key: cord-0917065-wprj9mq6 authors: Bo, Wenyan; Xi, Yue; Tian, Zhenjun title: The role of exercise in rehabilitation of discharged COVID-19 patients date: 2021-09-14 journal: Sports Med Health Sci DOI: 10.1016/j.smhs.2021.09.001 sha: b212815934135be28c963ac08d26022e8a03e97c doc_id: 917065 cord_uid: wprj9mq6 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly caused pneumonia and pulmonary fibrosis through upper respiratory tract infection, which resulted in acute respiratory distress syndrome (ARDS) and multiorgan damage of cardiovascular, nervous, digestive, and genitourinary systems. Although the virus test turned negative after the patient recovered, the damage to multiorgan which caused by SARS-CoV-2 may irreversible. Therefore, the health status of the recovered patients has gradually become the focus of people’s attention. Whether coronavirus disease 2019 (COVID-19) patients can receive exercise rehabilitation training after discharge? and what’s the basis? We try to analyze and answer these questions, will provide some ideas about the patients to develop a reasonable and effective exercise rehabilitation program. SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) and enters host cells six months after convalescence, the common symptoms of COVID-19 patients were 120 fatigue or muscle weakness. 6 A three-month follow-up survey of 538 COVID-19 121 patients showed that women were more prone to physical decline or fatigue, post 122 activity hyperhidrosis, and hair loss than men. 26 Lower exercise ability may be 123 associated with lung dysfunction, as well as muscle pain and fatigue. 124 Furthermore, decreased, or damaged liver dysfunction 27 and spermatogenic cells 28 , 125 conjunctivitis, and other digestive 29 , reproductive, and sensory organ diseases also 126 were reported in COVID-19 patients. These symptoms may also accompany patients 127 for a long time after they are discharged from hospital. Therefore, methods for 128 rehabilitation are essential to help patients recover better. Characterization of extracellular redox enzyme 552 concentrations in response to exercise in humans Muscle-derived extracellular superoxide dismutase inhibits 555 endothelial activation and protects against multiple organ dysfunction syndrome in mice Clinical characteristics of coronavirus disease 2019 in China Clinical characteristics of Covid-19 in 561 functional capacity and quality of life in patients with severe chronic obstructive pulmonary 595 disease (COPD): a pilot study Early rehabilitation with dedicated use of belt-type 598 electrical muscle stimulation for severe COVID-19 patients Feasibility and efficacy of the pulmonary rehabilitation 601 program in a rehabilitation SEVERE COVID-19 aCUTE respiratory distress syndrome Effectiveness of COVID-19 Vaccines against the 605 2 (Delta) Variant Sequencing on an imported case in China of COVID-19 Delta 608 variant emerging from India in a cargo ship in Zhoushan Rapid spread of the SARS-CoV-2 Delta 611 variant in some French regions SARS-CoV-2 Delta VOC in Scotland: demographics, 614 risk of hospital admission, and vaccine effectiveness Covid-19: Fully vaccinated people can carry as much delta virus as unvaccinated 616 people, data indicate Fig 1. Effect and mechanism of severe acute respiratory syndrome coronavirus 2 621 (SARS-CoV-2) infection on multiple organ injuries 622 (A) Mechanism of coronavirus disease 2019 (COVID-19) induced multi-organ injury 623 (B) SARS-CoV-2 infection-induced impairment of multiple organ functions ACE2, 624 angiotensin-converting enzyme 2; CNS, central nervous system; CRS, inflammatory 625 cytokine storm; GM-CSF, granulocyte-macrophage colony stimulating factor MCP-1, monocyte chemoattractant protein-1 PNS, peripheral niveous system; RASS, renin-angiotensin-aldosterone system; ROS, 628 reactive oxygen species; SARS-CoV-2, severe acute respiratory syndrome TMPRSS2, transmembrane protease serine 2; TNF-α, tumor necrosis factor alpha BDNF, brain-derived neurotrophic factor; FGF21, fibroblast growth factor 21; GDF-636 15, growth differentiation factor-15 IL-6, interleukin-6 LIF, leukemia inhibitory factor; MCP-1, monocyte chemotactic protein 638 ROS, reactive oxygen species; SIRT1, Sirtuin 1; TNF-α, tumor necrosis factor Exercise activated endogenous extracellular superoxide dismutase (EcSOD) 643 and cytokines to inhibit inflammatory cytokines and oxidative stress 644 (A) Enhanced skeletal muscle EcSOD expression by exercise promotes mitigation of 645 oxidative stress and damage in a variety of peripheral tissues and disease conditions Elevated EcSOD abundance/activity prevents extracellular oxidative stress 647 endothelial dysfunction and endothelial cell activation by scavenging superoxide 648 anion. (C) Exercise inhibited intracellular and extracellular oxidative stress and 649 inflammation induced by SARS-COV-2. EcSOD, extracellular superoxide 650 dismutase ROS, reactive oxygen 651 species; SARS-CoV-2, severe acute respiratory syndrome (20) The authors declare no competing interests.