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Can exercise reduce the effects of COVID-19?
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I've always wanted to look into exactly if/how exercise actually helps the body fight off a virus or other illnesses.

I found some good peer-reviewed articles, and particularly a study on respiratory illness and exercise, which can be referenced here: https://www.ncbi.nlm.nih.gov/...articles/PMC7109453/

I found that a lot of what I thought was scientific fact regarding exercise and health, was actually theories based on facts. Rather than write pages of boring information, I made a simple video, which can be referenced here: https://www.youtube.com/watch?v=BR4Hf1S96ag

Does anybody have other insights/resources that I can add to my list of findings, this stuff is very fascinating, particularly during the pandemic.
Last edited by: brunes83: Nov 18, 20 10:56
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Re: Can exercise prevent COVID-19? [brunes83] [ In reply to ]
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Clearer subject line might be useful. We're talking about either reducing the likelihood or severity of COVID-19. Not "preventing." It's pretty clearly that exercise doesn't full-up prevent it, e.g. Alex Dowsett just had to move back his hour record attempt because he got it.
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Re: Can exercise prevent COVID-19? [brunes83] [ In reply to ]
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Clearer subject line might be useful. We're talking about either reducing the likelihood or severity of COVID-19. //

Not sure if it was this OP's intention, but I have seen friends on FB and some others who are out there claiming that great health is like a vaccine against this and other disease. Of course it is absolutely false, utterly part of the denier playbook, and quite misleading.


News flash, if you are healthy and live an active lifestyle, you will generally do better than those that are not. And the barrier for bugs to get into your system might be a little tougher to penetrate, but not impenetrable.
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Re: Can exercise prevent COVID-19? [trail] [ In reply to ]
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trail wrote:
Clearer subject line might be useful. We're talking about either reducing the likelihood or severity of COVID-19. Not "preventing." It's pretty clearly that exercise doesn't full-up prevent it, e.g. Alex Dowsett just had to move back his hour record attempt because he got it.

The subject line has been changed. That should make you happier :-)
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Re: Can exercise reduce the effects of COVID-19? [brunes83] [ In reply to ]
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Well

https://onlinelibrary.wiley.com/doi/full/10.1111/obr.13128


Being overweight is a massive risk for dying from covid. So yes training and being lean means you are at less risk of having problems if you catch it.


Training when you have covid however is stupid :)
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Re: Can exercise prevent COVID-19? [brunes83] [ In reply to ]
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my ancillary N+1 experience. My neighbor is a nurse in a Covid unit. Her college aged daughter got it, and to keep it from progressing into her lungs, my neighbor made her kid walk a bunch. I think just moving and getting the blood circulating, using your airway is really helpful.
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Re: Can exercise prevent COVID-19? [mountain_erin] [ In reply to ]
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Her college aged daughter got it, and to keep it from progressing into her lungs, my neighbor made her kid walk a bunch. //

News flash, virtually all kids of that age without health issues, have a minor to no symptom case of Covid. But I imagine getting outside and getting some sunshine and fresh air does put a little + in the column regardless...
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Re: Can exercise reduce the effects of COVID-19? [brunes83] [ In reply to ]
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The issue is that for some reason this Virus LOVES the heart. Studies will take years but some recent ones show that between 20-35% of even asymptomatic NCAA DIV 1 athletes diagnosed with COVID developed clinical indicators of Myocarditis on echo and cardiac MRI. SO try getting your insurance to buy off on a cardiac MRI so that you can get physician clearance for return to play, not happening. If you are not a competitive athlete than yes you can take the personal chance and just get back to doing your exercise BUT the verdict is still out on how long you should have cardiac rest after even a MILD case of COVID without the above clearance.
This virus sucks, blood clots, myocarditis, brain fog.. entire university courses will be dedicated to this in the future due to its complex clinical presentations.
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Re: Can exercise prevent COVID-19? [trail] [ In reply to ]
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trail wrote:
Clearer subject line might be useful. We're talking about either reducing the likelihood or severity of COVID-19. Not "preventing." It's pretty clearly that exercise doesn't full-up prevent it, e.g. Alex Dowsett just had to move back his hour record attempt because he got it.

Bummer about Dowsett and the hour record attempt. Not sure just delaying it gets him over 55 kph. He may need to delay it for 6-12 months.
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Re: Can exercise reduce the effects of COVID-19? [caffeinatedtri] [ In reply to ]
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The answer is yes- "light" training is helpful.

The problem is that what is "light" - depends on how sick you are and what your previous condition was.

That requires good judgement.

Doctors and health care professionals would prefer a blanket rule that doesn't rely on other people's good judgement.

They want a blanket rule that minimizes harm (to them) and maximizes profits (to them).
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Re: Can exercise reduce the effects of COVID-19? [brunes83] [ In reply to ]
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"I found that a lot of what I thought was scientific fact regarding exercise and health was actually theories based on facts."

That's a great observation and I love it. Doesn't negate what you read; just puts it in perspective.

I think all the literature you find in the next year about Covid 19 and exercise is going to be expert opinion. Just because it is "opinion" doesn't mean it is useless. It will be consensus from real experts who know hearts and who know Covid. And by nature it will be conservative. Multiple weeks of gentle activity before anything strenuous with a low threshold for consulting with your physician.

There will be no randomized controlled trials. Ie Gather some Covid + people. Group A is given a challenging exercise regimen. Group B gets a Netflix subscription.

There will be case control studies; something like enrolling a bunch of people with Covid myocarditis and then looking back to see who exercised hard and who didn't. Try to draw some conclusions.

And there are probably cohort studies already in the works. Launched by entrprising researchers who saw the patchwork athletic guidelines as a huge free public health experiement. These will be interesting. Ie Enroll cross country runners in adjacent conferences with different Covid protocols. Compare those with truncated seasons against those with full seasons. Perform an echo a year later and compare the results. Or whatever.

You asked if anyone on Slowtwitch had anything worth sharing about Covid and exercise. I am confident that I do not know anything valuable. I only have anecdotes to share. So, not even as good as expert opinion.

a) A friend who is also a physician, who skis seriously, and who contracted Covid a few weeks ago is taking the long view. He is restricting himself to gentle activities like walking for now with a slow re introduction of non strenous exercise thereafter. Even though we have skiable snow. The restraint! He might be a valuable role model.

b) In the past 5 years or so, I have diagnosed a few young people with full blown heart failure. Like bad enough that cardiology gives them temporary or permanent defibrillators etc. One due to influenza, another due to some other virus, dunno which one. Also a couple cases of heart failure due to methamphetamine, one due to cocaine. In all professional honesty, I have probably missed some minor cases too. Scary random stuff! Perhaps a valuable reality check.

Disclosure: I am an emergency physician. I have little interest in exercise science. I care more about which 78 year old can be sent home with Covid, who can get by with nasal cannula O2 upstairs on a medical floor, who I need to intubate now and send to critical care, who needs a tertiary center, etc. I am learning. I will get better. Grateful that I have a headstart thanks to China Italy and coastal US.

Brunes83, sorry, I didn't tell you anything that you didn't already know. I watched your video. Well done. I think you are genuinely excited about fitness, health, and learning about Covid. I don't think you posted to simply broadcast your video, or if you did then congrats. Been a long time since I thought about superoxide dismutase.

As you note, it seems safe to conclude ...

1) That exercise does not prevent contracting viruses.
4) Regular endurance exercise is good for the body.

Time will tell about ...

2) Exercise may help reduce the symptoms of an illness [like Covid]
3) Regular endurance exercise may help reduce the severe symptoms of ARDS caused by Covid

I doubt that excercise amounts to a get-out-of-jail-free card for Covid.

Anyway, time for me to shut up, I have a tendency to show up on Slowtwitch, spray a bunch, then disappear for months.

[Edit: as usual, for typos, grammar, etc]
Last edited by: toddstr: Nov 18, 20 14:38
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Re: Can exercise reduce the effects of COVID-19? [toddstr] [ In reply to ]
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Well said, from another EM doc....

Colorado Triathlon Company, CO2UT 2021, Crooked Gravel 2022, Steamboat Gravel 2022
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Re: Can exercise reduce the effects of COVID-19? [brunes83] [ In reply to ]
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I watched your vid. Enjoyed it.

My PhD is in Sport Physiology and Performance. Not an MD!

I'm still a little unclear on if you mean exercise during an active case of covid or if you mean having been a regular exerciser before contracting covid.

It is important to make a distinction in exercise science whether you are talking about acute or chronic "exercise." Responses to acute vs. chronic exercise are vastly different, of course. (example: acute exercise raises HR, and chronic exercise reduces HR for a given work rate).

Things I think we agree on:
High fitness doesn't prevent contraction of covid.
Higher fitness levels before contracting covid are associated improved outcomes for both mild and more severe cases, probably across all populations/ages.

Skepticism:
I'm skeptical that actively endurance training, even mildly for short durations, is a wise idea during an active and even mildly symptomatic, covid case. I'm not sure if this is the case that you're making though. Is it?

FYI: my skepticism for the claim that endurance exercise during a symptomatic covid case may be useful, even if it upregulates EcSOD production, is that this is a very mechanistic approach to drawing a broader and unverified application. This is one of the most common ways that the field of exercise science has been led down years of dogmatic but erroneous and harmful thinking.

Example:
In resistance training for the purpose of hypertrophy (muscle growth), if rest intervals between sets of lifting are cut very short, and greater metabolic disturbance is present within the muscle tissue, as a result, there is an increase in testosterone post-workout, that exists to a much lesser degree, if no such cellular disturbance is caused in a scenario where the lifter uses longer inter-set rest periods. On it's face, this increase in testosterone, which is often quite substantial, and is highly reliable at least among male resistance trained subjects, seems like it is a hugely desirable goal. Testosterone is one of the most anabolic (muscle growth-promoting) substances on the planet. Thus, there were books published, including the NSCA's gold standard textbook for more than a decade, that cited that the best way to cause muscular hypertrophy was to train with low rest intervals between sets. The painful irony is that the tradeoffs of taking shorter rest between sets far outweigh any very transient increase in intramuscular protein accretion (hypertrophy) caused by the similarly transient increase in post-workout testosterone.

The dogma died hard and it was all caused by looking at the mechanism in an acute scenario and drawing chronic adaptation-related conclusions from it.

It seems likely from what you're saying that EcSOD production is indeed increased during or post-exercise, and it sounds like you're speaking about acute exercise in the video. But, the health-promoting effects of EcSOD in a symptomatic covid case outweighing the illness-furthering effects of exercise (increased systemic stress, mechanical irritation of tissues, increased tissue inflammatory response, tissue swelling, etc) seems unlikely to me.

I would at the VERY least wait until non-mechanistic studies, and more purely applied studies on the matter have been completed. Certainly, promoting blood flow is ideal for most pathologic situations, but doing so with anything that might be classified as endurance exercise, even if mild, comes with a whole host of other possible mechanisms that might further illness. Namely, acute endurance training load of any kind reduces immunity and increases susceptibility and severity of virtually every illness. While there may be acute responses of increased blood flow, clearing out lungs via increased respiration, coughing, and clearing out airways via increased respiration and reduced viscosity of the mucus/fluid in those passages, that is purely an acute response and usually results in worse symptoms 6-24 hrs post-exercise during illness, in my humblest of both personal and professional experience.

Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
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Re: Can exercise reduce the effects of COVID-19? [caffeinatedtri] [ In reply to ]
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That's interesting. I didn't know any of this. I've been suspecting that this virus may have long term effects that we're not aware of yet.
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Re: Can exercise reduce the effects of COVID-19? [toddstr] [ In reply to ]
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toddstr, thank you for the information. I will take any medical professional's 'opinion' over someone else's any day. I'm not a medical professional, I'm a mechanical engineer. Which means I know nothing more than the lay person of physiology, but I like to learn why and how.

Anyway, are there any other studies done out there that could give us insight into the correlation of exercise and health? It's been very fascinating to take a deep dive into this the past couple of weeks.
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Re: Can exercise reduce the effects of COVID-19? [DrAlexHarrison] [ In reply to ]
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DrAlexHarrison

Thanks for the reply. I should have clarified that I wasn't talking about exercise after contracting COVID, rather regular endurance exercise in preparation if you get COVID (or any illness for that matter).

So I don't have a formal education in medicine or physiology and anything like that. All of my information is from peer-reviewed studies. Regarding EcSOD, I was just repeating what that study concluded, which is increased EcSOD MAY prevent having severe symptoms of ARDS. However, since the study was done well before COVID, we can' conclude that increased EcSOD would have any effect for someone that has ARDS due to COVID. My basic brain says, "probably." But as said above, I don't know more than the lay person regarding physiology.
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Re: Can exercise reduce the effects of COVID-19? [brunes83] [ In reply to ]
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brunes83 wrote:
DrAlexHarrison

Thanks for the reply. I should have clarified that I wasn't talking about exercise after contracting COVID, rather regular endurance exercise in preparation if you get COVID (or any illness for that matter).

So I don't have a formal education in medicine or physiology and anything like that. All of my information is from peer-reviewed studies. Regarding EcSOD, I was just repeating what that study concluded, which is increased EcSOD MAY prevent having severe symptoms of ARDS. However, since the study was done well before COVID, we can' conclude that increased EcSOD would have any effect for someone that has ARDS due to COVID. My basic brain says, "probably." But as said above, I don't know more than the lay person regarding physiology.

Then I think we're in almost complete agreement. Exercise pre-covid definitely improves outcomes for litany of reasons.

Exercise during covid is a strong "no" from me. But I am not an expert in ARDS or covid for that matter. ;)

Very much appreciate your clarification!

Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
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📱 Check out our app → Saturday: Pro Fuel & Hydration, a performance nutrition coach in your pocket.
Join us on YouTube → Saturday Morning | Ride & Run Faster and our growing Saturday User Hub
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Re: Can exercise reduce the effects of COVID-19? [DrAlexHarrison] [ In reply to ]
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DrAlexHarrison wrote:
brunes83 wrote:
DrAlexHarrison

Thanks for the reply. I should have clarified that I wasn't talking about exercise after contracting COVID, rather regular endurance exercise in preparation if you get COVID (or any illness for that matter).

So I don't have a formal education in medicine or physiology and anything like that. All of my information is from peer-reviewed studies. Regarding EcSOD, I was just repeating what that study concluded, which is increased EcSOD MAY prevent having severe symptoms of ARDS. However, since the study was done well before COVID, we can' conclude that increased EcSOD would have any effect for someone that has ARDS due to COVID. My basic brain says, "probably." But as said above, I don't know more than the lay person regarding physiology.

Then I think we're in almost complete agreement. Exercise pre-covid definitely improves outcomes for litany of reasons.

Exercise during covid is a strong "no" from me. But I am not an expert in ARDS or covid for that matter. ;)

Very much appreciate your clarification!
When would you say it's safe to return to exercise after a covid diagnosis?
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Re: Can exercise reduce the effects of COVID-19? [duganator99] [ In reply to ]
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duganator99 wrote:
DrAlexHarrison wrote:
brunes83 wrote:
DrAlexHarrison

Thanks for the reply. I should have clarified that I wasn't talking about exercise after contracting COVID, rather regular endurance exercise in preparation if you get COVID (or any illness for that matter).

So I don't have a formal education in medicine or physiology and anything like that. All of my information is from peer-reviewed studies. Regarding EcSOD, I was just repeating what that study concluded, which is increased EcSOD MAY prevent having severe symptoms of ARDS. However, since the study was done well before COVID, we can' conclude that increased EcSOD would have any effect for someone that has ARDS due to COVID. My basic brain says, "probably." But as said above, I don't know more than the lay person regarding physiology.


Then I think we're in almost complete agreement. Exercise pre-covid definitely improves outcomes for litany of reasons.

Exercise during covid is a strong "no" from me. But I am not an expert in ARDS or covid for that matter. ;)

Very much appreciate your clarification!

When would you say it's safe to return to exercise after a covid diagnosis?

No idea! I wouldn't return while symptomatic in lungs, chest, or airways, or with general fatigue.

Covid-toes are worrisome but seem manageable with extreme care during indoor cycling. But .....

I'm not an MD. Just a lowly PhD.

Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
-------------------------------------------------------------------------------------------------------------------------------------------------
📱 Check out our app → Saturday: Pro Fuel & Hydration, a performance nutrition coach in your pocket.
Join us on YouTube → Saturday Morning | Ride & Run Faster and our growing Saturday User Hub
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