Movement and Exercise

The entire page is in work and incomplete

sometimes citations and/or confirmations is missing

Explorative

• Summary
• Relevance
  • Literature on Movement during Covid Times
• Biological Mechanisms
  • Ahead of a possible Infection
  • Early Phase of Covid-19
  • Convalescent Phase of Covid-19
• Epidemiological Evidence
  • Epidemiological Evidence Movement is Beneficial
  • Epidemiological Evidence that NO Movement is Bad
• References
  • References Exercise During Covid Times
  • References Effects of Movement on SARS-CoV-2 Infections
  • References Effects of Movement on Respiratory Infections

Summary

Movement has many health benefits including increased resistance against symptomatic and severe respiratory infections. Movement is also helpful in the early phase of Covid-19 helps to produce a good immune response. In the convalescent phase movement speeds up recovery and reduces the probability of long term effects.

During a Covid only adequate and moderate movement (e.g. a walk) and not intense exercise is recommended. Exercise during Covid has risks such as heart muscles inflammations. Additionally very intense breathing can result in a more widespread distribution of viruses in the lower respiratory tract.

In many countries it is not allowed leaving the private ground upon infection. Circumvention: owning/buying a large garden and owning/building a personal fitness studio (importantly with a built in ventilation unless used alone!). Also commented in in the movement summary on the Covid19 page.

Relevance

To support good health and Covid prognosis the measures and the isolation and quarantine rules) should take the benefits of movement into account.

Literature on Movement during Covid Times

Since exercise involves movement, some citations are about exercise but often the findings hold for any form of movement.

• In his readable interview Zhu asks precise question to Dr. Woods about the effects of exercising on virus infections and the immune response.
• Ali and Kunugi describe several adverse consequences of reduced/no movement.
• Movement and adequate exercise is recommended in many recommendations regarding rehabilitation.

Biological Mechanisms

simplified, a more detailed argumentation to be done

While the focus is on SARS-CoV-2, many mechanisms are valid for other respiratory virus infections.

Ahead of a possible Infection

Movement ahead of an infection increases the overall fitness level.

Early Phase of Covid-19

Only very light movement is recommended. Intense movement is discouraged due to various risks such as heart muscle inflammations.

One reason movement is important in the early phase of Covid, is that the circulation of the lymph is better since the circulation is partly passive and driven by body movement [to confirm and cite]. With movement the virus ‘signatures’ reach the lymph nodes faster where capable immune cells can be recruited. Some of these cells migrate to protect other body locations: e.g. when infected in the upper respiratory tract some cells migrate to protect lower the lungs. Extern movement makes them migrate faster. With healthy movement, for infections starting in the upper respiratory tract, protective immune cells (mainly T cells) are likely to reach the lungs before the viruses have time to replicate to high numbers.

Convalescent Phase of Covid-19

In the convalescent phase movement is important since

1. Movement helps clearing the lymph and thus remnants of SARS-2 (antigens which can cause inflammation) are removed.
2. Movement or even careful sport keep the immune system in check and prevent it from overshooting which is likely a major reason for long covid.

Epidemiological Evidence

Epidemiological Evidence Movement is Beneficial

There is epidemiological evidence supporting the above argumentation:

• Countless athletes have caught Covid infections. Despite their fitness is thoroughly supervised and regularly competitively evaluated so that even a slight performance decrease is noticed - to my knowledge - no long term effects have been observed. Besides having a good health, adequate training likely helped to overcome Covid.

  In 2021, sporadic cases of sportives with longer lasting effects or effects on their performance have been published. This effects could be associated to vaccination which could mess around with the immune system.

• Important risk factors for severe Covid are well correlated with few movements/sports e.g. obesity, arteriosclerosis and diabetes. Since behavior patters are often stable, it is possible that too few movement/sports is to some extent a confounding cause for the mentioned risk factors.

• Bielik et al observe that physically active people are about two times as likely to experience a SARS-CoV-2 infection as asymptomatic compared to less active controls. When additional to physical activity, cold water swimming is practiced to chance of being asymptomatic is even higher. Furthermore the cold water swimmers have about double the chance to have no acute respiratory infection in a year. // the results are shown in Table 3 in the paper.

• de Souza et al Performing at least 150 min of moderate or 75 min intense physical activity per week reduces the probability of hospitalization by about a third. The reduction is about 35% and significant with 0.028 even when adjusted for age, sex and BMI (Results are shown in Table 3 in the paper). Spending more than 4.7 hours a day sitting increases the hospitalization rate by about 30%.

• Yates et al find that the risk for severe Covid and death is lowered for people with a self reported brisk walking speed. Overweight and obesity also increase the risk for severe Covid and especially for death. //Fig. 1 in the paper

• Rowlands et al find that increased physical activity measured by accelerometers during 2013 - 2015 is associated to less severe Covid is especially for women. The chances to catch Covid are more or less the same. // Odds ratios are visualized in Figure S2 and S3 with adjustments and in Figure S4 for unadjusted models.

Epidemiological Evidence that NO Movement is Bad

• In situations with strict stay-at-home orders the fatality rate (fatality rates in different locations shown in Table 4 in Ioannidis including rates for those younger than 70) and the rates of severe cases are higher than in situations without stay-at-home orders (isolation rules can be mostly ignored, especially in spring 2020 since the case detection rates mostly were below 5 %). [more precise analyses on todo]
• Long Covid seems to be nearly exclusively observed in countries with strict quarantine rules. E.g. in Africa seroprevalence observed in late 2020 was often symptom associated, not even during the infection (Spread Analysis Covid in Africa).

References

References Exercise During Covid Times

Ali

Amira Mohammed Ali, Hiroshi Kunugi COVID-19: A pandemic that threatens physical and mental health by promoting physical inactivity https://doi.org/10.1016/j.smhs.2020.11.006

Zhu

Zhu W. Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods. J Sport Health Sci 2020;9:105
7. https://doi.org/10.1016/j.jshs.2020.01.005

References Effects of Movement on SARS-CoV-2 Infections

Bielik

Bielik,V.;Grendar,M.; Kolisek, M. A Possible Preventive Role of Physically Active Lifestyle during the SARS-CoV-2 Pandemic; Might Regular Cold-Water Swimming and Exercise Reduce the Symptom Severity of COVID-19? Int. J. Environ. Res. Public Health 2021, 18, 7158. https://doi.org/10.3390/ijerph18137158

de Souza

Association of physical activity levels and the prevalence of COVID-19-associated hospitalization https://doi.org/10.1016/j.jsams.2021.05.011

Yates

Yates, T., Razieh, C., Zaccardi, F. et al. Obesity, walking pace and risk of severe COVID-19 and mortality: analysis of UK Biobank. Int J Obes 45, 1155–1159 (2021). https://doi.org/10.1038/s41366-021-00771-z

Summary af Geijerstam

af Geijerstam A, Mehlig K, Börjesson M, et al. Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts. BMJ Open 2021;11:e051316. <doi:10.1136/bmjopen-2021-051316>

In a prospective cohort study, the authors find that a high CRF at the time of military conscription (about 20 of age) reduces the chances of hospitalization, ICU and death from Covid-19 later in life. //Results shown in Figure 2.

Rowlands

Rowlands AV, Dempsey PC, Gillies C, Kloecker DE, Razieh C, Chudasama Y, Islam N, Zaccardi F, Lawson C, Norris T, Davies MJ, Khunti K, Yates T, Association between accelerometer-assessed physical activity and severity of COVID-19 in UK Biobank, Mayo Clinic Proceedings: Innovations, Quality & Outcomes (2021), doi: https://doi.org/10.1016/j.mayocpiqo.2021.08.011.

Lee

Lee, S. W., Lee, J., Moon, S. Y., Jin, H. Y., Yang, J. M., Ogino, S., Song, M., Hong, S. H., Abou Ghayda, R., Kronbichler, A., Koyanagi, A., Jacob, L., Dragioti, E., Smith, L., Giovannucci, E., Lee, I. M., Lee, D. H., Lee, K. H., Shin, Y. H., Kim, S. Y., … Yon, D. K. (2021). Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study. British journal of sports medicine, bjsports-2021-104203. Advance online publication. https://doi.org/10.1136/bjsports-2021-104203

References Effects of Movement on Respiratory Infections

Chastin

Chastin, S., Abaraogu, U., Bourgois, J. G., Dall, P. M., Darnborough, J., Duncan, E., Dumortier, J., Pavón, D. J., McParland, J., Roberts, N. J., & Hamer, M. (2021). Effects of Regular Physical Activity on the Immune System, Vaccination and Risk of Community-Acquired Infectious Disease in the General Population: Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.), 51(8), 1673–1686. https://doi.org/10.1007/s40279-021-01466-1