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

Tayrine Ordonio Filgueira,Lucas Eduardo R Santos,Angela Castoldi,Weydyson De Lima Do Nascimento Anastácio,Geraldo José De Amorim,Matheus Santos De Sousa Fernandes,Tony Meireles Santos,Eduardo Zapaterra Campos,Fabrício Oliveira Souto

doi:10.3389/fimmu.2021.587146

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.

Highlights

After decades of qualified research to understand the effects of physical inactivity and sedentarism on human health, this topic continues to be discussed and is still a challenge to achieve satisfactory levels of physical activity [1]
The original silent aspect of sedentarism becomes abruptly relevant in suddenly adverse conditions such in war, public calamities, and pandemics, as that caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which resulted in Coronavirus Disease-2019 (COVID-19) [4, 5]
The opposite was observed during influenza infection, IL-6 knockout mice had increased mortality associated with reduced macrophage infiltration in the lung, increased fibroblast proliferation, decreased epithelial cell survival, and increased collagen deposition, suggesting a role for IL-6 in regulating fibrosis development [153, 154]. These findings suggest that IL-6 is required for protection against fibrosis development secondary to influenza infection, physically active patients, adapted to regular exercise could be protected from the severe outcome of COVID-19 by anti-inflammatory effects of exercise adaptation, which is associated with decreased IL-6

Summary

Introduction

After decades of qualified research to understand the effects of physical inactivity and sedentarism on human health, this topic continues to be discussed and is still a challenge to achieve satisfactory levels of physical activity [1]. A cyclic pattern is established, with no precise beginning, but includes: a reduction of corporeal capacity; an increase in physical and emotional discomfort when exposed to higher levels of physical demand; and a sedentarism behavioral pattern associated with any kind of exercise avoidance, which is often associated with others dangerous behaviors to health [2]. The entrance to this vicious cycle might be promoted by social, economic, clinical, age, gender, schooling, race, civil status, and others factors [3]. Regardless of sedentarism, in calamity conditions, humans are exposed to mentally, physically, and nutritionally unusual situations, with a direct impact on health, mediated by, among other factors, the immune system [6]

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