- Protection against oxidative stress and damage (in relation to ARDS)

University of Michigan - Ann Arbor

Regular exercise and physical activity (PA) confer physiological benefits that relate to the pathophysiology of COVID-19. These interactions involve multiple systems, including modulations of the immune response, metabolic adaptations such as protection against oxidative stress, and cardiovascular changes. Additionally, PA has implications for the expression of ACE2 in relation to COVID-19.

Exercise/PA benefits and relation to COVID-19 pathophysiology

Yan Z, Spaulding HR.PMID: 32220789 Extracellular superoxide dismutase, a molecular transducer of health benefits of exercise. Redox Biol. 2020. doi:10.1016/j.redox.2020.101508.

Extracellular superoxide dismutase, a molecular transducer of health benefits of exercise

Exercise/PA and metabolic changes in relation to COVID-19

Exercise/PA levels have been shown to modulate immune response in different ways.  

Exercise/PA and changes to immune system in relation to COVID-19

COVID-19 pathology often includes changes to cardiovascular physiology, exercise/PA has a dramatic effect on the cardiovascular system as well, the relationship between the two could help identify individuals at higher risk.

Exercise/PA and changes to cardiovascular system related to COVID-19

- randomized, double-blinded, placebo-controlled physical training intervention that lasted 4 weeks
- expression of ACE2 mRNA in skeletal muscle and ACE2 serum concentration in 21 healthy men were measured
- treatment with or without Vitamin C and E in addition to exercise
- results showed an overall increase in ACE2 mRNA expression in skeletal muscle, but a decrease in ACE2 serum concentration
- this implied that the ACE2 mRNA in skeletal muscle does not play a large role in ACE2 serum concentration
-  limitations of this study included a small sample and the inability to use ACE2 mRNA measurements to measure ACE2 protein levels
- future research should focus on more directly related COVID-19 tissue with a larger, more diverse cohort
- regardless, it may be beneficial for those who are able to exercise and are at higher risk to incorporate more physical activity in thier daily lives

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