H. Vaish1, M. Goyal1
1Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, India

Background: COVID-19 is a highly contagious disease and most people lack immunity against this novel virus. The current COVID-19 therapy involves only management of symptoms and supportive care but no targeted medication is yet available; hence, the best strategy remains prevention. Exercise has been proposed to improve immune function and probably lessens risk and severity of respiratory viral infections.  

Purpose: Thus, the aim of the present review is to discuss the role of exercise for boosting immunity as prophylaxis against COVID-19.

Methods: Electronic databases, Pubmed and PEDro from 31 December 2019 – 25 July 2020 were systematically searched for related published articles. The following search strategy was implemented and these key words (in title/ abstracts) were searched: "Coronavirus" or “COVID-19” or "SARS-CoV2" or "2019-nCov" And “immunity” or “immune system” AND “prevention” or “precaution” or “exercise” or “physical activity”.  

Results: Total of 11 studies were included in the review that discusses different aspects of exercise to boost immune system as prophylaxis against COVID-19. The regular practice of moderate intensity exercise can be considered as an immune system controller however high exercise training workloads are linked to immune dysfunction, inflammation and oxidative stress. The associated factors that lead to improvements in immunity due to regular moderate intensity exercise may be reduction in inflammation, alteration in composition of younger and older immune cells, maintenance of thymic mass, enhanced immune-surveillance and amelioration of psychological stress. Exercising at a rate of perceived exertion (RPE) of 11–13 is suggested for sedentary individuals, and an RPE of 13–15 may be recommended for those who have been previously exercising.  Qigong has been proposed as potentially useful for the prevention and rehabilitation of respiratory infections, including COVID-19. The elderly, in particular, could benefit from Qigong during the ongoing pandemic, for it is easy to practice. Use of technology has been addressed in literature especially in COVID 19 pandemic; health care providers can review the individual data and develop a personalized exercise regimen on basis of feedback and fitness apps and wearable devices.  

Conclusion(s): Improving host immunity and modifying the adverse effects of isolation via physical activity is strongly reasonable. Practice of regular moderate intensity aerobic exercise will help the community to deal with the coronavirus by protecting the human systems naturally.  As the behavior of the SARS-CoV-2 is still not fully understood and most persons are restricted to challenging environments, exercise should be done by strictly adhering to the current standard public health recommendations.

Implications: The immune system is very reactive to exercise, with the magnitude and time-duration reflecting the degree of physiological stress levied by the workload. Adequate intensity exercises have an improved effect on the immune system which may have an ultimate protective advantage among healthy persons by preventing new incidence in the present outbreak of Covid-19. Exercise can be an easy and essential way to promote a healthy way of living that may not only prevent communicable but also non-communicable diseases. Making use of technology to educate and promote adequate physical activity seems promising.

Funding, acknowledgements: No specific financial support was obtained for this study

Keywords: Coronavirus, Immune system, Physical activity

Topic: COVID-19

Did this work require ethics approval? No
Institution: Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
Committee: IEC of Maharishi Markandeshwar (Deemed to be University)
Reason: The study was a literature review. There was no involvement of any human subjects

All authors, affiliations and abstracts have been published as submitted.

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