Acute exercise increases immune responses to SARS CoV-2 in a previously infected man

Abstract

Evidence is emerging that exercise and physical activity provides protection against severe COVID-19 disease in patients infected with SARS-CoV-2, but it is not known how exercise affects immune responses to the virus. A healthy man completed a graded cycling ergometer test prior to and after SARS-CoV-2 infection, then again after receiving an adenovirus vector-based COVID-19 vaccine. Using whole blood SARS-CoV-2 peptide stimulation assays, IFN-γ ELISPOT assays, flow cytometry, ex vivo viral-specific T-cell expansion assays and deep T-cell receptor (TCR) β sequencing, we found that exercise robustly mobilized highly functional SARS-CoV-2 specific T-cells to the blood compartment that recognized spike protein, membrane protein, nucleocapsid antigen and the B.1.1.7 α-variant, and consisted mostly of CD3+/CD8+ T-cells and double-negative (CD4-/CD8-) CD3+ T-cells. The magnitude of SARS-CoV-2 T-cell mobilization with exercise was intensity dependent and robust when compared to T-cells recognizing other viruses (e.g. CMV, EBV, influenza). Vaccination enhanced the number of exercise-mobilized SARS-CoV-2 T-cells recognizing spike protein and the α-variant only. Exercise-mobilized SARS-CoV-2 specific T-cells proliferated more vigorously to ex vivo peptide stimulation and maintained broad TCR-β diversity against SARS-CoV-2 antigens both before and after ex vivo expansion. Neutralizing antibodies to SARS-CoV-2 were transiently elevated during exercise after both infection and vaccination. Finally, infection was associated with an increased metabolic demand to defined exercise workloads, which was restored to pre-infection levels after vaccination. This case study provides impetus for larger studies to determine if these immune responses to exercise can facilitate viral clearance, ameliorate symptoms of long COVID syndrome, and/or restore functional exercise capacity following SARS-CoV-2 infection.

Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people

“…During Visit 3 , the resting serum sample was also used to confirm whether all vaccinated individuals had seroconverted and presented with a positive SARS-CoV-2 IgG titer. To exclude the possibility of including participants who had been infected naturally between laboratory visits, whole blood samples collected in two lithium heparin coated tubes were stimulated with overlapping peptide pools spanning the breadth of the spike, membrane, and nucleocapsid antigens (10 μg/mL; Miltenyi) before measuring IFN-γ in plasma by ELISA (R&D Systems; Minneapolis, MN) following methods we recently described ( 16 ). No responses to membrane or nucleocapsid antigen were found post vaccine in the participants who had not been infected naturally (data not shown)( 17 ).…”

Systematic Review of COVID-19-Related Physical Activity-Based Rehabilitations: Benefits to Be Confirmed by More Robust Methodological Approaches

“…The underlying systemic inflammation contributes to muscle atrophy indirectly (lung obstruction and forced inactivity) or directly (increased muscle wasting, necrosis, fibrosis and autophagy, and mitochondrial dysfunction), while viral antigen mimicry might cause muscle denervation in peripheral nerves. While physical activity (PA) has been identified as a predictive and protective factor against severe forms of COVID-19 [ 17 , 18 , 19 , 20 ], it has also been suggested as a key factor for rehabilitation [ 21 , 22 , 23 ], both for the acute and long-term consequences of this new global disease. According to a survey questioning the specific rehabilitation needs reported by post-COVID-19 patients themselves [ 24 ], exercise guidance appears to be a primary concern.…”

Effects of Exercise on COVID-19 Patients: A Narrative Review

“…In a cross-sectional study on a healthy man, Baker et al ( 46 ) concluded that acute exercises like incremental continuous cycling affect multiple SARS-CoV-2 specific T-cell mobilization to the blood vessels and elevation of neutralizing antibodies temporarily, which can be caused by increased lymphatic flow due to exercise. Furthermore, exercise increased the IFN- response to SARS-CoV-2 peptide stimulation in the blood.…”