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

Moderate Intensity Aerobic Exercise Potential Favorable Effect Against COVID-19: The Role of Renin-Angiotensin System and Immunomodulatory Effects

“…Regular exercise leads to a negative energy balance and decreases body fat ( Gleeson et al, 2011 ). Regular daily exercise causes training adaptation, which boosts anti-inflammatory activity notably, while along with weight loss ( Simpson et al, 2020 ; Calabrese and Neiman, 2021 ). The existence of a deleterious microbiota profile in obesity was demonstrated ( Quiroga et al, 2020 ), emphasizing the importance of exercise approach as a potent non-pharmacological strategy in early obesity ( Quiroga et al, 2020 ).…”

“…Exercise has a major effect on susceptibility to infection ( Nieman and Wentz, 2019 ), especially in people susceptible to infectious complications such as autoimmune inflammatory rheumatic diseases (AIIRD), who have immune dysfunction and are at high risk for acute respiratory viral infections and severe COVID-19 ( Calabrese and Neiman, 2021 ). Regular exercise activity has not only protective effects against SARS-CoV-2 infection, but also reduces the severity of infectious events ( Grande et al, 2020 ).…”

“…Further, reduced risk of infection and an enhanced immunological response to vaccination are some noticeable clinical outcomes of exercise ( Kohut et al, 2004 ; Weinhold et al, 2016 ). So the possibility of physical activity to increase the antibody and T cell response to COVID-19 vaccines, specifically in situations experiencing weakened vaccine efficacy like obesity, old age, and inflammation of the joints in arthritis disease ( Nieman and Wentz, 2019 ) and AIIRD ( Calabrese and Neiman, 2021 ), has been proposed. Regular exercise lowers enrollment of leukocytes to AT and consequently lowers the pro-inflammatory state of AT and cause a shift to anti-inflammatory phenotype of many immune cells (macrophages, monocytes, T-cells) ( Gleeson et al, 2011 ).…”

“…Regular moderate intensity aerobic exercise (25–30 min per session/three times a week) for 10 months caused a significant rise in level (titer) of antibodies in the blood after influenza vaccination ( Kohut et al, 2004 ). The effect of moderate intensity exercise on reducing prevalence of acute respiratory infections as well as the common cold, influenza, pneumonia, and COVID-19 has been proposed ( Calabrese and Neiman, 2021 ). Immune response to influenza vaccination has been improved in individuals performing long-term exercise training ( Nieman and Wentz, 2019 ; Valenzuela et al, 2021 ).…”

“…The people who performed recreational exercise activities for general physical fitness preillness, after recovering from COVID-19 with mild-to-moderate manifestations, without hospitalization and concerning heart-related symptoms should be able to proceed moderate intensity recreational exercise according to physical activity guidelines for Americans ( Calabrese and Neiman, 2021 ; Salman et al, 2021 ), which recommends changing sedentary behaviors by moving more and sitting less, getting at least 150 min of moderate aerobic activity or 75 min of vigorous aerobic activity per week and performing exercises that develop muscular strength on two or more days a week ( Piercy et al, 2018 ).…”