Intrahospital supervised exercise training improves survival rate among hypertensive COVID-19 patients
Fernandez et al.
, Intrahospital supervised exercise training improves survival rate among hypertensive COVID-19 patients
, Journal of Applied Physiology, doi:10.1152/japplphysiol.00544.2022
Retrospective 439 severe COVID-19 hospitalized patients with hypertension, 201 receiving a supervised exercise program, showing significantly lower mortality with exercise. Exercise included of aerobic, breathing, and musculoskeletal exercises, 3 to 4 times per week. There were significantly more control patients on beta-adrenergic blockers and thiazide diuretics.
There are many possible mechanisms of action, including improved circulation, stress reduction, hormone regulation, improved sleep, increased antioxidant levels, and increased nitric oxide levels in the respiratory system. Over-exercising may be detrimental and lead to impaired immune function.
risk of death, 47.5% lower, RR 0.53, p = 0.02, high activity levels 16 of 201 (8.0%), low activity levels 62 of 238 (26.1%), NNT 5.5, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fernandez et al., 2 Feb 2023, retrospective, Chile, peer-reviewed, 10 authors.
INTRAHOSPITAL SUPERVISED EXERCISE TRAINING IMPROVES SURVIVAL
RATE AMONG HYPERTENSIVE COVID-19 PATIENTS
**Francisco Fernandez1,2, **Manuel Vazquez-Muñoz3, Andrea Canals4, Alexis
Arce-Álvarez3, Camila Salazar-Ardiles1,7, Cristian Alvarez5, Rodrigo Ramirez-
Campillo5, Gregoire P. Millet6, Mikel Izquierdo7,8, *David C. Andrade1
Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de
Altura, Departamento Biomedico, Facultad de Ciencias de la Salud, Universidad de Antofagasta,
Antofagasta, Chile. 2Programa de Magister en Fisiología Clínica del Ejercicio, Facultad de Ciencias,
Universidad Mayor, Santiago, Chile. 3Escuela de Kinesiología, Facultad de Odontología y Ciencias
de la Rehabilitación, Universidad San Sebastián, Santiago, Chile. 4Unidad de Estadística,
Departamento de Calidad, Clínica Santa María, Santiago, Chile. 5Exercise and Rehabilitation
Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad
Andres Bello, Santiago 7591538, Chile, 6Institute of Sport Sciences, University of Lausanne, CH1015, Lausanne, Switzerland, 7Navarrabiomed, Hospital Universitario de Navarra (HUN),
Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain. 8CIBER of Frailty and Healthy
Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
Running Head: intrahospital exercise and COVID-19
** These authors contributed equally to this work.
*Corresponding author: David C. Andrade, Ph.D.
Exercise Applied Physiology Laboratory
Centro de investigación en Fisiología y Medicina de Altura
Facultad de Ciencias de la Salud,
Universidad de Antofagasta
Tel: +569 88928666
Among the people most affected by coronavirus disease 2019 (COVID-19) are
those suffering from hypertension (HTN). However, pharmacological therapies for
HTN are ineffective against COVID-19 progression and severity. It has been
proposed that exercise training (EX) could be used as post-COVID treatment,
which does not rule out the possible effects during hospitalization for COVID-19.
Therefore, we aimed to determine the impact of supervised EX on HTN patients
with COVID-19 during hospitalization. Among a total of 1,508 hospitalized COVID-
19 patients (confirmed by PCR), 439 subjects were classified as having HTN and
were divided into two groups: EX (n=201) and control (n=238) groups. EX (3 to 4
times per week during all hospitalizations) consisted of aerobic exercises (15 to 45
min) (i.e., walking); breathing exercises (10 to 15 min) (i.e., diaphragmatic
breathing, pursed-lip breathing, active abdominal contraction); and musculoskeletal
exercises (8–10 sets of 12–15 repetitions/week) (lifting dumbbells, standing up and
sitting, lumbar stabilization). Our data revealed that the EX (clinician: patient, 1:1
ratio) intervention was able to improve survival rates among controlled HTN
patients with COVID-19 during their hospitalization when compared to the control
group (chi-squared: 4.83; hazard ratio: 1.8; 95% CI: 1.117 to 2.899; p=0.027).
Multivariate logistic regression analysis revealed that EX was a prognostic..
is less effective
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