Boosting your immune against COVID-19 infection

                                                Boosting your immune against COVID-19 infection

                                                                     Author: Supa Pudkasam, B.N.S, M.Sc. (exercise physiology), Ph.D. (nursing)         

                                                                            Faculty of Nursing Science, Assumption University, Bangkok, Thailand


Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) influenza virus now has been lasting for  three years which considering a number of new variants such as omicron and delta mutations (Suryasa, Rodríguez-Gámez, & Koldoris, 2021; Torjesen, 2021). It attacked many millions of people across the world and increased a huge number of deaths (Lai et al., 2020). There was an anticipation that the pandemic would terminate by the end of 2022, but it could be more fatal than seasonal influenza by 2023 (Chen, 2022).  Indeed, the whole world is concerned by the new SARS‐CoV‐2  variants as its rapid spread probably causes the high risk of mortality especially among vulnerable persons (Mallapaty, 2021).  Some people who were infected by SARS‐CoV‐2 have reported the manifestations of hyperinflammatory response such as releasing of pro-inflammatory cytokines which leading the susceptibility of infection, sepsis and multiple organs failure (Gustine & Jones, 2021).

Regarding to this global health issue, the development of COVID-19 vaccines is still continuing to cease the pandemic (Zhou & Wang, 2021). Mostly, the vaccines aim to bring on sturdy and durable human immunity response including antibodies and T cell-mediated immune to prevent severe acute respiratory tract infection and failure (Jeyanathan et al., 2020). Therefore, strengthening immunity and reducing systemic inflammatory process would be good ideas during SARS-CoV-2 spreading era. This article aims to discuss healthy lifestyles consisting of sufficient exercise, nutrition and sleep for boosting immune functions and attenuation of SARS-CoV-2 infection.

Immune functions and COVID-19 infection

The overall function of immune system is protection of host from foreign antigens such as microorganisms and chemicals (Schultz & Grieder, 1987). Immunological response can be classified into two processes. The first one is innate immunity or congenital process and the second is acquired immunity or adaptive process. Innate immunity is the first-line response against foreign antigens and processing through heredity. Meanwhile acquired immunity responds later as it memorises the pathogens and makes a specific reaction for fighting (Van Der Bie, 2006). COVID-19 infection is more severe than influenza virus because it results in adverse effects on human body by producing pro-inflammatory cytokines e.g., tumor necrosis factor α (TNF α), interleukin 1 and 6 (IL1 and IL6) which involve in tissue damage and pain (Rabaan et al., 2021). Additionally, it also suppresses human immunity (Rabaan et al., 2021). SARS-CoV-2 destroys immune system by involving in uncontrolled inflammatory process as evidence by lymphopenia, lymphocytes and monocytes dysfunction in severe patients with COVID-19 infection (Yang et al., 2020). Hence, the potential treatments for COVID-19 cases should be focusing on boosting antiviral immunity and inhibiting systemic inflammatory process (Yang et al., 2020). Interestingly, healthy lifestyles e.g., well-balanced diets , adequate exercise and well as sufficient sleep are likely to meet the requirement of mitigating  COVID-19 pathology (Lange & Nakamura, 2020).

The effect of nutrition on immune functions

Balanced diets and nutrients certainly strengthen immune system involving cell activation, enzyme functions and gene expression that can help in body tolerance with the impacts of viruses. Adequate nutrients such as vitamins ( A, B6, B12, C, and E), minerals (iron and zinc) and protein are vital mediators for strengthening immune functions as its can maintain the structure of bodily barriers such as epithelial tissue and integrity of skin (Gleeson, Nieman, & Pedersen, 2004; Gombart, Pierre, & Maggini, 2020). There are variety of vitamins and supplemental nutrition to help for prevention of viral infection; for example, vitamin A (beta-carotene in carrots, ripe papaya, tomato or pumpkin is a precursor) is effective to facilitate immune response after influenza vaccination in children. Likewise vitamin D (fatty fish and fish liver oils are the best sources) can help control infection and reduce the occurrence of acute respiratory tract infection (Jayawardena, Sooriyaarachchi, Chourdakis, Jeewandara, & Ranasinghe, 2020). Vitamin C (in citrus fruits e.g., orange, lemon, berries, tomato) has an antiviral effect and mitigates common cold symptoms. It can reduce systemic inflammatory response in COVID-19 patients (Bae & Kim, 2020). Nevertheless, excessive intake of vitamins and minerals is likely to suppress immune functions (Gleeson et al., 2004).

The effect of exercise on immune functions

Exercise has been recommended as one beneficial intervention for improvement of immune functions (Pudkasam & Apostolopoulos, 2022). It is well known that regular exercise or physical activity with moderate intensity can attenuate the incidence of infection (Gleeson, 2007). Moderate intensity of exercise can help to protect respiratory tract inflammation from viral infection (Ranasinghe, Ozemek, & Arena, 2020). In addition, performing long-termed light aerobic and/or weight training exercise can improve anti-inflammatory process which can reduce the incidence of chronic inflammatory diseases such as cardiovascular diseases, type 2 diabetes and cancers (Conraads et al., 2002; Ho, Dhaliwal, Hills, & Pal, 2013). In contrast, prolonged heavy exercise facilitates the susceptibility of infection (Gleeson, 2007).

Moderate physical activity is associated with the reduction in respiratory tract infection-related mortality. Regular physical activity seems to facilitate an effective response to COVID-19  vaccine (Polero et al., 2021). Hence, moderate aerobic exercise and duration should be suggested for all people particularly during the period of COVID-19 pandemic (Ranasinghe et al., 2020).

Sufficient sleep and immunity

The average of sufficient sleep time in adults between 7 to 9 hours daily is recommended to reduce health problems such as cardiovascular disease, diabetes and psychological distress (Park, Yoo, Kim, & Lee, 2021). More specifically, sufficient sleep time can reduce the incidence of COVID-19 infection (Park et al., 2021).Normally. the level of immune cells in human reaches a peak at night period and drops to its lowest level in the morning (Motivala & Irwin, 2007). Insufficient total sleeping time and deprivation of rapid eye movement sleeping can alter immune cells proliferation such as T-cell lymphocytes (e.g., CD4+ and CD8+); as a result, it is prone to get infection (Aman & Masood, 2020). There is a proof that short duration of sleep (less than 6 hours per night) is associated with the susceptibility of viral infection and depletion of longevity in human(Haspel et al., 2020).

Conclusion and Recommendation 

COVID-19 since 2019 has hit the world and caused a huge number of confirmed deaths (Lai et al., 2020). Even though vaccination for COVID-19 has been developing, there is the possibility of resistant SARS‐CoV‐2  variants (Aman & Masood, 2020). It is important to boost our immunity by healthy lifestyles such as balanced diets, regular exercise and sufficient sleep.  Well-balanced diets can play an important role of immunity strengthening. Micronutrients such as vitamins  and trace elements e.g., zinc, iron, and magnesium from several plants and meats should be advised for health (Calder, Carr, Gombart, & Eggersdorfer, 2020).

Exercise or physical activity for healthy people has been prescribed by the American College of Sport Medicine (ACSM) as such moderate intensity of aerobic activity for 150 minutes per week or heavy intensity for 75 minutes per week. In addition, weigh training at moderate to high intensity of arms and legs at least twice a week is highly recommended for general people (Ranasinghe et al., 2020).   

One more recommendation is enough sleeping at night that can strengthen human immune functions and protect viral infection (Haspel et al., 2020). Therefore, adopting such healthy habits may help to protect yourself from adverse effects of COVID-19 infection.


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