The Relevance of a Physical Active Lifestyle and Physical Fitness on Immune Defense: Mitigating Disease Burden, With Focus on COVID-19 Consequences

Abstract

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a fast spreading virus leading to the development of Coronavirus Disease-2019 (COVID-19). Severe and critical cases are characterized by damage to the respiratory system, endothelial inflammation, and multiple organ failure triggered by an excessive production of proinflammatory cytokines, culminating in the high number of deaths all over the world. Sedentarism induces worse, continuous, and progressive consequences to health. On the other hand, physical activity provides benefits to health and improves low-grade systemic inflammation. The aim of this review is to elucidate the effects of physical activity in physical fitness, immune defense, and its contribution to mitigate the severe inflammatory response mediated by SARS-CoV-2. Physical exercise is an effective therapeutic strategy to mitigate the consequences of SARS-CoV-2 infection. In this sense, studies have shown that acute physical exercise induces the production of myokines that are secreted in tissues and into the bloodstream, supporting its systemic modulatory effect. Therefore, maintaining physical activity influence balance the immune system and increases immune vigilance, and also might promote potent effects against the consequences of infectious diseases and chronic diseases associated with the development of severe forms of COVID-19. Protocols to maintain exercise practice are suggested and have been strongly established, such as home-based exercise (HBE) and outdoor-based exercise (OBE). In this regard, HBE might help to reduce levels of physical inactivity, bed rest, and sitting time, impacting on adherence to physical activity, promoting all the benefits related to exercise, and attracting patients in different stages of treatment for COVID-19. In parallel, OBE must improve health, but also prevent and mitigate COVID-19 severe outcomes in all populations. In conclusion, HBE or OBE models can be a potent strategy to mitigate the progress of infection, and a coadjutant therapy for COVID-19 at all ages and different chronic conditions.

Exercise, infection and rheumatic diseases: what do we know?

“…These include exerciseinduced influences on both innate and adaptive immune limbs, immune surveillance, acute and chronic inflammation and the trajectory of immunosenescence. [10][11][12][13][14][15] From a clinical perspective, one of the most intriguing and potentially important domains of physical activity and exercise is its effects on susceptibility to infection. 10 Despite the fact that patients with inflammatory rheumatic diseases are particularly susceptible to infectious complications due to the disease process and immunomodulatory therapies, there is a paucity of literature exploring the potential utility of exercise training with the explicit purpose of lowering infectious risks.…”

“…When exercise training is sustained for weeks and months, it may be postulated that the recurrent transient surge in circulating immune cells augments immunosurveillance against pathogens, lowers systemic inflammation, enhances antibody responses to vaccinations and reduces infectious disease morbidity and mortality. [10][11][12][13][14][15][16][17][18][19] Figure 2 summarises the burgeoning evidence supporting a broad spectrum and beneficial effect of regular exercise training against viral and bacterial infections. 10 12 18 20-23 Near-daily physical activity compared with inactivity has been linked to reduced incidence rates for influenza, the common cold and severe cases of COVID-19, with diminished mortality rates for pneumonia and other viral and bacterial infections in the general population.…”

COVID-19 pandemic as a risk factor for the reactivation of herpes viruses

“…The lesions appear as raised erythematous plaques upon which maculo-papulous vesicles settle, spreading through the affected dermatome, and usually accompanied by pain, itching, and burning in the area. Herpesvirus infections can occur as primary or nosocomial pathogens, but clinical manifestations are most commonly a re-activation of a latent viral infection [10] It is common knowledge that lifestyles with physical activity, and social, family, and cultural contacts constitute healthy habits that improve immune defences and the mental and emotional state [11]. The confinement of families in their homes, towns, cities, and even countries, isolated from other relatives, friends, and neighbours due to the COVID-19 pandemic has, for many people, presented a very stressful life event, triggering never-before-lived experiences that have threatened the subject's health and well-being.…”

“…It is common knowledge that lifestyles with physical activity, and social, family and cultural contacts constitute healthy habits that improve immune defences and the mental and emotional state [ 11 ]. The confinement of families in their homes, towns, cities and even countries, isolated from other relatives, friends and neighbours due to the coronavirus disease 2019 (COVID-19) pandemic has, for many people, presented a very stressful life event, triggering never-before-lived experiences that have threatened the subject's health and well-being.…”

Neuroprotective Effects of Physical Activity via the Adaptation of Astrocytes

“…Moreover, it is acknowledged that regular and balanced exercising ameliorates antibacterial and antiviral immune surveillance and delays immunological aging. Consistently, very recent studies have underlined the importance of physical activity as an intervention to prevent the progression towards severe forms of COVID-19, based on the fact that exercise can dampen excessive immune responses, thereby eliciting anti-inflammatory functions that promote psychological health [ 7 , 8 , 9 ]. Exercise represents an effective and successful weapon for optimal aging.…”