Coronavirus (COVID-19), Coagulation, and Exercise: Interactions That May Influence Health Outcomes

Abstract

The proinflammatory cytokine storm associated with coronavirus disease 2019 (COVID-19) negatively affects the hematological system, leading to coagulation activation and endothelial dysfunction and thereby increasing the risk of venous and arterial thrombosis. Coagulopathy has been reported as associated with mortality in people with COVID-19 and is partially reflected by enhanced D-dimer levels. Poor vascular health, which is associated with the cardiometabolic health conditions frequently reported in people with severer forms of COVID-19, might exacerbate the risk of coagulopathy and mortality. Sedentary lifestyles might also contribute to the development of coagulopathy, and physical activity participation has been inherently lowered due to at-home regulations established to slow the spread of this highly infectious disease. It is possible that COVID-19, coagulation, and reduced physical activity may contribute to generate a “perfect storm,” where each fuels the other and potentially increases mortality risk. Several pharmaceutical agents are being explored to treat COVID-19, but potential negative consequences are associated with their use. Exercise is known to mitigate many of the identified side effects from the pharmaceutical agents being trialled but has not yet been considered as part of management for COVID-19. From the limited available evidence in people with cardiometabolic health conditions, low- to moderate-intensity exercise might have the potential to positively influence biochemical markers of coagulopathy, whereas high-intensity exercise is likely to increase thrombotic risk. Therefore, low- to moderate-intensity exercise could be an adjuvant therapy for people with mild-to-moderate COVID-19 and reduce the risk of developing severe symptoms of illness that are associated with enhanced mortality.

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

“…According to clinical reports, Cytokines such as Interleukin-2 (IL-2), Interleukin-7 (IL-7), Interleukin-10 (IL-10), Granulocyte Colony-stimulating Factor (G-CSF), Interferongamma Inducible Protein (IP-10), Monocyte Chemoattractant Protein 1 (MCP-1), Macrophage In lammatory Protein (MIP1A), and Tumour Necrosis Factor alpha (TNFα) are increased in patients with COVID-19. Activation and spread of these cytokines lead to in lammation and endothelial dysfunction; eventually, these factors will cause problems for the body's arteries [3,32].…”

“…Likewise, lifestyle has been modi ied due to quarantine [1]. Insuf icient physical activity develops the incidence of venous thromboembolism, which leads to consequences, such as cardiovascular problems and, in some cases, death [3]. Researchers have announced an increase in venous thromboembolism in con irmed COVID-19 patients can progress mortality [33].…”

“…Researchers have announced an increase in venous thromboembolism in con irmed COVID-19 patients can progress mortality [33]. Thus, it has been recommended that regular physical activity strengthens the immune system and improves the homeostasis conditions [1,3].…”

“…In the last few months, the increase in cases and deaths due to COVID-19 in the world and the imposition of more social restrictions in most countries have caused many physiological and psychological disorders [1,2]. Recorded data from smartwatches show that the level of physical activity worldwide during the COVID-19 pandemic decreased between 8% to 48% [3]. The elderly, obese, and sedentary individuals with a body mass index (BMI) of more than 25 kg/m2 have been reported to be among the most vulnerable groups to the coronavirus [1].…”

The effects of health-preserving sports on the treatment of COVID-19

“…Exercise is known to mitigate many of the identified side effects from the pharmaceutical agents being trialled but has not yet been considered as part of management for COVID-19. [ 12 ] In China, there are many Health-Preserving Sports as a common way for people to exercise, such as Six-Character Tactic, Tai Chi, Five-Animal Exercise, Eight-Section Brocade, and Muscle-Bone Strengthening. Tai Chi, which combines psychological treatment and physical exercise and requires no special equipment, is widely practiced in China and is becoming increasingly popular in the rest of the world.…”