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Semin Thromb Hemost 2020; 46(07): 807-814
DOI: 10.1055/s-0040-1715094
Review Article

Coronavirus (COVID-19), Coagulation, and Exercise: Interactions That May Influence Health Outcomes

Emma Kate Zadow
1   Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
,
Daniel William Taylor Wundersitz
1   Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
,
Diane Louise Hughes
1   Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
2   Department of Pharmacy and Biomedical Sciences, School of Molecular Sciences, La Trobe University, Bendigo, Victoria, Australia
,
Murray John Adams
3   College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
,
Michael Ian Charles Kingsley
1   Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
4   Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
,
Hilary Anne Blacklock
5   Department of Haematology, Middlemore Hospital, Auckland, New Zealand
,
Sam Shi Xuan Wu
6   Department of Health and Medical Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
,
Amanda Clare Benson
6   Department of Health and Medical Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
,
Frédéric Dutheil
7   Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, Clermont-Ferrand, France
,
Brett Ashley Gordon
1   Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Abstract

The proinflammatory cytokine storm associated with coronavirus disease 2019 (COVID-19) negatively affects the hematological system, leading to coagulation activation and endothelial dysfunction and thereby increasing the risk of venous and arterial thrombosis. Coagulopathy has been reported as associated with mortality in people with COVID-19 and is partially reflected by enhanced D-dimer levels. Poor vascular health, which is associated with the cardiometabolic health conditions frequently reported in people with severer forms of COVID-19, might exacerbate the risk of coagulopathy and mortality. Sedentary lifestyles might also contribute to the development of coagulopathy, and physical activity participation has been inherently lowered due to at-home regulations established to slow the spread of this highly infectious disease. It is possible that COVID-19, coagulation, and reduced physical activity may contribute to generate a “perfect storm,” where each fuels the other and potentially increases mortality risk. Several pharmaceutical agents are being explored to treat COVID-19, but potential negative consequences are associated with their use. Exercise is known to mitigate many of the identified side effects from the pharmaceutical agents being trialled but has not yet been considered as part of management for COVID-19. From the limited available evidence in people with cardiometabolic health conditions, low- to moderate-intensity exercise might have the potential to positively influence biochemical markers of coagulopathy, whereas high-intensity exercise is likely to increase thrombotic risk. Therefore, low- to moderate-intensity exercise could be an adjuvant therapy for people with mild-to-moderate COVID-19 and reduce the risk of developing severe symptoms of illness that are associated with enhanced mortality.

Keywords

coronavirus - pharmaceutical medications - coagulation - fibrinolysis - physical activity


Publication History

Article published online:
03 September 2020

© 2020. Thieme. All rights reserved.

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