改善心肺適能對降低感染嚴重特殊傳染性肺炎重症和死亡風險的效應

目前全球嚴重特殊傳染性肺炎（coronavirus disease 2019, COVID-19）疫情發展趨緩，已有一般流感化的趨勢。但COVID-19病毒仍會持續突變，對人體健康的威脅依舊會持續一段時間。臨床研究認為增加身體活動或規律運動，可有效提升心肺適能。良好的心肺適能不僅可降低癌症、心血管疾病與總死亡風險，亦可降低上呼吸道感染、肺炎等傳染性疾病與死亡風險。本文目的是透過Google學術搜索引擎，以cardiorespiratory fitness、exercise、COIVD-19、mortality等關鍵詞蒐集相關文獻，彙整以心肺適能為比較指標，探討心肺適能優劣性對感染COVID-19症狀後之重症及死亡風險的影響，以及其可能其重要影響機制。分析結果指出經流行病學研究證據證實，較佳的心肺適能，具有降低感染COVID-19症狀住院、進入加護病房及死亡率等風險。增加身體活動或規律運動後提升心肺適能可能是經由促進人體免疫監視與免疫防禦作用、因而阻斷COVID-19病毒入侵細胞的路徑、提升抗發炎、抗氧化傷害能力、促進細胞粒線體生成以及增加粒線體的數量、密度、結構完整與功能等機制，因而降低細胞激素風暴，保護人體不致遭受COVID-19病毒嚴重傷害所造成的重症或死亡風險之升高狀態。

關鍵字

身體活動；上呼吸道感染；肺炎；粒線體生成；細胞激素風暴

並列摘要

At present, the crisis of the global pandemic of coronavirus disease 2019 (COVID-19) is mitigating, with symptoms tending to become as mild as influenza. As it continues to mutate, the adverse impact on human health may remain for a period of time. Increased physical activity and regular exercise enhances cardiorespiratory fitness, which in turn lowers risks of cancer, cardiovascular disease, and all-cause mortality. Improved cardiorespiratory fitness also lowers the severity and mortality of communicable diseases such as upper respiratory tract infection and pneumonia. The purpose of this paper is to explore published research regarding the impact of both good and poor cardiorespiratory fitness on the risk of severity and mortality after infection with COVID-19, and any potential mechanisms. Data was collected via the Google Scholar search engine using keywords cardiorespiratory fitness, exercise, COVID-19, and mortality. Results: evidence derived from epidemiological research confirm that increasing physical activity and regular exercise and improving cardiorespiratory fitness lowers the risks of hospitalization, admission to the intensive care unit, and mortality after being infected with COVID-19. Improved cardiorespiratory fitness through increased physical activity and regular exercise likely promotes immune surveillance and defense; reduces the pathway of viral entry into cells; improves anti-inflammatory and anti-oxidant capacity; increases mitochondrial biogenesis, density, number, structure, and function; and subsequently reduces cytokine storm and protects the human body from severe damage by COVID-19.

並列關鍵字

physical activity ； upper respiratory tract infection ； pneumonia ； mitochondrial biogenesis ； cytokine storm

參考文獻

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Arazi, H., Falahati, A., & Suzuki, K. (2021). Moderate intensity aerobic exercise potential favorable effect against COVID-19: The role of renin-angiotensin system and immunomodulatory effects. Frontiers in Physiology, 12, 747200. https://doi.org/10.3389/fphys.2021.747200

Arena, R., Bond, S., Calvo, I. R., Lebowicz, L., Ozemek, C., Severin, R., Laddu, D., Faghy, M. A., Lavie, C. J., & Carbone, S. (2022). Shelter from the cytokine storm: Healthy living is a vital preventative strategy in the COVID-19 era. Progress in Cardiovascular Diseases, 73, 56-60. https://doi.org/10.1016/j.pcad.2021.06.008

Boccalandro. F., & Von Schoettler, H. (2018). Exercise stress testing. In G. N. Levine (Ed.), Cardiology secrets (5th ed., pp. 38-45). Elsevier. https://doi.org/10.1016/B978-0-323-47870-0.00005-2

Brandenburg, J. P., Lesser, I. A., Thomson, C. J., & Giles, L. V. (2021). Does higher self-reported cardiorespiratory fitness reduce the odds of hospitalization from COVID-19? Journal of Physical Activity and Health, 18(7), 782-788. https://doi.org/10.1123/jpah.2020-0817

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