavirus disease-2019 (COVID-19) is a highly contagious respiratory viral disease for both the general population and healthcare professionals caring for infected patients. Of particular concern is the potential for significant respiratory, cardiovascular, physical, and psychological dysfunctions.Areas covered: In this context, the current review will focus on the following areas: 1) staying physically active during the COVID-19 pandemic; 2) highlighting the importance of understanding COVID-19 mechanisms; 3) preventing infections for healthcare workers by using personal protective equipment; 4) highlighting importance of respiratory care and physical therapy during hospitalization in patients with COVID-19; and 5) facilitating referral to a rehabilitation program in patients recovering from COVID-19.Expert opinion: We recommend daily physical exercise, outdoors or at home, as physical exercise increases the synthesis of anti-inflammatory cytokines; Patients with COVID-19 may develop severe acute respiratory syndrome, hypoxemia, diffuse alveolar damage, ACE2 reduction in the cardiovascular system and muscle weakness acquired through a prolonged hospital stay; The role of the physiotherapist in the hospital environment is of fundamental importance-early mobilization is highly recommended in severe cases of COVID-19.

Home-based training program during the SARS-CoV- 2 quarantine: training load, motivation, and wellbeing in professional elite female basketball players

BACKGROUND

due to the quarantine caused by the Coronavirus disease 2019 (COVID-19), professional team-sports adapted their training routine to maintain the athletes' performance and minimize the negative emotional effects. The purpose of the present study was to describe a home-based training program and extra-activities applied during the quarantine in elite professional female basketball players, and to compare the internal training load (ITL), session rating of perceived exertion (s-RPE), motivation, and wellbeing responses before and during the quarantine.

METHODS

nine female elite players (25.7 ± 7.0 years; 180.0 ± 8.0 cm; 79.0 ± 11.0 kg) belonging to a professional basketball team performed a home-based training program during the quarantine. ITL, s-RPE, training motivation, and wellbeing were examined before (phase 1), at the beginning (phase 2), and during (phase 3) of the quarantine.

RESULTS

ITL was higher (main effect) in phase 1 (449.5 ± 62.8 a.u.) compared to phase 2 (265.5 ± 39.0 a.u.) and phase 3 (423.1 ± 18.7 a.u.); s-RPE was higher in phase 1 (4.50 ± 0.63 a.u.) compared to phase 2 (3.8 ± 0.6 a.u.), but not to phase 3 (4.37 ± 0.79 a.u.). Motivation was higher in phase 1 (3.6 ± 0.3 a.u.) compared to phase 2 (2.3 ± 0.6 a.u.) and phase 3 (2.4 ± 0.5 a.u.).

CONCLUSIONS

in conclusion, the results of the study demonstrated that extra-activities involving online athletes' socialization were implemented to rouse the motivation, but the quarantine period induced a reduction in ITL and influenced the player's training motivation.

Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey

BACKGROUND

The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults.

METHODS

A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses "pre" and "during" the lockdown period. Participants responded to the Short Warwick-Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire.

RESULTS

Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20).

CONCLUSION

COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

Altered immunoemotional regulatory system in COVID-19: From the origins to opportunities

The emergence of the novel coronavirus (SARS-CoV-2) and the worldwide spread of the coronavirus disease (COVID-19) have led to social regulations that caused substantial changes in manners of daily life. The subsequent loneliness and concerns of the pandemic during social distancing, quarantine, and lockdown are psychosocial stressors that negatively affect the immune system. These effects occur through mechanisms controlled by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenocortical (HPA) axis that alter immune regulation, namely the conserved transcriptional response to adversity (CTRA), which promotes inflammation and diminishes antiviral responses, leading to inadequate protection against viral disease. Unhealthy eating habits, physical inactivity, sleep disturbances, and mental health consequences of COVID-19 add on to the pathological effects of loneliness, making immunity against this ferocious virus an even tougher fight. Therefore, social isolation, with its unintended consequences, has inherently paradoxical effects on immunity in relation to viral disease. Though this paradox can present a challenge, its acknowledgment can serve as an opportunity to address the associated issues and find ways to mitigate the adverse effects. In this review, we aim to explore, in detail, the pathological effects of the new social norms on immunity and present suggested methods to improve our physical, psychological, and healthcare abilities to fight viral infection in the context of the COVID-19 pandemic.

Impact of COVID-19 Pandemic on Serum Vitamin D Level among Infants and Toddlers: An Interrupted Time Series Analysis and before-and-after Comparison

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the implementation of social distancing and home confinement measures may elevate the risk of vitamin D deficiency particularly for infants. This study aimed to quantify changes in vitamin D level among infants and toddlers in Hong Kong after the COVID-19 outbreak. Methods: We recruited 303 infants and toddlers aged 2–24 months by stratified random sampling from 1 June 2019 to November 30, 2020. Regression models were used to estimate the effect of time on infants’ serum 25-hydroxyvitamin D (25(OH)D) level overall and by age groups before and after the outbreak. Interrupted time series (ITS) analysis was performed to examine the sustained effect of COVID-19 on their serum 25(OH)D level. Results: The ITS results showed no immediate reduction in serum 25(OH)D level among infants, but a decreasing trend was observed in the subsequent months post-outbreak at a monthly decline rate of −6.32 nmol/L. When analyzed by age group, the magnitude of post-outbreak reduction in 25(OH)D was stronger among younger infants (aged 2–6 months). Conclusion: Guidelines and recommendations should be given to pregnant women and mothers to ensure sufficient vitamin D level in their infants during the COVID-19 period.

Physical activity recommendations during the COVID-19 pandemic: a practical approach for different target groups

Introduction

Ensuring health and well-being during this pandemic is essential according to the United Nations Sustainable Development Goals. Physical exercise has an important role in the preservation of the immune system, which is vital to prevent infections. To promote physical exercise and maintain a healthy status, recent studies have suggested general exercise routines to be implemented during the quarantine period. However, to improve the health-related physical fitness components, any specific prescription should include intensity, volume, duration, and mode. Controversy persists about which is the best intensity of physical activity, while performing exercise at a moderate intensity could bring important benefits to asymptomatic people. High intensity or unaccustomed exercise should be restricted for older people, and for people of all ages with chronic diseases or compromised immune system, obesity, or upper respiratory tract infection with limited symptoms. Besides, physical activity guidelines should be particular to each population group, giving special consideration to those vulnerable to COVID-19 who are much more likely to suffer more self-isolation. Therefore, the present study is to provide specific physical activity recommendations for different populations during this pandemic.

"Oh, My God! My Season Is Over!" COVID-19 and Regulation of the Psychological Response in Spanish High-Performance Athletes

Background: In an unprecedented situation of interruption of the sporting dynamics, the world of sport is going through a series of adaptations necessary to continue functioning despite coronavirus disease 2019 (COVID-19). More than ever, athletes are facing a different challenge, a source of discomfort and uncertainty, and one that absolutely alters not only sports calendars, but also trajectories, progressions, and approaches to sports life. Therefore, it is necessary to identify the levels of psychological vulnerability that may have been generated in the athletes, because of the coexistence with dysfunctional responses during the COVID-19 experience, and which directly influence the decrease of their mental health. Methods: With a descriptive and transversal design, the study aims to identify the state of the dysfunctional psychological response of a sample of Spanish athletes (N = 284). The DASS-21 (Depression, Anxiety, and Stress Scale), Toronto-20 (alexithymia), and Distress Tolerance Scale questionnaires were administered to a sample of high-level Spanish athletes in Olympic programs. Results: The results suggest that the analyzed athletes indicate high levels of dysfunctional response (e.g., anxiety, stress, depression, and alexithymia) when their tolerance is low. In addition, the variables show less relational strength, when the capacity of tolerance to distress is worse and age is lower. At the same time, the greater the anxiety and uncertainty are, leading to more catastrophic and negative thoughts, the younger the athletes are. Conclusions: It is clear that both age and tolerance to distress are considered adequate protective factors for psychological vulnerability in general and for associated dysfunctional responses in particular. Moreover, the psychological resources offered by more experienced athletes are also a guarantee of protection against negativity and catastrophism.

Physical activity can change the physiological and psychological circumstances during COVID-19 pandemic: A narrative review

Background: With the outbreak of Coronavirus disease 2019 (COVID-19), many studies’ attention to this world’s complexity increased dramatically. Different views on sports and physical activities have been presented, which have addressed the advantages and disadvantages of sports activities in this period differently. The purpose of this review was to investigate the physiological and psychological effects of physical activity during the COVID-19 pandemic. Methods: Using PubMed, Science Direct, Medline, and Web of Science electronic databases, this review summarizes the current knowledge of direct and indirect effects of physical activity during the COVID-19 pandemic, evaluating the advantages and drawbacks of specific exercise physiology conditions. All types of studies were assessed, including systematic reviews, case-studies, and clinical guidelines. The literature search identified 40 articles that discussed COVID-19, immune system, the relation between immune system and exercise or diet, and psychological impacts of physical activity. Results: Forty articles review showed that the immune system depends on the type, frequency, intensity, and duration of the exercise. Intense or prolonged exercise with short recovery periods can progressively weaken the immune system and increase the risk of COVID-19. One of the acute responses after moderate-intensity training is improved immune function and a decrease in inflammatory cytokines. Paying attention to dietary intakes of micro-and macronutrients in conjunction with exercise can strengthen the condition to fight against coronavirus. Exercise can also affect the psychological dimensions of the COVID-19 pandemic, including depression, anxiety, and stress, which improve community mental health during the quarantine. Conclusion: Setting appropriate physical activity based on individuals’ properties and proper diet plan may enhance the physiological and psychological body’s condition to fight against coronavirus.

Athlete's Perceptions of a "Quarantine" Training Camp During the COVID-19 Lockdown

Globally, COVID-19-related movement restrictions have caused significant disruption to athlete's training and sporting competitions. "Quarantine" camps are one approach to maintain sport-specific training, whilst minimizing the risk of COVID-19 transmission between athletes and society. This cross-sectional study investigated the effects of a "quarantine" training camp on athlete's routines and wellbeing, performance support, perceived stress and sleep behaviors. A survey was completed at the end of a 30-day "quarantine" camp, by 76 elite athletes (17-46 years), predominantly (~80%) Olympic/Paralympic and/or world championship representatives. Athletes described their experiences in comparison to; pre-lockdown training and/or training during "lockdown" (immediately prior to the "quarantine" camp). Compared to "lockdown," the "quarantine" camp revealed improvements (p < 0.05; 0.33 ≤ d ≤ 0.90) in access to sport-specific training (28.6%), recovery facilities (22.2%), nutritional choices (17.5%), mental (12.4%) and emotional (11.4%) health, training motivation (20.0%); and perceived stress (7.4%, d = -0.27, p = 0.026). The camp resulted in a lower sleep duration (-8.5%, d = -0.73, p = 0.014), but an improved global sleep behavior score (-5.6%, d = -0.22, p = 0.001). During the camp, the performance support athletes received was not different to pre-lockdown (p > 0.05), but there was greater sports massage (20.4%, d = 0.39) and physiotherapy usage (18.1%, d = 0.36) (both p < 0.05). The adverse effects of lockdown were restored during the camp. A "quarantine" camp may offer comparable training experiences to pre-lockdown training, without inducing additional perceived stress. Coaches and sporting organizations may consider this approach as part of a virus mitigation strategy, whilst maintaining sport-specific training.

Home-based exercise can be beneficial for counteracting sedentary behavior and physical inactivity during the COVID-19 pandemic in older adults

The novel pandemic called coronavirus disease 2019 (COVID-19), as a global public health emergency, seems to be having a major impact on physical activity (PA) behaviors. Older adults are at high risk of death from the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Health authorities around the world have been implementing preventive health measures, including quarantine and self-isolation, to mitigate the COVID-19 outbreak. This period is characterized by the cessation of outdoor exercising. During this period of lockdown, PA has been one of the rare reasons for going out in some countries. To avoid the harmful effects of periods of exercise cessation, PA could be prescribed to older adults, which is of great importance for breaking their sedentary lifestyle and improving their immunity. The present review discusses the potential impacts of the COVID-19 pandemic on sedentary behavior and physical inactivity in older adults. The importance of performing PA to reduce the harmful effects of the COVID-19 pandemic is discussed, and useful recommendations on home-based exercise for the older adults to maintain their level of independence, physical and mental health as well as their well-being are provided.

Potentially Prolonged Psychological Distress from Postponed Olympic and Paralympic Games during COVID-19-Career Uncertainty in Elite Athletes

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the world of sports due to periods of home quarantine, bans against public gatherings, travel restrictions, and a large number of postponed or canceled major sporting events. The literature hitherto is sparse, but early indications display signs of psychological impact on elite athletes due to the pandemic. However, beyond acute effects from lockdown and short-term interrupted athletic seasons, the postponed and still uncertain Olympic and Paralympic Games may represent a major career insecurity to many athletes world-wide, and may lead to severe changes to everyday lives and potentially prolonged psychological distress. Given the long-term perspective of these changes, researchers and stakeholders should address mental health and long-term job insecurity in athletes, including a specific focus on those with small financial margins, such as many female athletes, parasports athletes, athletes in smaller sports, and athletes from developing countries. Implications and the need for research are discussed.

Second Wave of COVID-19 Global Pandemic and Athletes' Confinement: Recommendations to Better Manage and Optimize the Modified Lifestyle

Coronavirus 2019 (COVID-19) is an infectious viral disease that has spread globally, resulting in the ongoing pandemic. Currently, there is no vaccine or specific treatment for COVID-19. Preventive measures to reduce the chances of contagion consist mainly of confinement, avoiding crowded places, social distancing, masks, and applying strict personal hygiene as recommended by the World Health Organization (WHO). After the first wave of infection in many countries, the potential effects of relaxing containment and physical distancing control measures suggest that as a result of these measures, a second wave of COVID-19 appears probable in these countries. In sport, the period of self-isolation, and quarantine, for COVID-19 affects the physical preparation of athletes as well as their mental health and quality of life to an even greater extent (i.e., nutrition, sleep, healthy lifestyle), and thus, relevant and practical recommendations are needed to help alleviate these physical and mental health concerns. Our review aims to summarize the physiological and psychological effects of detraining associated with athletes' confinement during the proposed second wave of COVID-19. This article also proposes answers to questions that concern the advantages and disadvantages of different types of social media platforms, the importance of nutrition, and the effects of sleep disturbance on the health and modified lifestyle of athletes during this worldwide pandemic. Thus, this review provides some general guidelines to better manage their modified lifestyle and optimally maintain their physical and mental fitness with respect to measures taken during this restrictive proposed second wave of the COVID-19 confinement period.

Psychological consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study

BACKGROUND

Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily-living. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey (ECLB-COVID19) was launched on April 6, 2020 in seven languages to elucidate the impact of COVID-19 restrictions on mental health and emotional wellbeing.

METHODS

The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online-survey-platform and was promoted by thirty-five research organizations from Europe, North-Africa, Western-Asia and the Americas. All participants were asked for their mental wellbeing (SWEMWS) and depressive symptoms (SMFQ) with regard to "during" and "before" home confinement.

RESULTS

Analysis was conducted on the first 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%). The COVID-19 home confinement had a negative effect on both mental-wellbeing and on mood and feelings. Specifically, a significant decrease (p < .001 and Δ% = 9.4%) in total score of the SWEMWS questionnaire was noted. More individuals (+12.89%) reported a low mental wellbeing "during" compared to "before" home confinement. Furthermore, results from the mood and feelings questionnaire showed a significant increase by 44.9% (p < .001) in SMFQ total score with more people (+10%) showing depressive symptoms "during" compared to "before" home confinement.

CONCLUSION

The ECLB-COVID19 survey revealed an increased psychosocial strain triggered by the home confinement. To mitigate this high risk of mental disorders and to foster an Active and Healthy Confinement Lifestyle (AHCL), a crisis-oriented interdisciplinary intervention is urgently needed.

Fasting Ramadan During COVID-19 Pandemic: Immunomodulatory Effect

As of April 24, 2020, more than 1. 6 billion Muslims observe the holy fasting month of Ramadan worldwide. The safety of fasting of healthy adult Muslims during the COVID-19 era is debatable. In this perspective, we discuss the available scientific evidence of the advantages of fasting against COVID-19.

Applying digital technology to promote active and healthy confinement lifestyle during pandemics in the elderly

Although recognized as effective measures to curb the spread of the COVID19 outbreak, social distancing and home confinement have generated a mental health burden with older adults who are considered to be more vulnerable to psychosocial strains. To date, the application of digital technologies in response to COVID-19 pandemic has been narrowed to public-health needs related to containment and mitigation. However, information and communications technology (ICT)-based initiatives directed toward prediction and prevention of psychosocial support are still limited. Given the power of digital health solutions to allow easy and accurate characterization and intervention for health and disease, as well as to flatten the COVID19 incidence curves in many countries, our ECLB-COVID19 consortium is highlighting the importance of providing innovative ICT-based solutions (ICT-COVID-Companion) to improve elderly physical and mental health, thereby preventing/dampening psychosocial strain during pandemics. Based on innovative approaches (e.g., emotional/social computing, open social platform, interactive coaching, gamification, fitness-tracker, internet of things) and smart digital solutions (smartwatch/smartphone), smart companions must provide safe personalised physical, mental and psychosocial health surveillance. Additionally, by delivering personalised multi-dimension crisis-oriented health recommendations, such innovative crisis-oriented solutions would help (i) facilitate a user’s adherence to active and healthy confinement lifestyle (AHCL), (ii) achieve a rapid psychosocial recovery in case of depression issues and (iii) enhance preparedness for eventual future pandemics.