Physically Active Lifestyle as an Approach to Confronting COVID-19

Cracking the code: uncovering the factors that drive COVID-19 standard operating procedures compliance among school management in Malaysia

Malaysia's government's decision to reopen schools during the COVID-19 outbreak, especially for students taking important exams, has alarmed the public. However, the Ministry of Education has implemented a COVID-19 Standard Operating Procedure (SOP) for educational institutions. The school management's ability to protect children from COVID-19 rests on their understanding, attitudes, and practices regarding COVID-19 SOP compliance. This study investigated Selangor, Kuala Lumpur, and Putrajaya school management's COVID-19 SOP compliance determinants. Multistage sampling was used to sample 740 school management from Kuala Lumpur, Putrajaya, and Selangor. A self-administered questionnaire collected sociodemographic, occupational, and lifestyle data, knowledge, attitude, and practice of COVID-19 SOP compliance. The school management had good knowledge, attitude, and practice toward COVID-19 SOP. Monthly income, school location, smoking status, and physical activity differed significantly from KAP (p < 0.05). The correlation between KAP showed a significant relationship with the values (r = 0.348, p < 0.001) and (r = 0.358, p = 0.003). Nine independent variables strongly predicted SOPs compliance practice in multiple linear regression: knowledge, attitude, age, source of knowledge; Ministry of Health, physical activities, type of infectious disease exposed; Tuberculosis and Measles (p < 0.05). The data indicate that school management exhibits good knowledge, attitude, and compliance with SOPs during the pandemic. School management oversees SOPs, and to keep schools safe, management must analyse hazards and take action. Therefore, knowledge and attitude are expected to determine factors of practice toward COVID-19 SOP compliance.

Meta-analysis of the impact of physical activity on the recovery of physical function in COVID-19 patients

Background

The decrease in physical function resulting from COVID-19 infection exerts a substantial negative influence on the quality of life of individuals. Physical activity plays a crucial and irreplaceable role in hastening the elimination of adverse effects on the body caused by acute and chronic diseases. Nevertheless, there have been reports of unfavorable events following physical activity post-COVID-19 infection, sparking debate regarding the efficacy of physical activity as a rehabilitation method to enhance the physical function of COVID-19 patients.

Objective

The aim of this study is to investigate the impact of physical activity on promoting the restoration of physical function among individuals with COVID-19, and to offer guidance for the advancement and consideration of physical activity in the rehabilitation treatment of COVID-19 patients.

Methods

A search was conducted on the PubMed and Web of Science core collection databases, with the search period set from January 1, 2020, to February 6, 2023. The included literature was assessed for risk of bias and methodological quality according to the Cochrane Handbook for Systematic Reviews of Interventions, utilizing Review Manager 5.1 software. The outcome measures from the included studies were analyzed, and the quality of evidence for the outcome measures was graded using the GRADE classification criteria.

Results

The effect of physical activity intervention on improving the 6-Minute Walk Test score in COVID-19 patients was better than that of conventional treatment [WMD = 69.19(95%CI = 39.38, 98.99), I2 = 57%(p = 0.03)]. The effect of physical activity on improving the 30-Second Sit-to-Stand Test score was better than that of conventional treatment [WMD = 2.98(95%CI = 1.91, 4.04), I2 = 0%(p = 0.56)]. There was no significant difference between physical activity and conventional treatment in improving Grip strength in COVID-19 patients [WMD = 2.35(95%CI = -0.49, 5.20), I2 = 0%(p = 0.80)]. The effect of physical activity on improving the Timed Up and Go test score in COVID-19 patients was better than that of conventional treatment [WMD = -1.16(95%CI = -1.98, -0.34), I2 = 4%(p = 0.35)]. The effect of physical activity on improving Forced Vital Capacity in COVID-19 patients was better than that of conventional treatment [WMD = 0.14(95%CI = 0.08, 0.21), I2 = 0%(p = 0.45)]. The effect of physical activity on improving Forced Expiratory Volume in the first second in COVID-19 patients was better than that of conventional treatment [WMD = 0.08(95%CI = 0.02, 0.15), I2 = 52%(p = 0.10)].

Conclusions

Physical activity plays a crucial role in facilitating the recovery of exercise capacity and pulmonary function in COVID-19 patients, helping to expedite the restoration of overall physical health. It is crucial for COVID-19 patients to undergo an accurate assessment of their physical condition before engaging in any physical activity.

Examining Lifestyle Components in Hospitalized COVID-19 Patients, Iran 2021

Background

COVID-19 pandemic is a serious health threating element throughout the world. One of the key elements to strengthen the body’s immune system is to follow a healthy lifestyle to deal with health threating. The aim of this study was to evaluate the lifestyle components in COVID-19 patients.

Methods

This descriptive-analytical study carried on hospitalized COVID-19 patients from October 22, 2020 to January 19, 2021. Demographic characteristics, physical activity, nutritional status, stress and anxiety, and substance abuse were assessed. A simple model and multiple logistic regression model were used.

Results

About 32% were hospitalized in the intensive care unit (ICU). Healthy lifestyle was observed only in 28%. About 82% had insufficient physical activity, and 67.3% was reported to be unfavorable in nutritional status. Severe stress and anxiety were observed in 30.4% of people. There were significant relationships between age (AOR = 2.11, p = 0.036), education (AOR = 0.35, p = 0.002) and a healthy lifestyle. A significant correlation was observed between ICU admission and unhealthy lifestyle (AOR = 0.40, p = 0.015).

Conclusion

Unhealthy lifestyle behaviors were seen in the most COVID-19 patients. Considering the significance of lifestyle changes could prove effective in reducing the risk of transmissible viral infections.

Gender-related differences in the impact of COVID-19 pandemic in cardiometabolic patients in Latin America: The CorCOVID LATAM Gender sub-study

COVID-19 pandemic and lockdown measures have disrupted lifestyle habits and self-care. Gender differences in health behavior during the pandemic have not yet been fully elucidated. The aim of this study was to evaluate gender related differences in the impact of COVID-19 pandemic on patients with cardiometabolic diseases. A cross-sectional survey was administered to cardiometabolic patients in 13 Latin American countries between June 15th and July 15th, 2020. The study included 4216 participants, of which 2147 (50.9%) were women. Women reported healthier eating habits as well as lower tobacco and alcohol consumption than men but exercised less and reported increased symptoms of depression. Low income and symptoms of depression were associated with sedentarism in women. The interplay between psychological factors and sedentarism could increase the risk of cardiovascular events in this population.

Impact of COVID-19 on Children and Young Adults With Type 2 Diabetes: A Narrative Review With Emphasis on the Potential of Intermittent Fasting as a Preventive Strategy

Background: The world is still struggling to control the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The level of uncertainty regarding the virus is still significantly high. The virus behaves differently in children and young adults. Most children and adolescents are either asymptomatic or have mild symptoms. They generally have a very good prognosis. However, it is not well-known whether children and young adults with type 2 diabetes are at risk of getting a severe infection of COVID-19. Many Muslim children with type 2 diabetes have been performing dawn to dusk fasting during the month of Ramadan, before and during the COVID-19 pandemic, and the impact of this on their health has not been well investigated. Previous studies in adults have suggested that intermittent fasting may be beneficial in different ways including reversal of type 2 diabetes and prevention of COVID-19 infection. Objective: The primary aim of this narrative review is to summarise the impacts of the COVID-19 pandemic on children and young adults with type 2 diabetes, and to identify the knowledge gaps in the literature. It also explores the potential of intermittent fasting in reversing the pathogenesis of diabetes and highlighting how this approach could prevent these patients from developing chronic complications. Methods: This narrative review has been produced by examining several databases, including Google Scholar, Research Gate, PubMed, Cochrane Library, MEDLINE (EBSCO), and Web of Science. The most common search terms used were "COVID-19 AND Children", "SARS-CoV-2 AND/OR Children", "COVID-19 AND Diabetes" "COVID-19 Epidemiology", "COVID-19 AND Ramadan fasting", "COVID-19 and Intermittent fasting." All the resources used are either peer-reviewed articles/reports and/or official websites of various media, governmental and educational organisations. Results: Having reviewed the currently limited evidence, it has been found that the incidence of COVID-19 among children with type 2 diabetes seems to be not much different from children without diabetes. However, these patients are still vulnerable to any infection. Several studies have reported that prevention programmes such as intermittent fasting are effective to protect these groups of patients from developing any complications. Moreover, observing Ramadan fasting as a type of intermittent fasting could be beneficial for some children with established diabetes, prediabetes and people at risk. Conclusion: Children and young adults with type 2 diabetes are not at risk of severe COVID-19 infection as the case in adults with diabetes. More research is needed to identify the impact of COVID-19 and to investigate the efficacy and safety of intermittent fasting, including Ramadan fasting, among these age groups. Implementing these cost-effective programmes may have a great impact in minimising the incidence of diabetes. Moreover, this could be effective particularly at prediabetes stage by preventing these people from going onto develop type 2 diabetes and taking medications for the rest of their life and protecting people from complications linked to disease and infection.

The Role of the Smartphone in the Diagnosis of Vestibular Hypofunction: A Clinical Strategy for Teleconsultation during the COVID-19 Pandemic and Beyond

Introduction  Vestibular disorders (VDs) are highly prevalent in primary care. Although in general they comprise conditions that are not life-threatening, they are associated with significant functional and physical disability. However, the current coronavirus disease 2019 (COVID-19) pandemic has imposed limitations on the standard treatment of benign conditions, including VDs. In this context, other resources may aid in the diagnosis and management of patients with VDs. It is well known that teleconsultation and teletreatment are both safe and effective alternatives to manage a variety of conditions, and we maintain that VDs should be among these. Objective  To develop a preliminary model of clinical guidelines for the evaluation by teleconsultation of patients with suspected diagnosis of vestibular hypofunction during the COVID-19 pandemic and beyond. Methods  A bibliographic review of the diagnostic feasibility in VDs by teleconsultation was carried out in the LILACS, SciELO, MEDLINE, and PubMed databases; books and specialized websites were also consulted. The legal, regulatory, and technical issues involving digital consultations were reviewed. Results  We found 6 field studies published between 1990 and 2020 in which the efficiency of teleconsultations was observed in the contexts of epidemics and environmental disorders and disadvantageous geographical conditions. After reviewing them, we proposed a strategy to examine and address vestibular complaints related to vestibular hypofunction. Conclusion  The creation of a digital vestibular management algorithm for the identification, counseling, initial intervention, monitoring and targeting of people with possible vestibular hypofunction seems to be feasible, and it will provide a reasonable alternative to in-person evaluations during the COVID-19 pandemic and beyond.

Physical activity and medication in Brazilians suffering with non-communicable diseases in quarantine by COVID-19

This study aimed to compare the practice of physical activity in groups of people with chronic diseases with and without medication, before and during the pandemic. 298 Brazilian individuals with chronic non-communicable diseases such as cardiovascular, metabolic / endocrine, respiratory, orthopedic, gastrointestinal diseases, anxiety and depression were separated into two groups: with and without medication. A questionnaire with 14 questions was applied, tracing the behavioral profile in relation to physical exercises before and during isolation, interpreted through descriptive analysis, and the groups were compared through Mann-Whitman's statistics. The drop in the percentage of active individuals with or without medication occurred when comparing the scenarios before and during quarantine. However, the difference in the prevalence of active individuals between the groups was significant, showing that the group with medication remained more active. The fear of contamination, the measures of distance and the lack of adherence of the population to classes by videoconference reduced the frequency of physical activities in the general sample population. However, people who used medication showed greater concern about the practice of physical activity to optimize treatment. The isolation period had a negative impact on the practice of physical activity, regardless of the presence of some chronic disease or the use of medication.

Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature

Acute viral respiratory infections are the main infectious disease in the world. In 2020, a new disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19), became a global pandemic. The immune response to the virus depends on factors such as genetics, age and physical state, and its main input receptor is the angiotensin-converting enzyme 2. The practice of physical exercises acts as a modulator of the immune system. During and after physical exercise, pro- and anti-inflammatory cytokines are released, lymphocyte circulation increases, as well as cell recruitment. Such practice has an effect on the lower incidence, intensity of symptoms and mortality in viral infections observed in people who practice physical activity regularly, and its correct execution must be considered to avoid damage. The initial response is given mainly by type I interferons (IFN-I), which drive the action macrophages and lymphocytes, followed by lymphocyte action. A suppression of the IFN-I response has been noted in COVID-19. Severe conditions have been associated with storms of pro-inflammatory cytokines and lymphopenia, as well as circulatory changes and virus dispersion to other organs. The practice of physical activities strengthens the immune system, suggesting a benefit in the response to viral communicable diseases. Thus, regular practice of adequate intensity is suggested as an auxiliary tool in strengthening and preparing the immune system for COVID-19. Further studies are needed to associate physical exercise with SARS-CoV-2 infection.

Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature

Acute viral respiratory infections are the main infectious disease in the world. In 2020, a new disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19), became a global pandemic. The immune response to the virus depends on factors such as genetics, age and physical state, and its main input receptor is the angiotensin-converting enzyme 2. The practice of physical exercises acts as a modulator of the immune system. During and after physical exercise, pro- and anti-inflammatory cytokines are released, lymphocyte circulation increases, as well as cell recruitment. Such practice has an effect on the lower incidence, intensity of symptoms and mortality in viral infections observed in people who practice physical activity regularly, and its correct execution must be considered to avoid damage. The initial response is given mainly by type I interferons (IFN-I), which drive the action macrophages and lymphocytes, followed by lymphocyte action. A suppression of the IFN-I response has been noted in COVID-19. Severe conditions have been associated with storms of pro-inflammatory cytokines and lymphopenia, as well as circulatory changes and virus dispersion to other organs. The practice of physical activities strengthens the immune system, suggesting a benefit in the response to viral communicable diseases. Thus, regular practice of adequate intensity is suggested as an auxiliary tool in strengthening and preparing the immune system for COVID-19. Further studies are needed to associate physical exercise with SARS-CoV-2 infection.

Social Distancing: Prevalence of Depressive, Anxiety, and Stress Symptoms Among Brazilian Students During the COVID-19 Pandemic

Social distancing due to the COVID-19 pandemic can impact mental health, triggering symptoms such as anxiety, stress and depression. Therefore, this study aimed to assess the levels of anxiety, depression and stress during the period of social distancing due to COVID-19 in students from a campus of the Federal Institute in the metropolitan area of Porto Alegre/RS. A correlational and exploratory study was performed. The sample of the present research was composed by 208 students, who responded to a self-administered online questionnaire with sociodemographic variables and the Depression, Anxiety and Stress Scale Short Form – DASS-21. The detected prevalence of symptoms classified as moderate-severe was 49% for stress, 39% for depression and 33% for anxiety. An association was found between higher levels of anxiety symptoms (OR = 5.652; 95% CI = 2.872–11.123; p < 0.001), depression (OR = 3.289; 95% CI = 1.810–5.978; p < 0.001) and stress (OR = 5.684; 95% CI = 3.120–10.355; p < 0.001) with occurrence of sleep problems during the period of social distancing. There was a protective factor provided by regular physical exercise in relation to depressive symptoms (OR = 0.490; 95% CI = 0.250–0.960; p =0.033). These data are extremely important for understanding the adverse effect on the mental health of students and for developing psychological support strategies, thus promoting well-being during and after the pandemic.

Physical Activity Recommendations during COVID-19: Narrative Review

Regular practice of physical activity plays a fundamental role in preventing and treating cardiovascular diseases such as obesity, hypertension, diabetes, and metabolic syndrome. During the pandemic caused by COVID-19 and the lockdown established, people have reduced considerably their mobility and motor activity, which has led to an increase in unhealthy lifestyle habits, raising the risk of suffering from diseases. This paper consists of reviewing the existing scientific literature on recommendations of physical activity during the pandemic and to establish specific guidelines according to the type of population to which the activity would be directed. A search strategy has been carried out in the different databases: Embase, PubMed, SCOPUS, SPORTDiscus, and Web of Science (WoS), including all the articles published until 14 May 2020, to find essays with recommendations on aerobic activity, muscle strengthening, flexibility-stretching, meditation-relaxation, and balance exercises. The articles found have been evaluated considering the following criteria: type of publication, proposals for physical exercise, language, and, if it appears, volume of activity, frequency, intensity, and rest. The results obtained 29 articles that discuss patterns of physical activity, although there is no common consensus on such recommendations during confinement, nor are they suitable for all people. From these results, we can conclude that physical activity is widely recommended during the confinement caused by COVID-19, mainly through the performance of aerobic, strength, flexibility, and balance exercises.

Physical Exercise and Immune System in the Elderly: Implications and Importance in COVID-19 Pandemic Period

Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public health challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic.

Lockdown During COVID-19 and the Increase of Frailty in People With Neurological Conditions

Governments around the globe have introduced quarantine, lockdown, and mandatory isolation to slow the transmission of COVID-19. These public health and policy measures aim to protect the public and vulnerable people. This perspective paper argues that the impacts of lockdown (such as social disconnection, reduced exercise, and fewer physiotherapy treatments) may be amplified for people with neurological conditions with subsequent increases in frailty. The paper outlines why this may occur, and explores how adverse impacts for these vulnerable populations may be minimized through strategies such as telehealth, exercise programs, and health policies.

How children and young people can stay physically active during the novel coronavirus pandemic while take into account safety measures and precautions

The novel coronavirus (COVID-19) outbreak has caused major public concern and posed challenges to societies across the globe. The COVID-19 pandemic might have implications for health-related behaviors, such as physical activity, among people in different age groups. Lately, a number of papers have offered suggestions and recommendations on how to stay physically active during the novel coronavirus pandemic while take into account safety measures and precautions. Many of these suggestions and recommendations might be relevant for health professionals and health practitioners working to facilitate physical activity, health, and well-being among children and young people. In light of the COVID-19pandemic, this paper provides an overview of (a) suggestions and recommendations on physical activities; and (b) safety measures and precautions while being physically active.

The effect of COVID-19 lockdown on lifestyle and mood in Croatian general population: a cross-sectional study

Aim

To investigate the effect of the coronavirus 2019 (COVID-19) lockdown on lifestyle behaviors and mood changes in the Croatian general population.

Methods

During ten days of the COVID-19 lockdown in Croatia, 3027 respondents (70.3% female) from the general population completed an online, self-report questionnaire. Demographic data and data on lifestyle habits and mood changes before and during the COVID-19 lockdown were collected.

Results

A total of 95.64% of respondents reported to follow most or all restrictions, with female sex (P < 0.001) and higher education level (P < 0.001) being associated with higher restriction compliance. Women smoked an increased number of cigarettes (P < 0.001). The proportion of respondents of both sexes who did not drink or drank 7 drinks per week or more increased (P < 0.001). Women also reported lower frequency (P = 0.001) and duration of physical exercise (P < 0.001). In total, 30.7% of respondents gained weight, with female sex (OR, 2.726) and higher BMI (OR, 1.116; both P < 0.001) being associated with an increased likelihood of gaining weight. Both men and women felt more frequently afraid (P < 0.001), discouraged (P < 0.001), and sad (P < 0.001).

Conclusion

Public health authorities should promote the adoption of healthy lifestyles in order to reduce long-term negative effects of the lockdown.

The Relationship between Health Consciousness and Home-Based Exercise in China during the COVID-19 Pandemic

During the COVID-19 pandemic, people have reduced the frequency of going out, and need to engage in health behaviors at home. Home-based exercise has aroused people's attention. This paper aims to examine the influencing mechanism of health consciousness on home-based exercise during the COVID-19 pandemic. A questionnaire method was used to select 449 Chinese respondents on an online platform; the questionnaire includes a health consciousness scale, health life goal scale, perceived behavioral control scale, and the home-based exercise scale. A T-test was used to conduct differential analysis. The hierarchical regression analysis method was used to examine the relationship between health consciousness and home-based exercise, and the Hayes' SPSS PROCESS macro was used to test mediating effect. The results show that there are significant differences in home-based exercise with respect to gender, age, and marital status. Health consciousness has a significant positive effect on home-based exercise. Perceived behavioral control acts as the mediator between health consciousness and home-based exercise. Health consciousness can influence home-based exercise through health life goals and perceived behavioral control in turn. This paper takes a home-based exercise survey, and expands the theoretical research of home-based exercise. The findings suggest that people should pay attention to promoting the transformation of health consciousness into home-based exercise. It provides enlightenment for people to adopt health behaviors during the COVID-19 pandemic.

Depression in High-Risk Type 2 Diabetes Adults

BACKGROUND

Patients suffering from diabetes mellitus are two to three times more vulnerable to develop depressive symptomatology.

PURPOSE

To report the association between depression and high-risk diabetes in India.

METHODS

A total of 1,606 adults were recruited for the study. A patient health questionnaire was used to determine the depression on the basis of score. A statistical analysis was done using analysis of covariance (ANCOVA) and binary logistic regression to determine the association between diabetes categories and four degrees of depression.

RESULTS

Out of 1,606 participants, 52.6% were males and 47.4% were females, 56.4% belonged to the urban area and 43.6% to the rural area. However, 19.5% (314) had diabetes; 29.1% of diabetes individuals had minimal depression, 38.7% had mild, 17.2% moderate, 12.0% moderately severe, and 3.1% had severe depression. In the self-reported diabetic participant group (N = 142), there was a significantly higher degree of severe depression (3.3%) in the uncontrolled group (HbA1c >7%) as compared to the well-controlled diabetes group (HbA1c <7%). ANCOVA in gender differences in the uncontrolled diabetes group showed that male gender had significantly (P = -.02) higher mean scores of depression.

CONCLUSION

This study found that there is a positive association between depression and uncontrolled diabetes in male gender.

Physical Inactivity Is Associated With Increased Levels of Anxiety, Depression, and Stress in Brazilians During the COVID-19 Pandemic: A Cross-Sectional Study

Objective: To evaluate the levels of anxiety, depression, and stress associated with the practice of physical exercise (PE) during pandemic by COVID-19. Methods: This study has a cross-sectional characteristic and was carried out between May 12 and 14, 2020. An online questionnaire was applied with questions to assess sociodemographic characteristics and physical exercise during the CoVID-19 pandemic, in addition to depression, anxiety, and stress analysis. The study was approved by the local ethics committee (CAAE: 31521720.8.0000.5082). Results: One thousand one hundred and fifty four answered the questionnaire (69.84% female). During the isolation period, the number of participants who declared not to exercise was 54.16%. Women generaly presented higher levels of anxiety, depression, and stress when compared to men (p < 0.0001 for all domains). The risk of having increased anxiety were 118% higher (OR = 2.183; 95% CI = 1.717-2.775), the risk of depression was 152% higher (OR = 2.525; 95% CI = 1.991-3.205), and the risk of stress symptoms increased 75.1% (OR = 1.751; 95% CI = 1.386-2.213) in the participants who did not perform PE when compared to those who maintain regular PE. Conclusion: People who was not involved with PE during the COVID-19 pandemic had higher anxiety, depression, and stress scores. Based on this, it seems important to advise people to continue PE, following all the recommendations of preventive measures of the pertinent health organizations.