Baseline physical activity is associated with reduced mortality and disease outcomes in COVID-19: A systematic review and meta-analysis.

Among coronavirus disease 2019 (COVID-19) patients, physically active individuals may be at lower risk of fatal outcomes. However, to date, no meta-analysis has been carried out to investigate the relationship between physical activity (PA) and fatal outcomes in patients with COVID-19. Therefore, this meta-analysis aims to explore the hospitalisation, intensive care unit (ICU) admissions, and mortality rates of COVID-19 patients with a history of PA participation before the onset of the pandemic, and to evaluate the reliability of the evidence. A systematic search of MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and medRxiv was conducted for articles published up to January 2022. A random-effects meta-analysis was performed to compare disease severity and mortality rates of COVID-19 patients in physically active and inactive cases. Twelve studies involving 1,256,609 patients (991,268 physically active and 265,341 inactive cases) with COVID-19, were included in the pooled analysis. The overall meta-analysis compared with inactive controls showed significant associations between PA with reduction in COVID-19 hospitalisation (risk ratio (RR) = 0.58, 95% confidence intervals (CI) 0.46-0.73, P = 0.001), ICU admissions (RR = 0.65, 95% CI 0.52-0.81, P = 0.001) and mortality (RR = 0.47, 95% CI 0.38-0.59, P = 0.001). The protective effect of PA on COVID-19 hospitalisation and mortality could be attributable to the types of exercise such as resistance exercise (RR = 0.27, 95% CI 0.15-0.49, P = 0.001) and endurance exercise (RR = 0.41, 95% CI 0.23-0.74, P = 0.003), respectively. Physical activity is associated with decreased hospitalisation, ICU admissions, and mortality rates of patients with COVID-19. Moreover, COVID-19 patients with a history of resistance and endurance exercises experience a lower rate of hospitalisation and mortality, respectively. Further studies are warranted to determine the biological mechanisms underlying these findings.

A Guide to Different Intensities of Exercise, Vaccination, and Sports Nutrition in the Course of Preparing Elite Athletes for the Management of Upper Respiratory Infections during the COVID-19 Pandemic: A Narrative Review.

Elite athletes use high-intensity training to maintain their fitness level. However, intense training can harm the immune system, making athletes suspectable to COVID-19 and negatively affecting their performance. In addition, the diet of athletes should be appreciated more as it is another influencer of the immune system, especially during the COVID 19 pandemic. The other important issue elite athletes face currently is vaccination and its possible intervention with their training. The present study attempts to discuss the impact of different training intensities, nutritional strategies, and vaccination on the immune system function in elite athletes. To this end, Scopus, ISC, PubMed, Web of Science, and Google Scholar databases were searched from 1988 to 2021 using the related keywords. The results of our review showed that although high-intensity exercise can suppress the immune system, elite athletes should not stop training in the time of infection but use low- and moderate-intensity training. Moderate-intensity exercise can improve immune function and maintain physical fitness. In addition, it is also better for athletes not to undertake high-intensity training at the time of vaccination, but instead perform moderate to low-intensity training. Furthermore, nutritional strategies can be employed to improve immune function during high-intensity training periods.

Exercise-induced modulation of monocytes in breast cancer survivors.

BACKGROUND: Exercise training reduces inflammation in breast cancer survivors; however, the mechanism is not fully understood. OBJECTIVES: The effects of acute and chronic exercise on monocyte toll-like receptor (TLR2 and 4) expression and intracellular cytokine production were examined in sedentary breast cancer survivors. METHODS: Eleven women with stage I, II, or III breast cancer within one year of treatment completion performed an acute, intermittent aerobic exercise trial. Blood samples were obtained before, immediately, and 1 h after a 45-min acute exercise trial that was performed before and after 16 weeks of combined aerobic and resistance. LPS-stimulated intracellular IL-1ß, TNF, and IL-6 production, and TLR2 and TLR4 expression were evaluated in CD14+CD16- and CD14+CD16+ monocytes using flow cytometry. RESULTS: Exercise training decreased IL-1ß+CD14+CD16- proportion (24.6%, p=0.016), IL-1ß+CD14+CD16- mean fluorescence intensity (MFI) (-9989, p=0.014), IL-1ß+CD14+CD16+ MFI (-11101, p=0.02), and IL-6+CD14+CD16- proportion (16.9%, P=0.04). TLR2 and TLR4 expression did not change following exercise training but decreased 1 h after acute exercise in CD14+CD16- (-63, p=0.002) and CD14+CD16+ (-18, p=0.006) monocytes, respectively. Immediately after the acute exercise, both monocyte subgroup cell concentration increased, with CD14+CD16+ concentrations being decreased at 1 h post without changes in intracellular cytokine production. CONCLUSIONS: Exercise training reduced monocyte intracellular pro-inflammatory cytokine production, especially IL-1ß, although these markers did not change acutely. While acute exercise downregulated the expression of TLR2 and TLR4 on monocytes, this was not sustained over the course of training. These results suggest that the anti-inflammatory effect of combined aerobic and resistance exercise training in breast cancer survivors may be, in part, due to reducing resting monocyte pro-inflammatory cytokine production.

Exercise in an Overweight Patient with Covid-19: A Case Study.

Coronavirus (COVID-19) is a dangerous infectious disease that is easily transmitted and which is called an acute respiratory syndrome. With the spread of the coronavirus around the world and its epidemic among humans, we are losing many humans. The long process of treatment in hospitalized patients who are receiving intensive care and medication is associated with physical weakness. It has been suggested that lifelong exercise can create a safe margin for a person that allows them to avoid becoming infected with the virus. The current study was conducted to assess the effects of low-intensity exercise and breathing exercises on cardiorespiratory responses and physical status in an overweight 20-year-old woman infected with COVID-19. The patient was referred to Hazrat Ali Ibn Abitaleb Hospital in Rafsanjan. The patient had initial symptoms of coronavirus including weakness, shortness of breath, fever, and chills, and the initial tests confirmed that the person was infected with the coronavirus. Although COVID-19 reduces respiration and blood oxygen and severely reduces movement and physical activity, low-intensity rehabilitation and breathing exercises along with medication can improve blood oxygen status, resting heart rate, blood pressure, and hand power status in patients and possibly speeding up the healing process. The results of the present study show that low-intensity exercise and breathing exercises in patients with COVID-19, whose disease severity is mild to moderate, can be performed safely under the supervision of their physicians to prevent the disease process.

Endurance exercise training decreased serum levels of surfactant protein D and improved aerobic fitness of obese women with type-2 diabetes.

BACKGROUND: Surfactant protein D (SP-D) is a member of the collectin family and is an important component of the pulmonary innate host defense. To find the relationship between exercise training and SP-D in diabetes, we examined the possible effects of a 10-week endurance exercise-training program on serum levels of SP-D, leptin, lipid profile and insulin resistance in obese women with type-2 diabetes mellitus (T2DM). METHODS: Twenty-two obese women with T2DM were randomly assigned to either exercise training (ET) or control (C) group. A subject dropped from ET group due to personal reasons and 1 subject dropped from C group due to commitment to experiments conditions. A total of twenty obese women with T2DM were randomly assigned into endurance exercise training (ET = 10) and control (C = 10) groups. The training group underwent a progressive endurance-training program for 10 weeks (running on a treadmill for 30-55 min/day at 50-75% heart rate reserve) and the control group did not participate in any exercise program. Venous blood samples were collected from both groups before and 72 h after the last session of exercise training for analysis of serum SP-D, leptin, lipid profile, glucose and insulin. Data were analyzed using 2 (group: control, endurance training) × 2 (time: pre, post) ANOVA with repeated measures on the second factor. Absolute changes from rest (∆ baseline) values were calculated according to the following formula: ((measure-baseline)·baseline-1)·100. Percent change between groups was analyzed using independent t-tests (p < 0.05). All analyses were completed using SPSS 19. RESULTS: The serum SP-D levels were decreased after exercise training in ET (∆ = - 78.78 ± 17.14%, p = 0.001) when compare to C (∆ = 9.41 ± 4.75%). Obese diabetic women in the ET group showed significantly lower serum leptin levels (8053.27 ± 878.7 pg/ml, ∆ = - 26.97 ± 16.41%) when compared with women in the control group (9885.5 ± 696 pg/ml, ∆ = 7.02 ± 3.46%, p = 0.003). Fasting glucose was favorably and significantly affected by the intervention (ET ∆ = - 17.01 ± 12.74%, Control ∆ = 15.47 ± 7.32%, p = 0.011). VO2max as an index of aerobic fitness was significantly increased after 10-weeks of endurance exercise training (ET ∆ = 19.29 ± 6.18%). CONCLUSIONS: Endurance exercise training with improvement in aerobic fitness induced a significant reduction of serum SP-D levels in obese women with T2DM.

The effect of endurance training and downhill running on the expression of IL-1ß, IL-6, and TNF-α and HSP72 in rat skeletal muscle.

This study investigated changes in the myokines IL-1ß, IL-6, and TNF-α, as well as HSP72, after endurance training and after a session of downhill running. Twenty-eight rats were allocated to four different groups: 1. Eight weeks of endurance training at 65-70% VO2max (Trained); 2. Endurance training and a single session of downhill running on a 16° slope (Trained plus downhill); 3. A single session of downhill running (Sedentary plus downhill); and 4. Sedentary (Control, no exercise). Soleus and extensor digitorum longus (EDL) muscles were harvested 48h after training and/or a single session of downhill running and protein levels of IL-1ß, IL-6, TNF-α, and HSP72 were measured and compared to the levels in the control animals. Creatine kinase (CK) was measured in plasma. Endurance training augmented intramuscular levels of HSP72 and IL-6 in both soleus and EDL muscles (p<0.05). Endurance training elevated IL-1ß and decreased TNF-α significantly only in EDL (P<0.05). IL-6 increased in both sedentary and trained rats after downhill running (P<0.05), while HSP72 increased only in the previously sedentary rats. CK was lower in trained than sedentary rats after downhill running. In conclusion, endurance training for 8weeks elevated muscular HSP72 protein levels, which might have preconditioned the muscles for a single session of downhill running, as indicated by the CK and HSP72 responses. Interestingly, IL-6 was augmented by endurance training and further increased by downhill running. IL-1ß, along with IL-6, was increased by endurance training, and these myokines thus appear to be differently regulated than TNF-α.