Last updated: 27 March 2020 23:00EST by Frank Cusimano
SUMMARY:
Whether you are new to exercise, or an experienced athlete, exercise has been shown to reduce the pro-inflammatory process, improve your cardiopulmonary system, and improve the function of your immune system. Those who get the most benefits out of exercise are athletes who workout with mixed intensity and who vary their workouts throughout the week. With the current pandemic, a little bit goes a long way. If you are feeling sick, short of breath, have a fever or are experiencing any of the signs and symptoms of COVID19, please call your doctor or go to the nearest hospital with an emergency department.
Background:
A recent paper mentioned the need to maintain regular physical activity during the pandemic . While not a great paper, it highlights important benefits of exercise. With social distancing & the closing of many private & public gyms, normal fitness & exercise resources are limited. Many have asked, how important is exercise during this pandemic?
Important, is an understatement.
While combing the literature, there are countless of studies showing the benefits of exercise on the immune system . A few things to note: none of them look directly at infection with SARS-CoV2, but many can be transferrable from other viral respiratory infections.
The benefits of exercise follows what scientists call a J-Curve: those that do not exercise & those that exercise too much are worse off . Elite athletes who over train suppress their immune system & increase their risk of infection . Those who exercise moderately with a mixture of easy, mod & high intensity receive the most benefit. A mix of aerobic (endurance), anaerobic (high intensity) & resistant training is recommended for long-term benefits. Both acute bouts of exercise and exercise lasting longer than one hour suppress lymphocyte proliferation in a time and dose related fashion . 15-weeks of mod exercise was shown to shorten infectious episodes & “acute & chronic mod exercise induces a level of stress hormones that down-regulates excessive inflammation within the respiratory tract & aids in activating innate anti-viral immunity shifting the immune response towards a Th2 profile preventing the excessive Th1 immune reaction to pathogens” . Epidemiological studies have shown that physical inactivity is associated with systemic low-grade inflammation and that physical activity and fitness are associated with a reduced concentration of various inflammatory cytokines . Exercise training directly affects the conversion of M1 into M2 macrophages reducing the secretion of pro-inflammatory cytokines .
For COVID-19, IL-6 is a contributing cytokine released in the inflammatory response. In a meta-analysis of adults over 50 years of age, resistance training produced anti-inflammatory effects decreasing CRP & decreasing IL-6 . Although the mechanism isn’t known, physical exercise is known to stimulate the lymphatic system, increase circulation through the spleen & potentially expel undocked pathogens in the lungs & airways . It has been shown that exercise increases lung capacity, lung ventilation and oxygen utilization capacity improving the working function of the lungs . Although we don’t know how these improvements will help with patients with advanced ARDS, it is not unreasonable to extrapolate how it could delay progression of the disease and hypoxemia.
Lastly, although this data is from mice, previous research has shown that exercise training may modulate the microbiome and reduce the host response to sepsis. Differences in the microbial compostion effected the hosts response to infection and altered the course of the disease decreasing end organ damage and reducing the pro-inflammatory response . When looking at viral infections, chronic exercise in rodents, reduced the severity of illness, decreases viral load, and results in greater anti-inflammatory effects than acute exercise during viral flu like infections . Although these two findings were not in human models, it is interesting to understand that the microbiome, viremia and sepsis may be altered from long term exercise.
If you are interested in more data on COVID-19 and how to protect yourself from the novel coronavirus, make sure to check out the rest of the site. And no, unfortunately, Vitamin C will not prevent you from getting infected.
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Disclaimer: Opinions on this site or on social media do not reflect that of my institutions. I do not provide medical advice. If you have a medical question please see your doctor or if you have a medical emergency, please go to the nearest emergency room.. I have a PhD in Nutrition and Metabolic Biology and three masters degrees including two master’s in nutrition & metabolism. I am a personal trainer & have researched nutrition for 12 years. The info I post is my interpretation of the medical and scientific literature.
