COVID-19: Lifestyle, CoVesity and Exercise Time to Identify and Defeat the Real Culprits with Clinical Physiological Interventions
Dr. Hanjabam Barun Sharma,
Faculty Incharge, SEMS (Sports-Exercise Medicine and Sciences), PE-FLM (Performance, Environmental-Functional and Lifestyle Medicine) Lab., Department of Physiology, Institute of Medical Sciences (IMS), Varanasi, Uttar Pradesh, India.
Coronavirus Disease-2019 (COVID-19) is a global pandemic. Morbidity-mortality is related with hyperimmuno-thrombo inflammation. Unhealthy lifestyle and obesity with high inflammation, should be prone for increased morbidity-mortality in COVID-19. Hence, physical activity, exercise and positive lifestyle are beneficial. The review explored this relationship. Literature search was done for association of physical inactivity, obesity, fitness, exercise and other lifestyle factors with COVID-19. Relevant articles (~43) were selected, the core information was then incorporated. The complications of COVID-19 are associated with modifiable lifestyle risk factors: physical inactivity, obesity and low fitness etc., which are the real culprits. There is bi-directional, reciprocal and positive association between pandemic of physical inactivity/obesity and that of COVID-19. Obesity and inactivity are associated with high COVID-19 incidence, viral shedding duration, vaccine inefficiency; hospital and Intensive Care Unit (ICU) admission, duration of stay and death. These real culprits need effective management using various Clinical Physiological Interventions (CPIs) including fitness, nutritional and lifestyle improvement. Cardiorespiratory Fitness (CRF), physical activity and exercise have protective role in COVID-19. Moderate aerobic exercise of ≥150-300 minutes/week, or ≥75-150 minutes/week of vigorous aerobic-activity (or equivalent combination), with ≥2 days/week of moderate or higher intensity strength-training should be done. Unexplained alterations in physical activity Ratings of Perceived Exertions (RPE) may indicate Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Early mobilisation from passive-to-active movements to light-to-moderate activity should be part of multidisciplinary, phase-wise, and symptom-led rehabilitation. Asymptomatic positives should restrain from intense-exercise for ≥2 weeks. Return-to-Play (RTP), with ≥2 weeks of minimal exertion reaching preCOVID activity after ≥4-5 weeks, may be done for recovered players (no symptoms for ≥7-10 days and ≥10 days of symptoms-onset). There should be no sports for ≥3 and ≥6 months for players with pericarditis and myocarditis respectively, ≥4 weeks for pneumonia, and ≥2-4 weeks for symptomatic players with no myocarditis and pneumonia. Medical evaluation/examination and, when required, relevant cardiac, pulmonary, ergometry, biochemical and other investigations are needed before RTP. Optimal, individualised, nutrient dense, natural and whole food based chrono-nutrition with no metaflammation is a must. Good sleep, healthy circadian rhythm, limiting sedentary behaviour, coping skills with no mental/psychological/emotional stress and addiction, meditation, healthy relationship and positive social connections are other key lifestyle factors to be prioritised.