Exercise role in improving the immune system and physical fitness during Corona pandemic period and associated exercise guidelines

Document Type : review article

Authors

1 Faculty of Sports and Health Sciences, Shahid Beheshti University, Tehran, Iran.

2 Faculty of Physical Education and Sports Sciences, Allameh Tabatabai University, Tehran, Iran.

Abstract

A novel virus that expanded globally from China known as severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), causing Corona Virus Disease 2019 (COVID-19). Based on the pandemic
and fast spreading characteristics of corona virus (COVID-19), it causes concerns for elderly individuals
and those with chronic diseases. To lower the chances of spreading the coronavirus, and preventing
the social and economic burden, most of the credible medical centers and organizations have
recommended social distancing and isolations. Disclosure of gyms and sport centers and isolation has
resulted in inactivity in different individuals. The corona virus disease has led to challenges for keeping
the active lifestyle and it can induce some diseases due to inactivity such as obesity metabolic
disorders (e.g., diabetes), cardiovascular diseases, and other diseases that can increase hospital
referral. Since this is a novel disease and although the effects of regular exercise on it has not been
investigated yet, exercise and active lifestyle through increasing energy expenditure, body
metabolism, and improving physical and psychological fitness can result in increasing health, reducing
virus infection and in the case of having the corona disease it helps a quicker recovery. Since, corona
disease influences on the immune and cardiorespiratory system and the person’s physical fitness can
be effective in tolerating the disease side effects, this article expands on the effects of regular exercise
on immune system, viral infections (inflammation), cardiorespiratory system and physical fitness and
at the end presents exercise guidelines for different populations.

Keywords


  1. Di Gennaro F, Pizzol D, Marotta C, Antunes M, Racalbuto V, Veronese N, Smith L. Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review. International Journal of Environmental Research and Public Health. 2020. 14;17(8).
  2. Pedersen BK, Hoffman-Goetz L. Exercise and the immune system: regulation, integration, and adaptation. Physiological Review. 2000. 80(3):1055-1081.
  3. Walsh NP, Gleeson M, Shephard RJ, Gleeson M, Woods JA, Bishop NC, Fleshner M, Green C, Pedersen BK, Hoffman-Goetz L, Rogers CJ, Northoff H, Abbasi A, Simon P. Position statement. Part one: Immune function and exercise. Exercise Immunology Review. 2011. 17:6-63.
  4. Walsh NP, Gleeson M, Pyne DB, Nieman DC, Dhabhar FS, Shephard RJ, Oliver SJ, Bermon S, Kajeniene A. Position statement. Part two: Maintaining immune health. Exercise Immunology Review. 2011. 17:64-103.
  5. Simpson RJ, Kunz H, Agha N, Graff R. Exercise and the Regulation of Immune Functions. Progress in Molecular Biology and Translational Science. 2015. 135:355-380.
  6. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V and Uusitupa M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine. 2001. 344: 1343-1350,
  7. Nocon M, Hiemann T, Muller-Riemenschneider F, Thalau F, Roll S and Willich SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. European Journal of Cardiovascular Prevention & Rehabilitation. 2008. 15: 239-246,
  8. Monninkhof EM, Elias SG, Vlems FA, van dT, I, Schuit AJ, Voskuil DW and van Leeuwen FE. Physical activity and breast cancer: a systematic review. Epidemiology. 2007. 18:137-157.
  9. Wolin KY,YanY, Colditz GA and Lee IM. Physical activity and colon cancer prevention: a meta-analysis. British Journal of Cancer. 2009.100: 611-616.
  10. Paffenbarger RS, Jr., Lee IM and Leung R. Physical activity and personal characteristics associated with depression and suicide in American college men. Acta Psychiatrica Scandinavica (Suppl). 1994. 377: 16-22.
  11. Pedersen BK. The diseasome of physical inactivity--and the role of myokines in muscle--fat cross talk. Journal of Physiology. 2009. 587: 5559-5568,
  12. Petersen AM and Pedersen BK. The anti-inflammatory effect of exercise. Journal of Applied Physiology. 2005. 98: 1154-1162.
  13. Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain, Behavior, and Immunity. 2005. 19 (5):377-380.
  14. Agha NH, Mehta SK, Rooney BV, Laughlin MS, Markofski MM, Pierson DL, Katsanis E, Crucian BE, Simpson RJ. Exercise as a countermeasure for latent viral reactivation during long duration space flight. FASEB Journal. 2020. 34(2):2869-2881.
  15. Spielmann G, McFarlin BK, O’Connor DP, Smith PJ, Pircher H, Simpson RJ. Aerobic fitness is associated with lower proportions of senescent blood T-cells in man. Brain, Behavior, and Immunity. 2011. 25(8):1521-1529.
  16. Kohut ML, Arntson BA, Lee W, Rozeboom K, Yoon KJ, Cunnick JE, McElhaney J. Moderate exercise improves antibody response to influenza immunization in older adults. Vaccine. 2004. 22(17-18):2298-2306.
  17. Woods JA, Keylock KT, Lowder T, Vieira VJ, Zelkovich W, Dumich S, Colantuano K, Lyons K, Leifheit K, Cook M, Chapman-Novakofski K, McAuley E. Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. Journal of the American Geriatrics Society. 2009. 57(12):2183-2191.
  18. Shinkai S, Kohno H, Kimura K, Komura T, Asai H, Inai R, Oka K, Kurokawa Y, Shephard R. Physical activity and immune senescence in men. Medicine and Science in Sports and Exercise. 1995. 27(11):1516-1526.
  19. Pedersen BK, Bruunsgaard H. Possible beneficial role of exercise in modulating lowgrade inflammation in the elderly. Scandinavian Journal of Medicine Science in Sports. 2003. 13(1):56-62.
  20. Yan H, Kuroiwa A, Tanaka H, Shindo M, Kiyonaga A, Nagayama A. Effect of moderate exercise on immune senescence in men. European Journal of Applied Physiology. 2001. 86(2):105-111.
  21. Phillips MD, Flynn MG, McFarlin BK, Stewart LK, Timmerman KL. Resistance training at eight-repetition maximum reduces the inflammatory milieu in elderly women. Medicine and Science in Sports and Exercise. 2010. 42(2):314-325.
  22. Woods JA, Ceddia MA, Wolters BW, Evans JK, Lu Q, McAuley E. Effects of 6 months of moderate aerobic exercise training on immune function in the elderly. Mechanisms of Ageing and Development. 1999. 109(1):1-19.
  23. Drela N, Kozdron E, Szczypiorski P. Moderate exercise may attenuate some aspects of immunosenescence. BMC Geriatrics. 2004. 4:8.
  24. Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain, Behavior, and Immunity. 2005. 19(5):377-380.
  25. Hojman P, Dethlefsen C, Brandt C, Hansen J, Pedersen L, Pedersen BK. Exerciseinduced muscle-derived cytokines inhibit mammary cancer cell growth. American Journal of Physiology-Endocrinology and Metabolism. 2011. 301(3): E504-E510.
  26. Ahmadizad S, Avansar AS, Ebrahim K, Avandi M, Ghasemikaram M. The effects of short-term high-intensity interval training vs. moderate-intensity continuous training on plasma levels of nesfatin-1 and inflammatory markers. Hormone Molecular Biology and Clinical Investigation. 2015. 21(3):165-173.
  27. Hovanloo F, Arefirad T, Ahmadizad S. Effects of sprint interval and continuous endurance training on serum levels of inflammatory biomarkers. Journal of Diabetes and Metabolic Disorders. 2013. 12(1):22.
  28. Liguori G. ACSM's health-related physical fitness assessment manual. Philadelphia: Wolters Kluwer Health. Chapter 1. 2018.
  29. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, Haskell WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis R, Sawada SS, Sui X, Wisløff U. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016. 134(24): E653-E699.
  30. Sui X, Sarzynski MA, Lee DC, Kokkinos PF. Impact of Changes in Cardiorespiratory Fitness on Hypertension, Dyslipidemia and Survival: An Overview of the Epidemiological Evidence. Progress in Cardiovascular Diseases. 2017. 60(1):56-66.
  31. Lavie CJ, Kokkinos P, Ortega FB. Survival of the Fittest-Promoting Fitness throughout the Life Span. Mayo Clinic Proceedings. 2017.92(12):1743-1745.
  32. Farrell SW, Finley CE, Barlow CE, Willis BL, DeFina LF, Haskell WL, Vega GL. Moderate to High Levels of Cardiorespiratory Fitness Attenuate the Effects of Triglyceride to High-Density Lipoprotein Cholesterol Ratio on Coronary Heart Disease Mortality in Men. Mayo Clinic Proceedings. 2017. 92 (12):1763-1771.
  33. Ahmadizad S, Zahediasl S, Sajadi SM, Ebramin K, Bassami M. Effects of twelve weeks of resistance training on the resting levels of cardiac and related hormones in healthy men. Physiology and Pharmacology. 2012. 15 (4), 517-526.
  34. Ahmadizad S, Ghorbani S, Ghasemikaram M, Bahmanzadeh M. Effects of short-term nonperiodized, linear periodized and daily undulating periodized resistance training on plasma adiponectin, leptin and insulin resistance. Clinical Biochemistry. 2014. 47(6):417-422.
  35. Gibala MJ, Little JP, van Essen M, Wilkin GP, Burgomaster KA, Safdar A, Raha S, Tarnopolsky MA. Short-term sprint interval versus traditional endurance training: similar initial adaptations in human skeletal muscle and exercise performance. Journal of Physiology. 2006. 575(Pt 3):901-911.
  36. Nieman DC. Immune response to heavy exertion. Journal of Apply Physiology. 1997. 82(5):1385-1394.
  37. Nieman DC. Immunonutrition support for athletes. Nutrition Reviews. 2008. 66(6):310-320.
  38. Nieman DC, Henson DA, Gross SJ, Jenkins DP, Davis JM, Murphy EA, Carmichael MD, Dumke CL, Utter AC, McAnulty SR, McAnulty LS, Mayer EP. Quercetin reduces illness but not immune perturbations after intensive exercise. Medicine and Science in Sports and Exercise. 2007. 39(9):1561-1569.
  39. Talanian JL, Galloway SD, Heigenhauser GJ, Bonen A, Spriet LL. Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women. Journal of Apply Physiology. 2007. 102(4):1439-1447.
  40. Gaesser GA, Angadi SS. High-intensity interval training for health and fitness: can less be more? Journal of Apply Physiology. 2011. 111(6):1540-1541.
  41. Shigenori Ito. High-intensity interval training for health benefits and care of cardiac diseases-The key to an efficient exercise protocol. World Journal of Cardiology. 2019. 11(7): 171-188.
  42. Ahmadizad S, Nouri-Habashi A, Rahmani H, Maleki M, Naderi N, Lotfian S, Salimian M. Platelet activation and function in response to high intensity interval exercise and moderate continuous exercise in CABG and PCI patients. Clinical Hemorheology and Microcirculation. 2016. 64(4):911-919.
  43. Aghaei Bahmanbeglou N, Ebrahim K, Maleki M, Nikpajouh A, Ahmadizad S. Short-Duration High-Intensity Interval Exercise Training Is More Effective Than Long Duration for Blood Pressure and Arterial Stiffness But Not for Inflammatory Markers and Lipid Profiles in Patients With Stage 1 Hypertension. Journal of Cardiopulmonary Rehabilitation and Prevention. 2019. 39(1):50-55.
  44. Soltani M, Aghaei Bahmanbeglou N, Ahmadizad S. High-intensity interval training irrespective of its intensity improves markers of blood fluidity in hypertensive patients. Clinical and Experimental Hypertension. 2020. 42(4):309-314.
  45. Westcott WL. Resistance training is medicine: effects of strength training on health. Current Sports Medicine Reports. 2012. 11(4):209-16.
  46. Mcleod JC, Stokes T, Phillips SM. Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease. Frontiers in Physiology. 2019. 10: 645.
  47. Ahmadizad S, Haghighi AH, Hamedinia MR. Effects of resistance versus endurance training on serum adiponectin and insulin resistance index. European Journal of Endocrinology. 2007. 157(5):625-31.
  48. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans [Internet]. Washington (DC): U.S. Department of Health and Human Services. 2008. Available from: http://health.gov/paguidelines/pdf/paguide.pdf
  49. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Pediatrics. 2011. 128(Suppl 5): S213-56.
  50. Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, Goldfield G, Connor GS. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity. 2011. 8:98.
  51. Bar-Or O, Rowland T. Pediatric Exercise Medicine: From Physiological Principles to Health Care Application. Champaign (IL): Human Kinetics. 2004. 501.
  52. Skinner JS. Aging for exercise testing and exercise prescription. In: Skinner JS, editor. Exercise Testing and Exercise Prescription for Special Cases: Theoretical Basis and Clinical Application. 3rd ed. Baltimore (MD): Lippincott Williams & Wilkins. 2005. 85-99.
  53. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise. 2009. 41 (7):1510-1530.
  54. Bassami M, Ahmadizad S, Doran D, MacLaren DP. Effects of exercise intensity and duration on fat metabolism in trained and untrained older males. European Journal of Applied Physiology. 2007. 101(4):525-32.
  55. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and Science in Sports and Exercise. 2011. 43 (7):1334-559.
  56. Nelson ME, Rejeski WJ, Blair SN Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise. 2007. 39 (8):1435-1445.
  • Receive Date: 21 May 2020
  • Revise Date: 07 February 2021
  • Accept Date: 31 December 2020
  • First Publish Date: 31 December 2020
  • Publish Date: 22 August 2020