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1.
Cardiovasc Res ; 118(10): 2253-2266, 2022 Jul 27.
Article in English | MEDLINE | ID: covidwho-2032022

ABSTRACT

Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.


Subject(s)
Cardiorespiratory Fitness , Cardiovascular Diseases , Cardiorespiratory Fitness/physiology , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/prevention & control , Exercise/physiology , Humans , Risk Factors
2.
Respir Physiol Neurobiol ; 302: 103898, 2022 08.
Article in English | MEDLINE | ID: covidwho-1763959

ABSTRACT

Fatigue is a common, debilitating, and poorly understood symptom post-COVID-19. We sought to better characterize differences in those with and without post-COVID-19 fatigue using cardiopulmonary exercise testing. Despite elevated dyspnoea intensity ratings, V̇O2peak (ml/kg/min) was the only significant difference in the physiological responses to exercise (19.9 ± 7.1 fatigue vs. 24.4 ± 6.7 ml/kg/min non-fatigue, p = 0.04). Consistent with previous findings, we also observed a higher psychological burden in those with fatigue in the context of similar resting cardiopulmonary function. Our findings suggest that lower cardiorespiratory fitness and/or psychological factors may contribute to post-COVID-19 fatigue symptomology. Further research is needed for rehabilitation and symptom management following SARS-CoV-2 infection.


Subject(s)
COVID-19 , Cardiorespiratory Fitness , Cardiorespiratory Fitness/physiology , Exercise Test , Fatigue/etiology , Humans , SARS-CoV-2
3.
BMJ Open Respir Res ; 8(1)2021 05.
Article in English | MEDLINE | ID: covidwho-1247381

ABSTRACT

INTRODUCTION: Participating in singing is considered to have a range of social and psychological benefits. However, the physiological demands of singing and its intensity as a physical activity are not well understood. METHODS: We compared cardiorespiratory parameters while completing components of Singing for Lung Health sessions, with treadmill walking at differing speeds (2, 4 and 6 km/hour). RESULTS: Eight healthy adults were included, none of whom reported regular participation in formal singing activities. Singing induced acute physiological responses that were consistent with moderate intensity activity (metabolic equivalents: median 4.12, IQR 2.72-4.78), with oxygen consumption, heart rate and volume per breath above those seen walking at 4 km/hour. Minute ventilation was higher during singing (median 22.42 L/min, IQR 16.83-30.54) than at rest (11 L/min, 9-13), lower than 6 km/hour walking (30.35 L/min, 26.94-41.11), but not statistically different from 2 km/hour (18.77 L/min, 16.89-21.35) or 4 km/hour (23.27 L/min, 20.09-26.37) walking. CONCLUSIONS: Our findings suggest the acute metabolic demands of singing are comparable with walking at a moderately brisk pace, hence, physical effects may contribute to the health and well-being benefits attributed to singing participation. However, if physical training benefits result remains uncertain. Further research including different singing styles, singers and physical performance impacts when used as a training modality is encouraged. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registry (NCT04121351).


Subject(s)
Cardiorespiratory Fitness/physiology , Heart Rate/physiology , Lung/physiology , Oxygen Consumption/physiology , Singing/physiology , Walking/physiology , Adult , Exercise Test , Female , Healthy Volunteers , Humans , Male , Metabolic Flux Analysis/methods , Music , Physical Exertion/physiology , Respiratory Function Tests/methods , Warm-Up Exercise
4.
PLoS One ; 16(5): e0250508, 2021.
Article in English | MEDLINE | ID: covidwho-1216955

ABSTRACT

BACKGROUND: It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID-19. METHODS: This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16th, 2020 to July 26th, 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20th percentile), moderate (20th to 80th percentile) and high (≥80th percentile) within sex and ten-year age groups (e.g. 50-60 years). Participants were classified as having COVID-19 if they tested positive (primarily PCR tests) at an in-patient or out-patient setting as of July 26, 2020. Participants were classified as having died from COVID-19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30th, 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. FINDINGS: There was no significant association between eCRF and testing positive for COVID-19. Conversely, individuals with moderate (aRR = 0.43, 95% CI: 0.25, 0.75) and high fitness (aRR = 0.37, 95% CI: 0.16, 0.85) had a significantly lower risk of dying from COVID-19 than those with low fitness. CONCLUSIONS: While eCRF was not significantly associated with testing positive for COVID-19, we observed a significant dose-response between having higher eCRF and a decreased risk of dying from COVID-19. This suggests that prior gains in CRF could be protective against dying from COVID-19 should someone develop the virus.


Subject(s)
COVID-19/diagnosis , Cardiorespiratory Fitness/physiology , Aged , COVID-19/epidemiology , COVID-19/mortality , COVID-19/virology , Cohort Studies , Female , Humans , Incidence , Male , Middle Aged , Prospective Studies , Risk , SARS-CoV-2/isolation & purification , Survival Rate
5.
Clin Nutr ; 40(4): 1637-1643, 2021 04.
Article in English | MEDLINE | ID: covidwho-1116485

ABSTRACT

The high prevalence of obesity and obesity-related comorbidities has reached pandemic proportions, particularly in Western countries. Obesity increases the risk to develop several chronic noncommunicable disease, ultimately contributing to reduced survival. Recently, obesity has been recognized as major risk factor for coronavirus disease-19 (COVID-19)-related prognosis, contributing to worse outcomes in those with established COVID-19. Particularly, obesity has been associated with higher hospitalization rates in acute or intensive care and greater risk for invasive mechanical ventilation than lean people. Obesity is characterized by metabolic impairments and chronic low-grade systemic inflammation that causes a pro-inflammatory microenvironment, further aggravating the cytokine production and risk of cytokine storm response during Sars-Cov2 sepsis or other secondary infections. Moreover, the metabolic dysregulations are closely related to an impaired immune system and altered response to viral infection that can ultimately lead to a greater susceptibility to infections, longer viral shedding and greater duration of illness and severity of the disease. In individuals with obesity, maintaining a healthy diet, remaining physically active and reducing sedentary behaviors are particularly important during COVID-19-related quarantine to reduce metabolic and immune impairments. Moreover, such stategies are of utmost importance to reduce the risk for sarcopenia and sarcopenic obesity, and to prevent a reduction and potentially even increase cardiorespiratory fitness, a well-known independent risk factor for cardiovascular and metabolic diseases and recently found to be a risk factor also for hospitalizations secondary to COVID-19. Such lifestyle strategies may ultimately reduce morbility and mortality in patients with infectious disease, especially in those with concomitant obesity. The aim of this review is to discuss how obesity might increase the risk of COVID-19 and potentially affect its prognosis once COVID-19 is diagnosed. We therefore advocate for implementation of strategies aimed at preventing obesity in the first place, but also to minimize the metabolic anomalies that may lead to a compromized immune response and chronic low-grade systemic inflammation, especially in patients with COVID-19.


Subject(s)
COVID-19/epidemiology , Disease Susceptibility/epidemiology , Obesity/epidemiology , Obesity/prevention & control , COVID-19/immunology , Cardiorespiratory Fitness/physiology , Comorbidity , Diet/standards , Disease Susceptibility/immunology , Exercise/physiology , Humans , Obesity/immunology , Prognosis , Risk Factors , SARS-CoV-2 , Severity of Illness Index
6.
J Cardiopulm Rehabil Prev ; 41(3): 199-201, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1072449

ABSTRACT

INTRODUCTION: Both inflammation and cardiorespiratory fitness (CRF) are associated with the risk of respiratory infections. To clarify the hypothesis that CRF attenuates the incident risk of pneumonia due to inflammation, we conducted a prospective study examining the independent and joint associations of inflammation and CRF on the risk of pneumonia in a population sample of 2041 middle-aged men. METHODS: Cardiorespiratory fitness was directly measured as peak oxygen uptake (V˙o2peak) during progressive exercise testing to volitional fatigue, and categorized into tertiles. Inflammation was defined by high-sensitivity C-reactive protein (hsCRP). Pneumonia cases were identified by internal medicine physicians using the International Classification of Diseases codes in clinical practice. RESULTS: During a median follow-up of 27 yr, 432 pneumonia cases were recorded. High hsCRP and CRF were associated with a higher risk (HR = 1.38; 95% CI, 1.02-1.88) and a lower risk of pneumonia (HR = 0.55; CI, 0.39-0.76) after adjusting for potential confounders, respectively. Compared with normal hsCRP-Fit, moderate to high hsCRP-Unfit had an increased risk of pneumonia (HR = 1.63; CI, 1.21-2.20), but moderate to high hsCRP-Fit was not associated with an increased risk of pneumonia (HR = 1.25; CI, 0.93-1.68). CONCLUSIONS: High CRF attenuates the increased risk of pneumonia due to inflammation. These findings have potential implications for the prevention of respiratory infection characterized by systemic inflammation, such as coronavirus disease-2019 (COVID-19).


Subject(s)
Cardiorespiratory Fitness/physiology , Inflammation/epidemiology , Inflammation/physiopathology , Pneumonia/epidemiology , Pneumonia/physiopathology , Adult , C-Reactive Protein/metabolism , Causality , Cohort Studies , Comorbidity , Exercise Test , Finland/epidemiology , Follow-Up Studies , Humans , Incidence , Inflammation/blood , Male , Middle Aged , Pneumonia/blood , Prospective Studies , Risk Factors
7.
J Cardiopulm Rehabil Prev ; 40(5): 287-289, 2020 09.
Article in English | MEDLINE | ID: covidwho-717246

ABSTRACT

The coronavirus disease-2019 (COVID-19) pandemic containment and mitigation strategies may lead to excessive physical inactivity and sedentary behavior, drastically impacting cardiorespiratory fitness and overall health. It is urgent to safely find ways to sit less and move more.


Subject(s)
Cardiorespiratory Fitness , Coronavirus Infections , Pandemics , Pneumonia, Viral , Public Health , Sedentary Behavior , Betacoronavirus , COVID-19 , Cardiorespiratory Fitness/physiology , Cardiorespiratory Fitness/psychology , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Humans , Needs Assessment , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Risk Factors , SARS-CoV-2
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