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Exercise may prevent ARDS in COVID-19 patients

Regular exercise helps to prevent a potentially fatal complication of COVID-19 infection. According to a review by Dr. Zhen Yan of the UVA School of Medicine, exercise has protective effects against acute respiratory distress syndrome (ARDS), which is a major cause of death among COVID-19 patients. 

Acute respiratory distress syndrome (ARDS) is characterized by severe shortness of breath. With this condition, fluid accumulates in the air sacs of the lungs and deprives the body of oxygen.

Dr. Yan found strong evidence to suggest that exercise can prevent or reduce the severity of ARDS.

The Centers for Disease Control and Prevention estimates that 20 to 42 percent of patients hospitalized for COVID-19 will develop ARDS. Among patients admitted to intensive care, 67 to 85 percent will develop the dangerous respiratory condition. 

“All you hear now is either social distancing or ventilator, as if all we can do is either avoiding exposure or relying on a ventilator to survive if we get infected,” said Dr. Yan. “The flip side of the story is that approximately 80% of confirmed COVID-19 patients have mild symptoms with no need of respiratory support. The question is why. Our findings about an endogenous antioxidant enzyme provide important clues and have intrigued us to develop a novel therapeutic for ARDS caused by COVID-19.”

Dr. Yan conducted an in-depth review of existing medical research to investigate an antioxidant known as extracellular superoxide dismutase (EcSOD). 

This is a powerful antioxidant which seeks out harmful free radicals to protect body tissues and help prevent disease. EcSOD is naturally secreted by the muscles, but the production of the potent antioxidant is boosted by cardiovascular exercise.

Dr. Yan found that diseases such as acute lung disease, heart disease, and kidney failure are associated with a significant decrease in EcSOD. 

Animal studies have shown that blocking EcSOD’s production worsens heart problems, while increasing its production can benefit heart health. 

Dr. Yan emphasizes that even a single session of exercise increases production of EcSOD. He is urging people to find ways to exercise, even while sheltering in place.

“We cannot live in isolation forever,” said Dr. Yan. “Regular exercise has far more health benefits than we know. The protection against this severe respiratory disease condition is just one of the many examples.”

The findings indicate that EcSOD may ultimately be used as a treatment for ARDS and many other health conditions. For example, gene therapy could be used to increase production of the antioxidant in patients battling COVID-19 to help protect the lungs and other organs.

EcSOD may prove beneficial against multi-organ dysfunction syndrome, a condition in which multiple organs begin to fail. Dr. Yan suggests that a better understanding of EcSOD’s function will allow doctors to unleash its potential in a more targeted and effective way. 

“We often say that exercise is medicine. EcSOD set a perfect example that we can learn from the biological process of exercise to advance medicine,” said Dr. Yan. “While we strive to learn more about the mysteries about the superb benefits of regular exercise, we do not have to wait until we know everything.”

The study is published in the journal Redox Biology.

By Chrissy Sexton, Staff Writer


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