The impact of regular exercise on COVID-19

Exercise is a key component to our overall health. However, could exercise also help reduce severity of COVID-19 should you get an infection?

As more information comes out on the various effects of COVID-19, recent studies indicate regular exercise helps combat COVID-19.

“People who regularly exercise are more probable to have less severe COVID-19 infections,” said Dr. Shereif Rezkalla, interventional cardiologist at Marshfield Clinic Health System.

Regular exercise helps improve immunity

Early in the COVID-19 pandemic, doctors encouraged exercise for its natural effects on mental health. This included reducing depression and other mental health conditions due to isolation. Now, studies show exercise can prove beneficial if you contract the COVID-19 virus.

“It is important to study how we can improve our immunity against this virus,” Rezkalla said. “A recent analysis of 110 athletes from various sports that had COVID-19 infection who had an exam, lab workup and EKGs done showed the antibodies that were detected in their system without vaccination were 88% higher than average.”

Regular physical activity may substantially reduce the risk of COVID-19-related risks including hospitalization, ICU admission and death, according to an observational study of nearly 50,000 people published in the British Journal of Sports Medicine.

Another study reviewed the COVID-19 experience of 65,000 patients in South Africa who contracted COVID-19 and matched their symptoms against their physical activity history, which was captured by smart devices, clocked gym attendance and participation in mass sporting events — in the two years prior to lockdown.

The study found that, compared to those with low levels of activity, high engagement in physical activity was associated with a:

• 34% lower risk of hospital admission,
• 41% lower risk of ICU admission,
• 45% lower risk of requiring ventilation, and
• 42% lower risk of death.

“A majority of athletes had milder disease compared to the general population,” Rezkalla said. “That tells us that exercise improves immunity and it does. We do advise everyone continue to have a regular (exercise) program that includes daily planned activity to improve immunity. Exercise is good for you. It makes you feel better, makes cardiac events less and if you do have COVID-19 infection, it is likely to be milder.”

Dr. Rezkalla says research will continue to find out more on the relationship of exercise and COVID-19.

Safely returning to exercise after COVID-19

While regular exercise helps with many aspects of your health, it is important to listen to your body. With viruses like COVID-19, it is common for infected people to have long-lasting symptoms for months following infection.

A common long-lasting impact from viruses is myocarditis, which is inflammation of the heart. Myocarditis can cause shortness of breath and chest pain.

Rezkalla says roughly 10% of people with influenza suffer myocarditis, but the number more than triples in COVID-19 patients. In an article he authored, Rezkalla said during the COVID-19 pandemic, 36% of patients had elevated cardiac troponin levels (common with myocarditis) with associated electrocardiographic and echocardiographic abnormalities.

When returning to exercise, do so gradually.

According to the American College of Sports Medicine, individuals under the age of 50 who had an asymptomatic infection and mild respiratory symptoms that resolved within seven days are deemed low risk to return to exercise.

Certain individuals should be evaluable before returning to regular exercise including:

• Individuals who suffered long-lasting fatigue, shortness of breath or chest pain, but did not require hospitalization, or
• Individuals who required hospitalization.

“It is important to ease back into activity, because it’s possible your infection affected your heart,” Rezkalla said. “It is important to work with your physician and have an EKG and echocardiogram performed to see if your heart is affected. I think these issues are a wake-up call to patients on how serious (COVID-19) is, but to people in the medical community, it is clear that a gradual approach to returning to physical activity mitigates risk.”

Talk to your primary care provider or cardiologist before returning to vigorous exercise after recovery from COVID-19.