Physical exercise effects on the brain during COVID-19 pandemic: links between mental and cardiovascular health

Accumulated HIIT inhibits anxiety and depression, improves cognitive function, and memory-related proteins in the hippocampus of aged rats

This study aimed to compare the effects of High-Intensity Interval Training (HIIT) performed in a single session(1xHIIT) versus three daily sessions (3xHIIT) on fitness level and behavior of aged rats. Eighteen-month-old Wistar rats were assigned to Untrained (UN), 1xHIIT, or 3xHIIT (n = 12/group). Both groups, 1xHIIT and 3xHIIT, performed 15 min of a treadmill running HIIT protocol during 8 weeks. 1xHIIT protocol consisted of a single daily session of 15 min, while the 3xHIIT performed three daily sessions of 5 min with a 4 h interval between the sessions. Morris Water Maze (MWM) task was used to evaluate spatial learning and memory. Splash test, Forced Swim test, and Elevated Plus Maze task (EPM) were used to evaluate anhedonic, depressive-like, and anxious behaviors, respectively. Rats were euthanized, and the hippocampus was harvested for western blot analyses (CaMKII and BDNF). Both HIIT protocols improved VO2max and spatial memory. Notably, only the 3xHIIT protocol attenuated anxious and depressive-like behaviors. Western blot analyses of the hippocampus revealed that both HIIT protocols increased BDNF levels. BDNF levels were higher in the 3xHIIT when compared with 1xHIIT group, and we observed increasement of the CamKII levels just in the 3x HIIT group. Therefore, this study provides evidence indicating that accumulated HIIT sessions is more effective than traditional daily HIIT sessions in improving fitness level, cognitive function, memory, inhibiting the development of mood disorders, and enhancing BDNF and CaMKII levels in the hippocampus of aged rats.

Wearable biosensors in cardiovascular disease

This review provides a comprehensive overview of the latest advancements in wearable biosensors, emphasizing their applications in cardiovascular disease monitoring. Initially, the key sensing signals and biomarkers crucial for cardiovascular health, such as electrocardiogram, phonocardiography, pulse wave velocity, blood pressure, and specific biomarkers, are highlighted. Following this, advanced sensing techniques for cardiovascular disease monitoring are examined, including wearable electrophysiology devices, optical fibers, electrochemical sensors, and implantable cardiac devices. The review also delves into hydrogel-based wearable electrochemical biosensors, which detect biomarkers in sweat, interstitial fluids, saliva, and tears. Further attention is given to flexible electronics-based biosensors, including resistive, capacitive, and piezoelectric force sensors, as well as resistive and pyroelectric temperature sensors, flexible biochemical sensors, and sensor arrays. Moreover, the discussion extends to polymer-based wearable sensors, focusing on innovations in contact lens, textile-type, patch-type, and tattoo-type sensors. Finally, the review addresses the challenges associated with recent wearable biosensing technologies and explores future perspectives, highlighting potential groundbreaking avenues for transforming wearable sensing devices into advanced diagnostic tools with multifunctional capabilities for cardiovascular disease monitoring and other healthcare applications.

Association Between Physical Activity and Mental Health in Health Professionals in the Context of the Pandemic: A Study in Southern Brazil

OBJECTIVE

The aim of the study was to verify the association between physical activity (PA) and mental health among health professionals in southern Brazil.

METHODS

This is a cross-sectional study with 101 workers during the COVID-19 pandemic. Mental health and PA were assessed using the questionnaires. The association of PA with stress was tested by linear regression, and anxiety and depressive symptoms by Poisson regression.

RESULTS

The stress was inversely associated with individuals who performed some PA (β: -3.53;95% CI: -6.63;-0.44) and who met the PA recommendations (active) (β: -6.84;95% CI: -12.44;-1.24). Workers who performed some PA (PR: 0.76;95% CI: 0.67;0.86) and were active (PR: 0.75;95% CI: 0.60;0.93) were less likely to have severe symptoms of anxiety. For depression, workers who performed some PA (PR: 0.81;95% CI: 0.71;0.92) and were active (PR: 0.69;95% CI: 0.54;0.88), the probability was also smaller.

CONCLUSIONS

The practice of PA was inversely associated with symptoms of stress, depression, and anxiety.

Unraveling the Role of the Blood-Brain Barrier in the Pathophysiology of Depression: Recent Advances and Future Perspectives

Depression is a highly prevalent psychological disorder characterized by persistent dysphoria, psychomotor retardation, insomnia, anhedonia, suicidal ideation, and a remarkable decrease in overall well-being. Despite the prevalence of accessible antidepressant therapies, many individuals do not achieve substantial improvement. Understanding the multifactorial pathophysiology and the heterogeneous nature of the disorder could lead the way toward better outcomes. Recent findings have elucidated the substantial impact of compromised blood-brain barrier (BBB) integrity on the manifestation of depression. BBB functions as an indispensable defense mechanism, tightly overseeing the transport of molecules from the periphery to preserve the integrity of the brain parenchyma. The dysfunction of the BBB has been implicated in a multitude of neurological disorders, and its disruption and consequent brain alterations could potentially serve as important factors in the pathogenesis and progression of depression. In this review, we extensively examine the pathophysiological relevance of the BBB and delve into the specific modifications of its components that underlie the complexities of depression. A particular focus has been placed on examining the effects of peripheral inflammation on the BBB in depression and elucidating the intricate interactions between the gut, BBB, and brain. Furthermore, this review encompasses significant updates on the assessment of BBB integrity and permeability, providing a comprehensive overview of the topic. Finally, we outline the therapeutic relevance and strategies based on BBB in depression, including COVID-19-associated BBB disruption and neuropsychiatric implications. Understanding the comprehensive pathogenic cascade of depression is crucial for shaping the trajectory of future research endeavors.

Association between sugar-sweetened beverages and duration of physical exercise with psychological symptoms among Tibetan university students at high altitude

Background

Sugar-sweetened beverages (SSBs) and duration of physical exercise are strongly associated with physical health. Unfortunately, there are few studies focused on the association with psychological symptoms, let alone Tibetan university students at high altitudes in China.

Methods

A stratified cluster sampling method was used to include 8,268 Tibetan university students aged 19-22 years in Qinghai and Tibet, both of which are high-altitude regions of China. Self-assessment questionnaires on SSBs, duration of physical exercise, and psychological symptoms were administered. The chi-square test and logistic regression analysis were used to analyze the associations among them.

Results

The detection rate of psychological symptoms among Tibetan university students in high-altitude areas of China was 16.7%, with in girls (18.2%) higher than that in boys (14.8%), and the difference was statistically significant (χ2 = 11.73, p < 0.01). The proportion of SSBs for university students ≤1 time/week, 2-5 times/week, and ≥ 6 times/week were 54.2, 24.3, and 21.5%, respectively. The proportion of duration of physical exercise for >60 min/d was only 5.4%. Logistic regression analysis showed that compared with the SSBs ≤1 time/week group of university students, SSBs 2-5 times/week (OR = 1.45, 95% CI: 1.24-1.70) and ≥ 6 times/week (OR = 3.06, 95% CI: 2.62-3.57) had an increased risk of psychological symptoms (p < 0.001). In the reference group, the risk of psychological symptoms was also significantly increased in the group of university students with duration of physical exercise >60 min/d (OR = 2.08, 95% CI: 1.48-2.93), and the risk of psychological symptoms was also significantly increased in the group with duration of physical exercise <30 min/d (OR = 2.08, 95% CI: 1.48-2.93). The risk of psychological symptoms was also significantly increased in the university students with the duration of physical exercise <30 min/d (OR = 2.08, 95% CI: 1.48 ~ 2.93) group.

Conclusion

SSBs and exercise time may be important influences on the psychological symptoms of Tibetan university students at high altitudes in China. This study has important implications for mental health planning in universities in highland areas and may also provide guidance for mental health interventions for Tibetan university students.

Cardiopulmonary rehabilitation's influence on cognitive functions, psychological state, and sleep quality in long COVID-19 patients: A randomized controlled trial

CLINICALTRIALS.GOV

NCT05035628.Trial registration: ClinicalTrials.gov identifier: NCT05035628..

Developing the theoretical model of Chinese physical education teachers' health communication competence: based on grounded theory

Background

Physical education teachers' health communication competence is a key factor in health promotion. Although health communication is a multidisciplinary field, medical practitioners are the primary focus of health communication research, whereas physical education teachers are marginalized. Therefore, this study proposes a theoretical model of health communication competence for physical education teachers.

Methods

This qualitative research utilized interviews as the primary data collection method. Purposeful sampling was employed to select participants, including university teachers, primary and secondary school teachers, and health education professionals from diverse regions of China. A total of 31 participants were interviewed through two focus groups (N = 15) and individual semi-structured interviews (N = 16). Grounded theory was used to analyze and code the collected interview materials.

Results

The health communication competence of physical education teachers consisted of three main categories, 10 subcategories, 30 concepts, and 240 statement labels. The three main categories were as follows: (i) foundations of health communication knowledge and skills (this category encompassed three subcategories, namely sport and health knowledge reserve, health beliefs, and health behaviors); (ii) health communication perception competence (this category included two subcategories, namely health risk and crisis perception competence and communication audience perception competence); and (iii) practical competence of health communication (this category consisted of five subcategories, namely language expression competence, organizational and design competence, utilization of new media tools competence, communication content selection and processing competence, and professional skills).

Conclusion

The theoretical model of health communication competence in this study provides a foundation for the involvement of physical education teachers in health communication work. It can serve as a reference for the development of both pre-service health education courses and in-service training systems for physical education teachers. Future research can expand the sample size and geographic coverage to further validate the applicability of the findings. Additionally, investigating the factors influencing the formation of the identified competencies is recommended.

Impact of the COVID-19 lockdown on physical fitness among college women living in China

PURPOSES

The purpose of this study was to evaluate the effects of the COVID-19 lockdown on physical fitness among college women living in China and to explore how fitness changed with different physical conditions.

METHODS

We performed repeated measures of BMI, 800 m running and sit-up performance assessment on college women from one university in China pre and post the COVID-19 lockdown. A total of 3658 (age 19.15 ± 1.08 yr.) college women who completed the same assessment pre and post the COVID-19 lockdown were included in the analysis. We analyzed the data using one way ANOVA and paired-samples t-test.

RESULTS

Due to the COVID-19 lockdown, the result shows a significant increase in BMI by 2.91% (95% CI =0.33, 0.40) and a significant decline in 800 m running and sit-up by 7.97% (95% CI =0.69, 0.77) and 4.91% (95% CI = -0.27, -0.19), respectively. College women in the highest quartile level of physical condition (Quartile 4) had more decreases than college women in the lowest quartile level (Quartile 1). Their BMI level was increased by 3.69% and 0.98% in college women in Quartile 4 and Quartile 1, respectively. Their performance of 800 m running was decreased by 9.32% and 7.37% in college women in Quartile 4 and Quartile 1, respectively. Their performance of sit-up was decreased by 13.88% in college women in Quartile 4 while it increased by 10.91% in college women in Quartile 1, respectively.

CONCLUSIONS

The COVID-19 lockdown might increase the BMI level and decrease 800 m running and sit-up performance among college women living in China. The decrease for college women in higher quartile level of physical condition (Quartile 4) were more seriously while college women in lower quartile level of physical condition (Quartile 1) were modest.

Health and quality of life among women after participation in a CBPR-informed physical activity intervention: with a pandemic perspective

The lack of culturally and contextually oriented interventions promoting physical activity (PA) has led to increased physical inactivity among women living in disadvantaged neighbourhoods in Sweden. In this study one such intervention informed by community-based participatory research (CBPR) has been evaluated among 34 women from a disadvantaged neighbourhood before and during COVID-19. Health-related quality of life (HRQOL), behavioural and biomedical outcomes were assessed directly prior and post-intervention, followed by evaluations at 6-months and 18-months follow-up during COVID-19. The results revealed that HRQOL, particularly psychological, social, and environmental health significantly increased post-intervention compared to prior to intervention but reversed back at 6-months follow-up. Perceived health satisfaction and environmental health increased at 18-months follow-up during COVID-19. Participation in PA improved post-intervention and at 6-months follow-up. Everyday activities and fruit and vegetable intake continued to increase through all timepoints. Systolic blood pressure significantly decreased post-intervention and 6-months follow-up; blood flow rate increased significantly at all timepoints. Overall, the findings underscores the potential effectiveness of CBPR approaches in promoting and sustaining healthy lifestyles, even during acute situations such as the COVID-19. It may even serve as a future model for promoting health and addressing health disparities in similar groups.

The Impact of Stress from Social Isolation during the COVID-19 Pandemic on Psychiatric Disorders: An Analysis from the Scientific Literature

The COVID-19 pandemic generated, in addition to severe symptoms, hospitalizations and deaths worldwide, as well as stress from the fear of the disease and social uncertainties, from restriction measures and social isolation. Stress from social isolation impacts mental health, aggravating existing conditions and triggering neuropsychiatric symptoms in individuals with biopsychosocial vulnerability. During and immediately after the period of social restriction imposed by the pandemic, the scientific community carried out several research protocols. These revealed results that relevantly demonstrate the harmful effect of the stress induced by the pandemic situation. This narrative review reports and discusses research results demonstrating impairments in psychiatric disorders such as autism spectrum disorder, dementia, eating disorders, schizophrenia, anxiety, and depression. In this sense, the community has identified a significant negative influence of social isolation on the mental health of individuals through the modification of individual routines and the absence of social interactions. Moreover, the community identified perceived differences related to the impacts on men and women. In addition to studies showing the effect of social isolation on disorders, an evaluation of protocols with some possible therapeutic intervention strategies during times of social restriction was developed.

Tracking Biomarker Responses to Exercise in Hypertension

PURPOSE OF REVIEW

Strong evidence is evolving that physical exercise prevents hypertension and reduces blood pressure in patients with pre- and manifest HTN. Yet, identifying and confirming the effectiveness of exercise are challenging. Herein, we discuss conventional and novel biomarkers such as extracellular vesicles (EVs) which may track responses to HTN before and after exercise.

RECENT FINDINGS

Evolving data shows that improved aerobic fitness and vascular function as well as lowered oxidative stress, inflammation, and gluco-lipid toxicity are leading biomarkers considered to promote HTN, but they explain only about a half of the pathophysiology. Novel biomarkers such as EVs or microRNA are providing additional input to understand the complex mechanisms involved in exercise therapy for HTN patients. Conventional and novel biomarkers are needed to fully understand the integrative "cross-talk" between tissues to regulate vasculature physiology for blood pressure control. These biomarker studies will lead to more specific disease markers and the development of even more personalized therapy in this field. However, more systematic approaches and randomized controlled trials in larger cohorts are needed to assess exercise effectiveness across the day and with different exercise types.

A Repeated Cross-Sectional Pilot Study of Physical Activity, Levels of Depression and Anxiety during the COVID-19 Pandemic in Young Greek Adults

Regular physical activity (PA) and, more specifically, exercise, is associated with lower levels of stress, depression, and anxiety. The aim of this repeated cross-sectional pilot study was to investigate the impact of participating in PA on the mental health of young adults in Greece during the COVID-19 pandemic. The study was carried out during two quarantine periods: Survey I on 5 May 2020, and Survey II on 30 April 2021. The Hamilton Anxiety (HAM-A) and Beck Depression Inventory-II (BDI-II) scales and the level of PA were used to assess a sample of individuals aged between 18 and 26 years old. In 2020 and 2021, a total of 268 (33.9% males) and 380 (37.1% females) subjects participated in the studies, respectively. According to the findings, the vast majority of the participants in both samples reported that they are physically active (p = 0.86), while they consider exercise as a significant health factor (p = 0.10). Moreover, anxiety levels statistically significant increased (p = 0.001), while depression levels remained relatively stable with a slight increase of approximately (p > 0.05). Additionally, in both surveys, individuals who engaged in a PA program exhibited reduced levels of depression and anxiety (p = 0.001). Also, gender appears to influence anxiety and depression levels, while a lack of exercise exacerbates these measures in both genders when compared to physically active individuals. Concludingly, it is crucial for public health strategies to include interventions that promote safe PA in the event of future lockdowns or similar emergencies.

Microstructural alterations in hypoxia-related BRAIN centers after COVID-19 by using DTI: A preliminary study

PURPOSE

To investigate whether the diffusion tensor imaging (DTI) parameters alterations in the in hypoxia-related neuroanatomical localizations in patients after COVID-19. Additionally, the relationship between DTI findings and the clinical severity of the disease is evaluated.

METHODS

The patients with COVID-19 were classified into group 1 (total patients, n = 74), group 2 (outpatient, n = 46), and group 3 (inpatient, n = 28) and control (n = 52). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from the bulbus, pons, thalamus, caudate nucleus, globus pallidum, putamen, and hippocampus. DTI parameters were compared between groups. Oxygen saturation, D dimer and lactate dehydrogenase (LDH) values associated with hypoxia were analyzed in inpatient group. Laboratory findings were correlated with ADC and FA values.

RESULTS

Increased ADC values in the thalamus, bulbus and pons were found in group 1 compared to control. Increased FA values in the thalamus, bulbus, globus pallidum and putamen were detected in group 1 compared to control. The FA and ADC values obtained from putamen were higher in group 3 compared to group 2. There was a negative correlation between basal ganglia and hippocampus FA values and plasma LDH values. The ADC values obtained from caudate nucleus were positively correlated with plasma D Dimer values.

CONCLUSION

ADC and FA changes may reveal hypoxia-related microstructural damage after COVID-19 infection. We speculated that the brainstem and basal ganglia can affected during the subacute period.

Attenuation of ferroptosis as a potential therapeutic target for neuropsychiatric manifestations of post-COVID syndrome

Coronavirus disease-19 (COVID-19), caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), is associated with the persistence of pre-existing or the emergence of new neurological and psychiatric manifestations as a part of a multi-system affection known collectively as "post-COVID syndrome." Cognitive decline is the most prominent feature among these manifestations. The underlying neurobiological mechanisms remain under intense investigation. Ferroptosis is a form of cell death that results from the excessive accumulation of intracellular reactive iron, which mediates lipid peroxidation. The accumulation of lipid-based reactive oxygen species (ROS) and the impairment of glutathione peroxidase 4 (GPX4) activity trigger ferroptosis. The COVID-19-associated cytokine storm enhances the levels of circulating pro-inflammatory cytokines and causes immune-cell hyper-activation that is tightly linked to iron dysregulation. Severe COVID-19 presents with iron overload as one of the main features of its pathogenesis. Iron overload promotes a state of inflammation and immune dysfunction. This is well demonstrated by the strong association between COVID-19 severity and high levels of ferritin, which is a well-known inflammatory and iron overload biomarker. The dysregulation of iron, the high levels of lipid peroxidation biomarkers, and the inactivation of GPX4 in COVID-19 patients make a strong case for ferroptosis as a potential mechanism behind post-COVID neuropsychiatric deficits. Therefore, here we review the characteristics of iron and the attenuation of ferroptosis as a potential therapeutic target for neuropsychiatric post-COVID syndrome.

Effect of web-implemented exercise interventions on depression and anxiety in patients with neurological disorders: a systematic review and meta-analysis

Introduction

Web-implemented exercise intervention is the latest and innovative method to improve people's mental health. Currently, many studies have proven that web-implemented interventions are effective to improve depression and anxiety in adults. However, the influence of different web-implemented exercise interventions on depression and anxiety in patients with neurological disorders is still unclear.

Objective

The study aims to systematically summarize the type and content of web-implemented exercise interventions and quantify the effect of different web-implemented exercise interventions on depression and anxiety in patients with neurological disorders.

Methods

Four literature databases (PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang data) were searched. The literature search considered studies published in English or Chinese before October 13, 2022. Randomized controlled trials (RCTs) that participants accepted web-implemented interventions were included. Two authors independently extracted data and assessed the risk of bias for included studies. Standardized mean differences (SMD) with 95% CI were used to integrate the effect size.

Results

16 RCTs (a total of 963 participants) were included. The results showed that web-implemented exercise intervention had a significant effect on depression (SMD = -0.80; 95% CI, -1.09 to -0.52; I2 = 75%; P < 0.00001) and anxiety (SMD = -0.80; 95% CI, -1.23 to -0.36; I2 = 75%; P = 0.0003) in patients with a neurological disorder. The subgroup analysis showed that the effectiveness of the web-implemented exercise intervention was influenced by several factors, such as web-implemented exercise intervention type, component, and intervention duration.

Conclusion

Web-implemented exercise intervention has a relieving effect on depression and anxiety symptoms in patients with neurological disorders. Additionally, the intervention type, intervention duration, and component can influence the effect size.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42023409538.

Relationships between the Physical Activity Intensity and the Medical Expenditure of Middle-Aged and Elderly People: Parsing from the CHARLS Database

There are many studies on the impact of physical activity on health but few studies on the relationship between physical activity and medical expenditure among the elderly. Based on the China Health and Retirement Longitudinal Survey (CHARLS) database and selected 4456 valid samples, this paper used a two-part model to analyze the effects of high, moderate, and low physical activity intensity on medical expenditure. It is found that the intensity of physical activity was negatively correlated with medical expenditure, and the medical expenditure of the high physical activity intensity group was significantly lower than that of the low physical activity intensity group. For example, compared to people with no physical activity, the total medical expenditure decreased by 22.4%, 40.4%, and 62.5% per week in those with low, moderate, and high physical activity intensity. Thus, the government should provide more places for the elderly to exercise, planning special exercise areas for the elderly in community playgrounds, such as a dancing square, which will also help the elderly to increase their amount of exercise per week and develop a daily exercise habit.

Activation of angiotensin-converting enzyme 2 produces an antidepressant-like effect via MAS receptors in mice

Angiotensin (Ang)-converting-enzyme (ACE) 2 converts Ang II into Ang (1-7), which in turn acts on MAS receptors (ACE2/Ang (1-7)/MAS receptors pathway). This pathway has neuroprotective properties, making it a potential therapeutic target for psychiatric disorders such as depression. Thus, we examined the effects of diminazene aceturate (DIZE), an ACE2 activator, on depressive-like behavior using behavioral, pharmacological, and biochemical assays. To determine whether DIZE or Ang (1-7) produce antidepressant-like effects, we measured the duration of immobility of mice in the tail suspension test following their intracerebroventricular administration. Next, we measured the levels of ACE2 activation in the cerebral cortex, prefrontal cortex, hippocampus, and amygdala after DIZE injection, and examined which cell types, including neurons, microglia, and astrocytes, express ACE2 in the hippocampus using immunofluorescence. Administration of DIZE or Ang (1-7) significantly shortened the duration of immobility time in the tail suspension test, while this effect was inhibited by the co-administration of the MAS receptor antagonist A779. DIZE activated ACE2 in the hippocampus. ACE2 was localized to neurons, astrocytes, and microglia in the hippocampus. In conclusion, these results suggest that DIZE may act on ACE2-positive cells in the hippocampus where it increases the activity of ACE2, thereby enhancing signaling of the ACE2/Ang (1-7)/MAS receptor pathway and resulting in antidepressant-like effects.

Long-term consequences of COVID-19 on mental health and the impact of a physically active lifestyle: a narrative review

BACKGROUND

Coronavirus-19 disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Respiratory viruses damage not only the upper respiratory tract in humans, but also several different organs such as the brain. Some of the neurological consequences of COVID-19 reported are anosmia, headache, stroke, declined cognitive function, and impaired mental health, among others. People who had COVID-19 have a higher risk of sequelae in the central nervous system (CNS). However, it is not known which are all possible sequelae and how long will last the long-term effects of the COVID-19 pandemic on behavioral patterns and quality of life.

AIM

We intend to address the long-term impacts of COVID-19 on mental health and the relevance of physical exercise during the pandemic.

METHODS

We conducted a literature search using PubMed to find the articles that were related to these themes.

RESULTS

We found 23,489 papers initially, and then we applied the inclusion/exclusion criteria to narrow down our search to 3617 articles and selected 1380 eligible articles after a thorough reading of titles and abstracts. The findings indicated that COVID-19 impacted general mental health and led many not only hospitalized patients to develop cognitive decline, memory impairment, anxiety, sleep alterations, and depressive-like behavior. Furthermore, the fear of vaccines and their effects had negatively affected mental health and directly impacted mortality rates in unvaccinated COVID-19 patients.

CONCLUSIONS

Preventive measures must be undertaken, such as the vaccination of the entire population, vaccination hesitancy discouragement by creating awareness among individuals, and people's engagement in a physically active lifestyle, since being physically active is a low-cost and effective measure to restore or inhibit the negative outcomes from COVID-19 on mental health.

Experiences of People with Cardiovascular Disease during COVID-19 in Sweden: A Qualitative Study

Although people with cardiovascular conditions were subjected to more rigorous restrictions during the COVID-19 pandemic, there is limited knowledge of how the restrictions affected their lives and well-being. Thus, the aim of this study was to describe how people with cardiovascular conditions experienced their life situation and physical and mental health during the second wave of the pandemic in Sweden. Fifteen participants (median age 69 years; nine women) were individually interviewed, and data were analyzed with systematic text condensation. The findings revealed that some of the participants were fearful of contracting COVID-19 as their medical condition made them vulnerable. Additionally, the restrictions changed their daily routines and their ability to take part in social activities, as well as their access to specialized outpatient care (medical check-ups and physiotherapy). Although emotional and psychological distress were present, several participants found strategies that reduced their worries, such as exercising and meeting friends outdoors. However, some had adopted a more sedentary lifestyle and unhealthy diets. These findings indicate that healthcare professionals should provide individualized support to persons with cardiovascular diseases in order to find well-functioning emotion- and problem-focused strategies aimed at improving physical and mental health during crises such as pandemics.

Stress induced proinflammatory adaptations: Plausible mechanisms for the link between stress and cardiovascular disease

Initiating from Hans Selye’s conceptualization of stress physiology, to our present understanding of allostatic load as the cumulative burden of chronic psychological stress and life events, investigators have sought to identify the physiological mechanisms that link stress to health and disease. Of particular interest has been the link between psychological stress and cardiovascular disease (CVD), the number one cause of death in the United States. In this regard, attention has been directed toward alterations in the immune system in response to stress that lead to increased levels of systemic inflammation as a potential pathway by which stress contributes to the development of CVD. More specifically, psychological stress is an independent risk factor for CVD, and as such, mechanisms that explain the connection of stress hormones to systemic inflammation have been examined to gain a greater understanding of the etiology of CVD. Research on proinflammatory cellular mechanisms that are activated in response to psychological stress demonstrates that the ensuing low-grade inflammation mediates pathways that contribute to the development of CVD. Interestingly, physical activity, along with its direct benefits to cardiovascular health, has been shown to buffer against the harmful consequences of psychological stress by “toughening” the SAM system, HPA axis, and immune system as “cross-stressor adaptations” that maintain allostasis and prevent allostatic load. Thus, physical activity training reduces psychological stress induced proinflammation and attenuates the activation of mechanisms associated with the development of cardiovascular disease. Finally, COVID-19 associated psychological stress and its associated health risks has provided another model for examining the stress-health relationship.

Assessing the impact of COVID-19 pandemic on the health of residents and the healthcare system in Alberta, Canada: an observational study-The Alberta POST-COVID Follow-up Study

INTRODUCTION

Very little is known about how the COVID-19 pandemic has affected the health of residents and the healthcare system in Alberta, Canada. The purpose of this study is to establish an observational study to characterise the health of residents in Alberta, Canada, over time, covering a population that tested negative or positive for COVID-19 during the pandemic. The primary outcome is to characterise 'long COVID-19' and the health status of residents during the COVID-19 pandemic. Secondary outcomes include the estimation of the risk of and risk factors associated with adverse health outcomes and healthcare utilisation and burdens.

METHODS AND ANALYSIS

This is a population-level provincial observational study which will follow-up with Alberta residents who underwent testing for COVID-19 and completed surveys adapted from the ISARIC COVID-19 long-term follow-up survey. The survey data will be linked with medical records. Statistical analyses will be carried out to characterise 'long COVID-19' and the health status of residents during the pandemic. The outcomes of this study will inform strategies for primary care and rehabilitation services to prevent chronic consequences; contribute to healthcare management, interventional studies, rehabilitation and health management to reduce overall morbidity and improve long-term outcomes of COVID-19 and the COVID-19 pandemic and potentially guide a self-evaluation of a remote monitoring system to manage individuals' health.

ETHICS AND DISSEMINATION

This study was reviewed and approved by the University of Alberta ethics committee (Study ID: Pro00112053 & Pro00113039) on 13 August 2021 and adheres to the Alberta Health Services research information management policy. Study results will be used to manage clinical care, published in peer-reviewed journals and presented at local, national and international conferences.

PROTOCOL VERSION

6 June 2022 EUROQOL ID: 161 015.

Changes in Physical Activity Associated with Mental Health in People with Type 1 Diabetes during the COVID-19 Pandemic

The social isolation carried out during the COVID-19 pandemic contributed to physical inactivity and impacted people's mental health, with physical activity being an important pillar in the treatment of Type 1 Diabetes Mellitus (T1DM). Thus, this study aims to verify whether there is an association between the perception of mental health and the practice of physical activity in individuals with T1DM during social isolation in the COVID-19 pandemic in Brazil. This was a cross-sectional study conducted in July 2020, with 472 adults with T1DM, using an online form to collect sociodemographic, mental health and physical activity data during social isolation. The Chi-Square test of independence was performed with adjusted residuals analysis (p < 0.05). A total of 51.3% of the participants remained sedentary or stopped doing physical activity during the period of social isolation. There was an association between being interested in performing daily activities (p = 0.003), not feeling depressed (p = 0.001), feeling slightly irritated (p = 0.006), having slight problems with sleep (p = 0.012) and practicing physical activity. There was also an association between maintaining physical activity and not feeling depressed (p = 0.017) and feeling very slightly irritated (p = 0.040). Adults with T1DM who practiced physical activity during the period of social isolation due to the COVID-19 pandemic showed better aspects of mental health.

Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach

Introduction

We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic.

Methods

A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction).

Results and Discussion

Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Higher rates of concussion following COVID-19 infection in high school athletes

OBJECTIVE

To compare concussion rates (CRs) over one academic year in high school athletes with and without a COVID-19 infection prior to concussion.

METHODS

Illness and concussion were prospectively reported for male and female high school athletes across six states over one academic year in the Players Health Rehab surveillance system. Concussion was truncated to 60 days following recovery and return to sport from COVID-19. CRs were estimated per 1000 athletes per academic year and stratified by those who tested positive for COVID-19 infection (with COVID-19) and those who did not (no COVID-19). Poisson regression analyses estimated rate ratio (RR) of concussion controlling for state, gender and an offset of the log athlete participation (with COVID-19 and no COVID-19).

RESULTS

Of 72 522 athletes, 430 COVID-19 infections and 1273 concussions were reported. The CR was greater in athletes who reported COVID-19 (CR=74.4/1000 athletes/year, 95% CI 49.6 to 99.3) compared with those who did not (CR=17.2, 95% CI 16.3 to 18.2). Athletes with recent COVID-19 had a threefold higher rate of concussion (RR=3.1, 95% CI 2.0 to 4.7).

CONCLUSION

Athletes returning from COVID-19 had higher CRs than those who did not experience COVID-19. This may be related to ongoing COVID-19 sequelae or deconditioning related to reduced training and competition load during the illness and when returning to sport. Further research is needed to understand the association of recent COVID-19 infection and concussion in order to inform preventive strategies.

Does cardiovascular preparticipation screening cause psychological distress in athletes? A systematic review

OBJECTIVE

To evaluate the psychological implications of cardiovascular preparticipation screening (PPS) in athletes.

DESIGN

Systematic review.

DATA SOURCES

MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, APA PsycInfo, Cochrane Library and grey literature sources.

STUDY ELIGIBILITY CRITERIA

Observational and experimental studies assessing a population of athletes who participated in a cardiovascular PPS protocol, where psychological outcomes before, during and/or after PPS were reported.

METHODS

Results of included studies were synthesised by consolidating similar study-reported measures for key psychological outcomes before, during and/or after screening. Summary measures (medians, ranges) were computed across studies for each psychological outcome.

RESULTS

A total of eight studies were included in this review (median sample size: 479). Study cohorts consisted of high school, collegiate, professional and recreational athletes (medians: 59% male, 20.5 years). Most athletes reported positive reactions to screening and would recommend it to others (range 88%-100%, five studies). Increased psychological distress was mainly reported among athletes detected with pathological cardiac conditions and true-positive screening results. In comparison, athletes with false-positive screening results still reported an increased feeling of safety while participating in sport and were satisfied with PPS. A universal conclusion across all studies was that most athletes did not experience psychological distress before, during or after PPS, regardless of the screening modality used or accuracy of results.

CONCLUSION

Psychological distress associated with PPS in athletes is rare and limited to athletes with true-positive findings. To mitigate downstream consequences in athletes who experience psychological distress, appropriate interventions and resources should be accessible prior to the screening procedure.

PROSPERO REGISTRATION NUMBER

CRD42021272887.

[Not Only Multimodal, but also Interdisciplinary: A Concept for Interdisciplinary Cooperation in the Rehabilitation of Post-COVID Syndrome]

Currently (March 2022), more than 17 million people in Germany have been infected with the SARS-CoV-2 virus. It is expected that 5-10% of those infected will develop a clinically relevant post-COVID syndrome. The most common symptoms are fatigue, dyspnoea and cognitive impairment. A causal therapy is currently not available, but there is increasing evidence that a multimodal treatment approach with psychotherapeutic elements is promising. Post-COVID is thus a current challenge for the health care system and especially for rehabilitation. This article describes a dual internal psychosomatic rehabilitation concept. The core elements are a behavioural therapy-oriented, disorder-specific psychotherapy group as well as exercise therapy that is adapted to the individual's capacity and slowly builds up. The goals are support in coping with the illness and an improvement in performance. Interventions based on ACT and the Avoidance Endurance Concept are used. In addition, respiratory therapy, cognitive training as well as nutritional and social counselling are offered on an indicative basis. The internal medicine team provides the patients with the security of being able to engage in the physical training programme. Experience so far shows that the concept is well accepted by the patients and that the intended treatment goals can be achieved.

A controlled open clinical trial of the positive effect of a physical intervention on quality of life in schizophrenia

JUSTIFICATION

Schizophrenia is a severe mental disorder associated with important physical (obesity and low motor functional capacity) and metabolic (diabetes and cardiovascular diseases) changes that contribute to a more sedentary lifestyle and a low quality of life.

OBJECTIVE

The study aimed to measure the effect of two different protocols of physical exercise [aerobic intervention (AI) versus functional intervention ([FI)] on lifestyle in schizophrenia compared with healthy sedentary subjects.

METHODOLOGY

A controlled clinical trial involving patients diagnosed with schizophrenia from two different locations [Hospital de Clinicas de Porto Alegre (HCPA) and Centro de Atenção Psicosocial (CAPS) in the city of Camaquã] was carried out. The patients undertook two different exercise protocols (IA: 5-min warm-up of comfortable intensity; 45 min of aerobic exercise of increasing intensity using any of the three modalities-a stationary bicycle, a treadmill, or an elliptical trainer; and 10 min of global stretching of large muscle groups; and FI: a 5 min warm-up with a stationary walk; 15 min of muscle and joint mobility exercises; 25 min of global muscle resistance exercises; and 15 min of breathing body awareness work) twice a week for 12 weeks and were compared with physically inactive healthy controls. Clinical symptoms (BPRS), life quality (SF-36), and physical activity levels (SIMPAQ) were evaluated. The significance level was p ≤ 0.05.

RESULTS

The trial involved 38 individuals, of which 24 from each group performed the AI, and 14 from each group underwent the FI. This division of interventions was not randomized but was instead decided upon for convenience. The cases showed significant improvements in quality of life and lifestyle, but these differences were greater in the healthy controls. Both interventions were very beneficial, with the functional intervention tending to be more effective in the cases and the aerobic intervention more effective in the controls.

CONCLUSION

Supervised physical activity improved life quality and reduced sedentary lifestyle in adults with schizophrenia.

The trajectory of psychological well-being during the COVID-19 pandemic and its association with health-promoting coping behavior among Japanese community-dwelling older adults: The Otassha Study

This study aims to identify the trajectory of psychological well-being during the COVID-19 pandemic among community-dwelling older adults and to clarify the association between coping behavior in the early stage of the pandemic and the trajectory of psychological well-being. The study was based on a cohort study, known as "the Otassha Study." We administered three follow-up surveys to 720 older adults who participated in the survey in October 2019 (T0): T1: June 2020, T2: October 2020, and T3: October 2021. Furthermore, we assessed coping behavior in T1 via a self-developed questionnaire comprising 10 items. Psychological well-being was assessed by the WHO-5 Well-Being Index (score range: 0 to 25) in all surveys. The trajectories of psychological well-being were identified by group-based trajectory modeling. The association between coping behaviors and trajectory patterns was assessed using multinomial logistic regression analysis. Furthermore, among the 508 participants who participated in the follow-up survey two times or more, three patterns of the trajectory of psychological well-being were identified: heavily decreased group (n = 39), decreased group (n = 352), and increased group (n = 39). "Walking" as a coping behavior had a significantly higher odds ratio (OR) to be in the increased group (OR = 2.32, 95 % confidence interval (CI) 1.06-5.05, p = 0.035) compared to the heavily decreased group. "Conversations with family living together" had a slightly higher OR to become an increased group (OR = 1.96, 95 % CI: 0.87-4.41, p = 0.106), and "actively gathering information on COVID-19" had a slightly lower OR to become the decreased group (OR = 0.53, 95 % CI: 0.26-1.06, p = 0.072) compared to the heavily decreased group. The results of this study suggest how maintaining health in the early stage of the pandemic had a great influence on the long-term health status.

Effects of full-body exercise-based pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis protocol

INTRODUCTION

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterised by progressive and irreversible fibrosis of the lung parenchyma, resulting in reduced lung function. Since conventional medicines can be associated with low effective rates and adverse events, pulmonary rehabilitation may be a promising non-pharmacological therapy for IPF. Thus, we aimed to evaluate the effects of full-body exercise-based pulmonary rehabilitation on patients with IPF by conducting a systematic review and meta-analysis of randomised controlled trials (RCTs).

METHODS AND ANALYSIS

This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). From inception to 31 August 2022, electronic databases in English and Chinese were searched, including PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials among the English databases. China National Knowledge Infrastructure, Chinese Biomedical Literature, VIP Chinese Science and Technology Periodical, and Wan Fang Data were among the Chinese databases. Two independent reviewers then screened the potential RCT studies, which were analysed according to the Cochrane Handbook criteria. The efficacy and safety of full-body exercise pulmonary rehabilitation for IPF were evaluated based on outcomes, including exercise capacity measured by 6 min walking distance and quality of life measured by St. George's Respiratory Questionnaire. Lung function was measured based on the forced vital capacity, total lung capacity, diffusing capacity of the lungs for carbon monoxide and dyspnoea assessed by the modified Medical Research Council scale.

ETHICS AND DISSEMINATION

Ethical approval was not required for this systematic review and meta-analysis. Results will be published in a peer-reviewed journal and presented at conferences.

PROSPERO REGISTRATION NUMBER

CRD42021284293.

Changes in Physical Activity and Health Indicators among Koreans during the COVID-19 Pandemic: Comparison between 2019 and 2020

This study aimed to compare the changes in physical activity (PA), chronic disease, and mental health indicators of Koreans before and after the COVID-19 outbreak, using raw data from more than 400,000 representative samples from the 2019-2020 Community Health Survey by the Korea Centers for Disease Control and Prevention, and to explore the correlations among them. We used two-way ANOVA to analyze changes and differences in PA and obesity levels. We assessed the influence of gender and recurrent PA using chi-square tests for mental health status and chronic disease. Finally, we performed a correlation analysis to determine the relationships among PA days, mental health, and chronic disease. The results showed that, compared to the levels before the COVID-19 period, moderate-intensity (Days: 1.415~1.217; Time: 114.688~107.321) and high-intensity (Days: 0.798~0.671; Time: 112.866~106.110) PA significantly decreased in Koreans during the COVID-19 period, while low-intensity (Time: 60.305~61.735) PA increased. Before and during the COVID-19 period, men (18,436 (8.1%)~16,124 (7.0%)) performed PA more regularly than women (13,207 (5.8%)~9382 (4.1%)). Compared to the number of regular PA participants before the COVID-19 period, regular PA participants (male, female) decreased from 31,643 (13.8%) to 25,506 (11.1%) during the COVID-19 period. Compared with the levels before the COVID-19 period, the experience rates of stress (3.1%~2.6%), depression (0.8%~0.6%), HBP (3.0%~2.2%), and diabetes (1.2%~0.9%) significantly changed under different levels of conventional PA intervention. In addition, the obesity rate during the COVID-19 period (23.957) was higher than it was before COVID-19 (23.477). During the COVID-19 period, the PA of Koreans was greatly restricted, but low-intensity PA was maintained and increased. PA is an effective activity for maintaining mental health and for preventing and reducing chronic diseases. Recommendations for appropriate intensity or a combination of high-, moderate-, and low-intensity PA should be based on the health status of Koreans to help them maintain mental health and to reduce the risk of chronic diseases during COVID-19 social distancing.

Inflammation in COVID-19 and the Effects of Non-Pharmacological Interventions during the Pandemic: A Review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic that hit the health systems worldwide hard, causing a collapse of healthcare systems. One of the main problems of this new virus is the high inflammatory response it provokes, which is the cause of much of the symptoms. Different pharmacological approaches tried to stop the advance of the pandemic, but it seems that only vaccines are the solution. In this line, different nonpharmacological approaches have been made in order to improve symptomatology, contagion, and spread of COVID-19, the principal factors being the physical activity, nutrition, physiotherapy, psychology, and life patterns. The SARS-CoV-2 virus produces a disproportionate inflammatory response in the organism of the guest and causes complications in this that can end the life of the patient. It has been possible to see how different nonpharmacological interventions based on physical activity, nutritional, psychological, and physical therapy, and lifestyle changes can be functional tools to treat this inflammation. Thus, in the present review, we aim to provide an overview of the role of inflammation in COVID-19 and the nonpharmacological interventions related to it.

Microglia and Alzheimer's Disease

There is a huge need for novel therapeutic and preventative approaches to Alzheimer's disease (AD) and neuroinflammation seems to be one of the most fascinating solutions. The primary cell type that performs immunosurveillance and helps clear out unwanted chemicals from the brain is the microglia. Microglia work to reestablish efficiency and stop further degeneration in the early stages of AD but mainly fail in the illness's later phases. This may be caused by a number of reasons, e.g., a protracted exposure to cytokines that induce inflammation and an inappropriate accumulation of amyloid beta (Aβ) peptide. Extracellular amyloid and/or intraneuronal phosphorylated tau in AD can both activate microglia. The activation of TLRs and scavenger receptors, inducing the activation of numerous inflammatory pathways, including the NF-kB, JAK-STAT, and NLRP3 inflammasome, facilitates microglial phagocytosis and activation in response to these mediators. Aβ/tau are taken up by microglia, and their removal from the extracellular space can also have protective effects, but if the illness worsens, an environment that is constantly inflamed and overexposed to an oxidative environment might encourage continuous microglial activation, which can lead to neuroinflammation, oxidative stress, iron overload, and neurotoxicity. The complexity and diversity of the roles that microglia play in health and disease necessitate the urgent development of new biomarkers that identify the activity of different microglia. It is imperative to comprehend the intricate mechanisms that result in microglial impairment to develop new immunomodulating therapies that primarily attempt to recover the physiological role of microglia, allowing them to carry out their core function of brain protection.

The health benefit of physical exercise on COVID-19 pandemic: Evidence from mainland China

Objectives

Our study aims to investigate the health benefit of regular physical exercise participation on a series of COVID-19 outcomes including COVID-19 morbidity, mortality, and cure rate.

Methods

Prefecture-level panel data related to physical exercise and the COVID-19 pandemic in China were collected from January 1 to March 17, 2020, (N = 21379). Multiple linear regression was conducted, and the ordinary least squares technique was used to estimate the coefficient.

Results

It was shown that regular sports participation significantly negatively affected COVID-19 morbidity (estimate = -1.1061, p<0.01) and mortality (estimate = -0.3836, p<0.01), and positively affected cure rate (estimate = 0.0448, p<0.01), implying that engaging in physical exercise regularly does have a significant positive effect on COVID-19 outcomes. Then, we explored the heterogeneity of the effect of physical exercise on areas with different risk levels and it was revealed that the effect of physical exercise was more pronounced in high-risk areas in terms of morbidity (estimate = -1.8776, p<0.01 in high-risk areas; estimate = -0.0037, p<0.01 in low-risk areas), mortality (estimate = -0.3982, p<0.01 in high-risk areas; estimate = -0.3492, p<0.01 in low-risk areas), and cure rate (estimate = 0.0807, p<0.01 in high-risk areas; 0.0193 = -0.0037, p<0.05 in low-risk areas).

Conclusions

Our results suggest that regularly engaging in physical exercise before the pandemic has positive health effects, especially in the case of a more severe epidemic. Therefore, we urge readers to actively engage in physical exercise so that we can reduce the risks in the event of a pandemic.

Cognitive decline in heart failure: Biomolecular mechanisms and benefits of exercise

By definition, heart failure (HF) is a human pathological condition affecting the structure and function of all organs in the body, and the brain is not an exception to that. Failure of the heart to pump enough blood centrally and peripherally is at the foundation of HF patients' inability to attend even the most ordinary daily activities and progressive deterioration of their cognitive capacity. What is more, between heart and brain exists a bidirectional relationship that goes well beyond hemodynamics and concerns bioelectric and endocrine signaling. This increasingly consolidated evidence makes the scenario even more complex. Studies have mainly chased how HF impairs cognition without focusing much on preventive measures, notably cardio-cerebral health proxies. Here, we aim to provide a brief account of known and hypothetical factors that may explain how exercise can help obviate cognitive dysfunction associated with HF in its different forms. As we shall see, there is a stringent need for a deeper grasp of such mechanisms. Indeed, gaining this new knowledge will automatically shed new light on the inner workings of HF itself, thus resulting in more effective prevention and treatment of this escalating syndrome.

Brain-Derived Neurotrophic Factor and Extracellular Vesicle-Derived miRNAs in an Italian Cohort of Individuals With Obesity: A Key to Explain the Link Between Depression and Atherothrombosis

Background

Obesity and depression are intertwined diseases often associated with an increased risk of cardiovascular (CV) complications. Brain-Derived Neurotrophic Factor (BDNF), altered in the brain both of subjects with depression and obesity, provides a potential link between depression and thrombosis. Since the relationship among peripheral BDNF, depression and obesity is not well-defined, the aim of the present report has been to address this issue taking advantage of the contribution played by extracellular vesicle (EV)-derived miRNAs.

Research Process

Associations among circulating BDNF, depression and EV-derived miRNAs related to atherothrombosis have been evaluated in a large Italian cohort of obese individuals (n = 743), characterized by the Beck Depression Inventory (BDI-II) score.

Results

BDI-II was negatively associated with BDNF levels without a significant impact of the rs6265 BDNF polymorphism; this association was modified by raised levels of IFN-γ. BDNF levels were linked to an increase of 80 EV-derived miRNAs and a decrease of 59 miRNAs related to atherosclerosis and thrombosis. Network analysis identified at least 18 genes targeted by these miRNAs, 7 of which involved in depression and CV risk. The observation of a possible link among BDNF, depression, and miRNAs related to atherothrombosis and depression in obesity is novel and may lead to a wider use of BDNF as a CV risk biomarker in this specific subject group.

Chronic, acute and protocol-dependent effects of exercise on psycho-physiological health during long-term isolation and confinement

Exercise could prevent physical and psychological deteriorations, especially during pandemic times of lock-down scenarios and social isolation. But to meet both, the common exercise protocols require optimization based on holistic investigations and with respect to underlying processes. This study aimed to explore individual chronic and acute effects of continuous and interval running exercise on physical and cognitive performance, mood, and affect and underlying neurophysiological factors during a terrestrial simulated space mission. Six volunteers (three females) were isolated for 120 days. Accompanying exercise training consisted of a continuous and interval running protocol in a cross-over design. Incremental stage tests on a treadmill were done frequently to test physical performance. Actigraphy was used to monitor physical activity level. Cognitive performance, mood (MoodMeter^®), affect (PANAS), brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1), vascular-endothelial growth factor (VEGF), and saliva cortisol were investigated prior to, four times during, and after isolation, pre- and post-exercise on two separate days, respectively. As a chronic effect, physical performance increased (and IGF-1 tended) in the course of isolation and training until the end of isolation. Subjective mood and affect state, as well as cognitive performance, basal BDNF and VEGF levels, were well-preserved across the intervention. No acute effects of exercise were detected, besides slower reaction time after exercise in two out of nine cognitive tests, testing sensorimotor speed and memory of complex figures. Consistently higher basal IGF-1 concentrations and faster reaction time in the psychomotor vigilance test were found for the continuous compared to the interval running protocol. The results suggest that 120 days of isolation and confinement can be undergone without cognitive and mental deteriorations. Regular, individual aerobic running training supporting physical fitness is hypothesized to play an important role in this regard. Continuous running exercise seems to trigger higher IGF-1 levels and vigilance compared to interval running. Systematic and prolonged investigations and larger sample size are required to follow up on exercise-protocol specific differences in order to optimize the exercise intervention for long-term psycho-physiological health and well-being.

Expression of the Endothelin-1 Gene and Its Type a Receptor including Physical Activity among Patients with Acute Myocardial Infarction

Cardiovascular diseases are the most common causes of death, in both Poland and the world. Their development and progression are largely influenced by the lifestyle with the presence/occurrence of classic, modifiable risk factors. Among them, low physical activity plays a significant role. The aim of the study was to evaluate the expression of the endothelin-1 gene and its type A receptor, taking into account physical activity (International Physical Activity Questionnaire—IPAQ) among patients with acute myocardial infarction. A total of 234 patients with acute myocardial infarction were examined, including 167 patients undergoing early post-hospital cardiac rehabilitation and 67 not participating in it. All of them were assessed with the IPAQ questionnaire and the quantitative real-time polymerase reaction method (QRT-PCR). Physical activity in the group of patients after early post-hospital cardiac rehabilitation increased after rehabilitation. Transcriptional activity of the endothelin-1 (ET-1) gene in both studied group of patients increased significantly, but in a group of patients not participating in early post-hospital cardiac rehabilitation more than in a group of patients participating in it. In our study, the expression of ET-1 was also significantly higher in the group of patients with acute myocardial infarction with ST-segment elevation, without diabetes, with lipid disorders, smoking, with normal body weight. Expression of the ENDRA (Endothelin receptor A) gene increased with age. These results prove the beneficial effect of rehabilitation and may indicate another pathomechanism of pro-atherogenic activity of above-mentioned factors.

Reactive gliosis in Alzheimer's disease: a crucial role for cognitive impairment and memory loss

Alzheimer's disease (AD) is a neurodegenerative disorder that leads to cognitive decline and memory loss. Insulin resistance in central nervous system (CNS) is a common feature in dementia. Defective insulin signaling is associated to higher levels of inflammation and to neuronal dysfunction. A reactive gliosis, a change that occurs in glial cells due to damage in CNS, seems to be one of the most important pro-inflammatory mechanisms in AD pathology. The first response to CNS injury is the migration of macrophages and microglia to the specific site of the injury. Oligodendrocytes are also recruited to to contribute with remyelination. The last component of a reactive gliosis is astrogliosis, which is the enhancement of astrocytes expression with concomitant changes in its morphology being the main cells of the glial scar. Here, we review the mechanisms by which a reactive gliosis can induce or contribute to the development and progression of AD.

Too hard to die: Exercise training mediates specific and immediate SARS-CoV-2 protection

Several mechanisms may explain how exercise training mechanistically confers protection against coronavirus disease 2019 (COVID-19). Here we propose two new perspectives through which cardiorespiratory fitness may protect against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Physical exercise-activated adenosine monophosphate (AMP)-activated protein kinase (AMPK) signaling induces endothelial nitric oxide (NO) synthase (eNOS), increases NO bio-availability, and inhibits palmitoylation, leading to specific and immediate SARS-CoV-2 protection. AMPK signaling also induces angiotensin 1-7 release and enhances eNOS activation thus further mediating cardio- and reno-protection. Irisin, a myokine released from skeletal muscles during aerobic exercise, also participates in the AMPK/Akt-eNOS/NO pathway, protects mitochondrial functions in endothelial cells, and antagonizes renin angiotensin system proinflammatory action leading to reductions in genes associated with severe COVID-19 outcomes. Collectively, all the above findings point to the fact that increased AMPK and irisin activity through exercise training greatly benefits molecular processes that mediate specific, immediate, and delayed SARS-CoV-2 protection. Maintaining regular physical activity levels is a safe and affordable lifestyle strategy against the current and future pandemics and may also mitigate against obesity and cardiometabolic disease syndemics. Move more because a moving target is harder to kill.

Too hard to die: Exercise training mediates specific and immediate SARS-CoV-2 protection

Several mechanisms may explain how exercise training mechanistically confers protection against coronavirus disease 2019 (COVID-19). Here we propose two new perspectives through which cardiorespiratory fitness may protect against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Physical exercise-activated adenosine monophosphate (AMP)-activated protein kinase (AMPK) signaling induces endothelial nitric oxide (NO) synthase (eNOS), increases NO bio-availability, and inhibits palmitoylation, leading to specific and immediate SARS-CoV-2 protection. AMPK signaling also induces angiotensin 1-7 release and enhances eNOS activation thus further mediating cardio- and reno-protection. Irisin, a myokine released from skeletal muscles during aerobic exercise, also participates in the AMPK/Akt-eNOS/NO pathway, protects mitochondrial functions in endothelial cells, and antagonizes renin angiotensin system proinflammatory action leading to reductions in genes associated with severe COVID-19 outcomes. Collectively, all the above findings point to the fact that increased AMPK and irisin activity through exercise training greatly benefits molecular processes that mediate specific, immediate, and delayed SARS-CoV-2 protection. Maintaining regular physical activity levels is a safe and affordable lifestyle strategy against the current and future pandemics and may also mitigate against obesity and cardiometabolic disease syndemics. Move more because a moving target is harder to kill.

Regulation of microRNAs in Alzheimer´s disease, type 2 diabetes, and aerobic exercise training

Alzheimer's disease (AD) is the most common type of dementia. The evolution and aggregation of amyloid beta (β) oligomers is linked to insulin resistance in AD, which is also the major characteristic of type 2 diabetes (T2D). Being physically inactive can contribute to the development of AD and/or T2D. Aerobic exercise training (AET), a type of physical exercise, can be useful in preventing or treating the negative outcomes of AD and T2D. AD, T2D and AET can regulate the expression of microRNAs (miRNAs). Here, we review some of the changes in miRNAs expression regulated by AET, AD and T2D. MiRNAs play an important role in the gene regulation of key signaling pathways in both pathologies, AD and T2D. MiRNA dysregulation is evident in AD and has been associated with several neuropathological alterations, such as the development of a reactive gliosis. Expression of miRNAs are associated with many pathophysiological mechanisms involved in T2D like insulin synthesis, insulin resistance, glucose intolerance, hyperglycemia, intracellular signaling, and lipid profile. AET regulates miRNAs levels. We identified 5 miRNAs (miR-21, miR-29a/b, miR-103, miR-107, and miR-195) that regulate gene expression and are modulated by AET on AD and T2D. The identified miRNAs are potential targets to treat the symptoms of AD and T2D. Thus, AET is a non-pharmacological tool that can be used to prevent and fight the negative outcomes in AD and T2D.

Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis

With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population.

REHABILITATION DURING THE COVID-19 PANDEMIC

The COVID-19 pandemic has affected the entire healthcare system, from emergency care, intensive care units, internal medicine wards, outpatient care to home care. The pandemic continues and brings a large number of patients with COVID-19-associated postintensive care syndrome suffering from physical, mental and cognitive impairments that threaten their return to normal life. The complexity and severity of illness in patients recovering from severe COVID-19 requires a coordinated and systematic approach to be applied as early as possible during the recovery phase. Considering the multiorgan dysfunction, debility, pulmonary, neurological, neuromuscular and cognitive complications, rehabilitation professionals can play an important role in the recovery process for individuals with COVID-19. Complications of COVID-19 can be reduced by 1) multidisciplinary rehabilitation, which begins early and continues throughout the hospital stay, 2) providing patient/family education for self-care after discharge from inpatient rehabilitation, and 3) continuing rehabilitation care in the outpatient setting, and at home either in person or with the help of telerehabilitation.

Moderate-intensity continuous training and high-intensity interval training improve cognition, and BDNF levels of middle-aged overweight men

The prevalence of overweight and obesity is increasing worldwide, which has been associated with poor cognitive outcomes. Participating in regular physical exercise may also improve cognition, and levels of brain-derived neurotrophic factor (BDNF), but the optimal exercise prescription remains to be elucidated. The purpose of the present study is to compare the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on cognition, and serum BDNF levels in middle-aged and overweight men. Twenty-five sedentary, overweight men participated in the 8-week training intervention. Subjects were randomized into MICT (n = 12) or HIIT (n = 13) and performed exercise sessions 3x/week for 8-weeks. Cognitive function, and serum BDNF levels were assessed pre- and post-intervention. Statistical analysis was carried out using the Graph Pad Prism 7.0, and the level of significance was set at 5%. Significant improvements were observed in cognitive test scores, and BDNF levels in MICT and HIIT groups (p < 0.05). There were no significant differences in cognitive function between MICT and HIIT. The present study implicates that 8 weeks of MICT or HIIT may be a very useful non-pharmacological treatment option to improve cognitive function, and BDNF levels in middle-aged overweight men.

Physical activity and mental well-being during COVID-19 pandemic

The corona virus disease 2019 (COVID-19) pandemic has resulted in most nations deciding upon self-isolation and social distancing policies for their citizens to control the pandemic and reduce hospital admission. This review aimed at evaluating the effect of physical activity on mental well-being during the COVID-19 pandemic. It was concluded that the COVID-19 pandemic may lead to augmented levels of angiotensin-converting enzyme (ACE)-2 that led to cardiovascular and neurological disorders associated with highly inflammatory effects of viral infection affecting the brain tissues leading to damage of the nervous system and resulting in cognition dysfunction, insulin sensitivity reduction, and behavioral impairments. Anxiety and depression may lead to negative effects on various quality of life domains, such as being physically inactive. Regular physical activities may reduce inflammatory responses, improve ACE-2 responses, and improve mental well-being during self-isolation and social distancing policies related to the COVID-19 pandemic. Further studies should be conducted to assess the different intensities of physical activities on cardiovascular function, and mental well-being during the COVID-19 pandemic.

A Narrative Review of the Safety of Anti-COVID-19 Nutraceuticals for Patients with Cancer

Simple Summary

Dietary supplement use has increased more than 35% globally since the COVID-19 outbreak. While some nutraceuticals are potentially efficacious against severe disease from COVID-19, their indiscriminate use by patients with cancer without medical supervision is concerning. The aim of this narrative review was to evaluate the data on safety of “anti-COVID-19” nutraceuticals for patients with cancer. We found that the use of vitamin C, vitamin D, and selenium supplements is likely safe and even potentially beneficial at typically recommended doses. However, caution is advised regarding the use of omega-3 fatty acids and zinc, as risks from their use may outweigh the benefits.

Abstract

Interest in dietary supplements and their efficacy in treating and preventing disease has increased greatly since the outbreak of the COVID-19 pandemic. Due to the risk of severe COVID-19 in patients with cancer, we conducted a narrative review aiming to better understand the data on the safety of the most efficacious “anti-COVID-19” nutraceuticals for patients with cancer. We conducted a PubMed database search aimed at identifying the most effective nutrients for use against COVID-19. For the identified nutraceuticals, we searched PubMed again regarding their safety for patients with cancer. Fifty-four total records (52 independent studies) were retrieved, pertaining to vitamin D, vitamin C, selenium, omega-3 fatty acids, and zinc. Vitamin D results from 23 articles indicated safe use, but two articles indicated potential harm. All 14 articles for vitamin C and five out of six articles for selenium indicated the safety of use (one study for selenium suggested harm with high-dose supplementation). Results for omega-3 fatty acids (seven articles) and zinc (one article), however, were rather mixed regarding safety. We conclude that vitamin D, vitamin C, and selenium supplements are likely safe or even beneficial at typically recommended doses; however, caution is urged with omega-3 fatty acid supplements, and zinc supplements should likely be avoided. More experimental research is needed, and nutraceutical use by patients with cancer should always be under the supervision of a healthcare team.

Exercise as a coping strategy and its impact on the psychological well-being of Japanese community-dwelling older adults during the COVID-19 pandemic: A longitudinal study

This study aimed to examine the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. In October 2019 (baseline [BL]), 720 community-dwelling older adults living in an urban area in Japan participated in a comprehensive health survey. Of these, 618 responded to a mail survey (follow-up [FL]) in June 2020, after the first state of emergency was lifted. Their psychological well-being was assessed using the WHO-5 Well-Being Index (WHO-5). Exercise as a coping strategy during the stay-at-home period was determined at FL by asking respondents whether they had engaged in 1) walking and 2) at-home exercise and strength training to maintain their physical and mental health. Each type of exercise's impact and the effective exercise combinations were examined. Time and group interaction effects on the WHO-5 scores were investigated using a two-way analysis of covariance. Of the final sample, 65.1% engaged in walking. The WHO-5 mean scores at BL and FL were 16.7 and 15.4 for the walking group and 16.7 and 14.5 for the non-walking group, respectively; interaction for time and group was significant. Additionally, 56.4% of the participants engaged home training. The WHO-5 mean score at BL and FL were 17.5 and 15.5 for the home training group and 15.7 and 14.5 for the no home training group, respectively; there was no significant interaction. Older adults who engaged in both walking and home training received higher score on the WHO-5 than those who engaged in only one activity at FL. The decline in psychological well-being was most attenuated in the walking only group compared to the at-home exercise and strength training groups. Exercise as a coping strategy during the stay-at-home period was associated with psychological well-being, with different impacts observed depending on the type of activity.

Physical exercise consequences on memory in obesity: A systematic review

Obesity is associated with changes in memory. Thus, the aim of this systematic review was to investigate the physical exercise consequences on memory in obesity. A search was carried out in the PubMed, Lilacs, and Scielo databases with the following descriptors: "physical exercise," "memory," and "obesity." A total of 16 studies were analyzed in this review. Low, moderate, and high intensity exercise training showed positive effects on memory in patients with obesity (100%). The animal models of obesity used in their physical exercise protocols: treadmill (72.7%) or wheel running (27.3%). Most of the animal studies (81.8%) revealed positive effects of the physical exercise protocol on memory in obesity. Mouse was the most commonly used animal (54.5%), and a 60% high-fat diet (HFD) was the most commonly method used to induce obesity (82%). We did not identify any knockout model of obesity that was used to evaluate memory and used physical exercise as the main intervention. Thus, exercise training, independently if it is resistance or endurance training, seems to be an excellent intervention to prevent and inhibit cognitive impairment and memory loss on obese patients and animal models of obesity.