Sedentary behavior, exercise and COVID-19: immune and metabolic implications in obesity and its comorbidities

J Sports Med Phys Fitness. 2021 Nov;61(11):1538-1547. doi: 10.23736/S0022-4707.20.11898-X. Epub 2020 Dec 11.

Abstract

Many reports showed a dramatic decrease in the levels of physical activity during the current pandemic of SARS-CoV-2. This has substantial immune and metabolic implications, especially in those at risk or with metabolic diseases including individuals with obesity and Type 2 diabetes. In this study we discussed the route from physical inactivity to immune and metabolic aberrancies; focusing on how insulin resistance could represent an adaptive mechanism to the low physical activity levels and on how such an adaptive mechanism could shift to a pathognomonic feature of metabolic diseases, creating a vicious circle of immune and metabolic aberrancies. We provide a theoretical framework to the severe immunopathology of COVID-19 in patients with metabolic diseases. We finally discuss the idea of exercise as a potential adjuvant against COVID-19 and emphasize how even interrupting prolonged periods of sitting with short time breaks of very light activity could be a feasible strategy to limit the deleterious effects of the outbreak.

MeSH terms

  • COVID-19*
  • Diabetes Mellitus, Type 2*
  • Exercise
  • Humans
  • Obesity / epidemiology
  • SARS-CoV-2
  • Sedentary Behavior