Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature

Abstract

Acute viral respiratory infections are the main infectious disease in the world. In 2020, a new disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19), became a global pandemic. The immune response to the virus depends on factors such as genetics, age and physical state, and its main input receptor is the angiotensin-converting enzyme 2. The practice of physical exercises acts as a modulator of the immune system. During and after physical exercise, pro-and anti-inflammatory cytokines are released, lymphocyte circulation increases, as well as cell recruitment. Such practice has an effect on the lower incidence, intensity of symptoms and mortality in viral infections observed in people who practice physical activity regularly, and its correct execution must be considered to avoid damage. The initial response is given mainly by type I interferons (IFN-I), which drive the action macrophages and lymphocytes, followed by lymphocyte action. A suppression of the IFN-I response has been noted in COVID-19. Severe conditions have been associated with storms of pro-inflammatory cytokines and lymphopenia, as well as circulatory changes and virus dispersion to other organs. The practice of physical activities strengthens the immune system, suggesting a benefit in the response to viral communicable diseases. Thus, regular practice of adequate intensity is suggested as an auxiliary tool in strengthening and preparing the immune system for COVID-19. Further studies are needed to associate physical exercise with SARS-CoV-2 infection.

COVID-19: A Challenge to Physiology of Aging

“…Numerous epidemiological studies of human populations provide unequivocal evidence of the benefits of adequately balanced nutrition and physical activity for preventing age-associated diseases and mortality ( Nieman and Wentz, 2019 ; Furrer and Handschin, 2020 ). It is increasingly recognized ( da Silveira et al, 2020 ; Heffernan et al, 2020 ; Jakobsson et al, 2020 ; Neto et al, 2020 ) that lifestyle interventions, including promotion of physical activity, are the most reasonable, robust, and cost effective measures for reducing the burden of COVID-19 on public health.…”

How children and young people can stay physically active during the novel coronavirus pandemic while take into account safety measures and precautions

“…Nonetheless, Hammami et al 17 suggested that those who safely and easily can access outdoor environments, such as parks and fields or similar, are recommended to use these to engage in physical activity. It has also been recognized that parents can be physically active with children, through play and exercise, 16,37 and that many activities can be performed with family members. 18 Suggested forms of exercises are aerobic, musclestrengthening, balance, and stretching (or a combination thereof).…”

“…Among others, recommended activities are (brisk) walking (outdoor or at home), Nordic walking, jogging, running (outdoor or on the spot at home), bicycling, stair climbing, lifting and carrying groceries or transporting items of moderate weight, as well as household tasks such as cleaning, gardening, washing and ironing clothes, sweeping floors, vacuuming, and mowing the lawn. 15,18,20,22,23,25,27,28,[30][31][32][37][38][39][40][41][42] In addition, some papers suggested activities such as Qigong and Yoga, Pilates, and Tai Chi, or dance-based exercise. 15,17,22,23,41 In their paper, Schwendinger and Pocecco recommended intermittent high-intensity interval training (i.e., alternating bouts of high-intensity exercise with low-intensity recovery periods) with bodyweight exercises, such as push-ups, burpees, air-squats, jumping lunges, single-step climbing, and rope skipping.…”

“…17,23,24,28,39,42,43 In addition, it has been recognized that everyday household objects can be used as exercise equipment, such as broomsticks, ropes, towels, product packages and (water-filled) bottles, backpacks, books, and furnitures. 18,22,24,26,28,37,39 Some specific suggestions on exercises were also provided in the papers, such as abdominal crunches, push-ups, plank, squats, split squats, box jumps, burpees, jumping jacks, step-up onto a chair, triceps-dip on a chair, calf raises on the edge of an incline, and jump roping. 15,17,25,26,28,31,37,39,42,43 Moreover, Margaritis et al 24 suggested that board games could be modify to incorporate balancing and stretching challenges.…”

“…18,22,24,26,28,37,39 Some specific suggestions on exercises were also provided in the papers, such as abdominal crunches, push-ups, plank, squats, split squats, box jumps, burpees, jumping jacks, step-up onto a chair, triceps-dip on a chair, calf raises on the edge of an incline, and jump roping. 15,17,25,26,28,31,37,39,42,43 Moreover, Margaritis et al 24 suggested that board games could be modify to incorporate balancing and stretching challenges. In their paper, Calcaterra et al 29 provided some examples of different game-based physical activities that might be considered.…”