The effects of 105 biological, socioeconomic, behavioral, and environmental factors on the risk of SARS-CoV-2 infection and a severe course of COVID-19: a prospective, explorative cohort study.

The confirmed number of SARS-CoV-2 infections up to 18 October 2022 is 626 million worldwide, but information about factors affecting the probability of infection or a severe course of COVID-19 remains insufficient and often speculative. Only a small number of factors have been rigorously examined, mostly by retrospective or cross-sectional studies.We ran a preregistered study on 5164 Internet users who shared information with us about their exposure to 105 risk factors and reported being COVID-19 negative before the beginning of the fourth wave of COVID-19 in the Czech Republic. After the fourth wave, in which 709 (13.7%) of participants were infected, we used a partial Kendall test controlled for sex, age, and urbanization to compare the risk of infection and a severe course of the disease in subjects who initially did and did not report exposure to particular risk factors.After the correction for multiple tests, we identified 13 factors - including male sex, lower age, blood group B, and larger household size - that increased the risk of infection and 16 factors - including mask-wearing, borreliosis in the past, use of vitamin D supplements, or rooibos drinking - that decreased it. We also identified 23 factors that increased the risk of a severe course of COVID-19 and 12 factors that decreased the risk.This preregistered longitudinal study is of explorative nature. Therefore, although the observed effects were strong and remained highly significant even after correction for multiple tests, it will be necessary to confirm their existence in future independent studies.

Infrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trial.

BACKGROUND: Passive heat therapies have been reported to have similar effects on the cardiovascular system as exercise. Studies supporting these findings in healthy populations have predominantly been done with men using warm water immersions or traditional saunas, rather than newer infrared-based saunas. OBJECTIVE: To explore short-term thermal and cardiovascular responses in women using an infrared sauna as compared to moderate-intensity exercise. STUDY DESIGN: Randomized controlled crossover trial with balanced allocations. SETTING: Brisbane, Australia (August 2019 - March 2020) PARTICIPANTS: Ten healthy women (36 ±â€¯9 years) INTERVENTIONS: 45 min of resting, infrared sauna or indoor bicycling PRIMARY OUTCOME MEASURES: tympanic/skin temperatures; respiratory rate; blood pressure; arterial stiffness; heart rate variability RESULTS: Tympanic temperatures were elevated during infrared sauna as compared to both control (mean diff = +1.05 oC ±â€¯SEM 0.12 oC, 95% C.I.: 0.73 - 1.36, p < 0.0005) and exercise (mean diff = +0.79 oC ±â€¯SEM 0.12 oC, 95% C.I.: 0.49 - 1.08, p < 0.0005). Respiratory rates were higher during exercise as compared to both control (mean diff = +7.66 ±â€¯SEM 1.37, 95% C.I.: 4.09 - 11.23, p < 0.0005) and infrared sauna (mean diff = +6.66 ±â€¯SEM 1.33, 95% C.I.: 3.20 - 10.11, p < 0.0005). No significant differences in non-invasive measures of blood pressure, arterial stiffness or heart rate variability were detected between any of the interventions. CONCLUSIONS: These findings suggest the physiological effects of infrared sauna bathing are underpinned by thermoregulatory-induced responses, more so than exercise-mimetic cardiorespiratory or cardiovascular activations.

Covid-19 and the next outbreak: decreasing frailty by using mild stress?

The coronavirus disease 2019 (Covid-19) has resulted in many deaths, particularly of very old or obese people. These people are at risk to die in the event of an outbreak, like under one-year old babies were at risk to die one century ago from various diseases. It is argued that mild stress could help people to resist new outbreaks. The people who are obese because of bad feeding habits (snacking, junk food, overfeeding) and inactivity should adopt more healthy behaviours. Because an inactive way of life at old age can increase frailty, physical and mental activities should be kept at the highest possible level in elderly people, particularly if they live in retirement homes. In the event of an outbreak, management staff of these homes should not confine residents in their room for weeks or months, as it can increase inactivity, under-nutrition, sarcopenia, and depressive symptoms. People with or without co-morbidities should be active and one could wonder whether other mild stresses such as sauna bathing could help to better resist infection.

High fitness levels, frequent sauna bathing and risk of pneumonia in a cohort study: Are there potential implications for COVID-19?

BACKGROUND: There is an ongoing debate on a potential protective role of habitual physical activity and passive heat therapy on the risk of COVID-19, a respiratory infectious disease that can manifest as severe pneumonia. To explore these putative roles, we evaluated the independent and joint associations of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) with pneumonia risk in a prospective cohort study of 2275 men aged 42-61 years at recruitment. MATERIAL AND METHODS: Objectively measured CRF and self-reported sauna bathing habits were assessed at baseline. CRF was categorized as low and high (median cut-offs) and FSB as low and high (defined as ≤1 and 2-7 sessions/wk, respectively). Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident pneumonia. RESULTS: During a median follow-up of 26.6 years, 529 cases of pneumonia occurred. Comparing high vs low CRF, the multivariable-adjusted HR (95% CIs) for pneumonia was 0.75 (0.61-0.91). Comparing high vs low FSB, the corresponding HR was 0.81 (0.68-0.97). Compared to men with low CRF & low FSB, the multivariable-adjusted HRs of pneumonia for the following groups: high CRF & low FSB; low CRF & high FSB; and high CRF & high FSB were 0.88 (0.65-1.20), 0.89 (0.71-1.13), and 0.62 (0.48-0.80) respectively. CONCLUSIONS: In a general male Caucasian population, a combination of high fitness levels and frequent sauna baths is associated with a substantially lowered future pneumonia risk compared with each modality alone. The implications of these findings in altering COVID-19 disease or its severity deserve study.

Sauna bathing frequency in Finland and the impact of COVID-19.

OBJECTIVES: Recent research has revealed multiple potential health benefits of frequent sauna bathing. Finland is a country with extraordinary sauna culture and bathing opportunities. However, coronavirus disease 2019 (COVID-19) pandemic introduced regulations and unprecedented closures to shared sauna facilities. In this study we aimed to examine the previously unknown baseline bathing frequency and its possible change during the epidemic. DESIGN: We investigated several aspects of sauna bathing with self-reports: the frequency, its possible changes, reasons for change, and beliefs about its health effects among a representative sample of thousand Finns aged 18-75 years. This online survey was administered in May 2020. RESULTS: Before the pandemic, 59 % of our respondents had enjoyed sauna at least once a week. Since the pandemic began, up to 23 % had reduced or stopped their bathing. This was often due to restricted sauna access. However, 11 % of respondents bathed more frequently and attributed this change to seeking relaxation and passing time. These findings demonstrate a surprising flexibility in this health-promoting national pastime. Men were more active bathers than women overall and women under 35 enjoy sauna more seldom than older women. Only 7.9 % of all respondents bathed at least four times a week, exceeding a suggested threshold for maximum health benefits. CONCLUSIONS: Finnish people are active sauna bathers. The COVID-19 pandemic demonstrated that the frequency of bathing is dependent on good access to sauna facilities. This flexibility and wide access could be exploited to improve public health in the long term if more frequent bathing became a standard.

Turning up the heat on COVID-19: heat as a therapeutic intervention.

Enveloped viruses such as SAR-CoV-2 are sensitive to heat and are destroyed by temperatures tolerable to humans. All mammals use fever to deal with infections and heat has been used throughout human history in the form of hot springs, saunas, hammams, steam-rooms, sweat-lodges, steam inhalations, hot mud and poultices to prevent and treat respiratory infections and enhance health and wellbeing. This paper reviews the evidence for using heat to treat and prevent viral infections and discusses potential cellular, physiological and psychological mechanisms of action. In the initial phase of infection, heat applied to the upper airways can support the immune system's first line of defence by supporting muco-ciliary clearance and inhibiting or deactivating virions where they first lodge. This may be further enhanced by the inhalation of steam containing essential oils with anti-viral, mucolytic and anxiolytic properties. Heat applied to the whole body can further support the immune system's second line of defence by mimicking fever and activating innate and acquired immune defences and building physiological resilience. Heat-based treatments also offer psychological benefits and enhanced mental wellness by focusing attention on positive action, enhancing relaxation and sleep, inducing 'forced-mindfulness', and invoking the power of positive thinking and 'remembered wellness'. Heat is a cheap, convenient and widely accessible therapeutic modality and while no clinical protocols exist for using heat to treat COVID-19, protocols that draw from traditional practices and consider contraindications, adverse effects and infection control measures could be developed and implemented rapidly and inexpensively on a wide scale. While there are significant challenges in implementing heat-based therapies during the current pandemic, these therapies present an opportunity to integrate natural medicine, conventional medicine and traditional wellness practices, and support the wellbeing of both patients and medical staff, while building community resilience and reducing the likelihood and impact of future pandemics.