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The Role of Exercise as a Treatment and Preventive Strategy during Covid-19 Pandemic

Yıl 2020, Sayı: Special Issue on COVID 19, 238 - 245, 20.03.2020
https://doi.org/10.21673/anadoluklin.731902

Öz

On 11 March 2020, World Health Organization has made the assessment that COVID-19 can be characterized as a pandemic. COVID-19 is a usually self-limited infection but it can be present a severe and fatal disease in patients with comorbitidies and the elderly. The characteristics of the virus and general health condition of the host determine disease progression. Scientists have been investigating on the pathophysiology of this disease, diagnostic tools, effective treatment protocols, and the development a vaccine. Preventive strategies are as important as the treatment modalities. This review focuses on the pathophysiological mechanisms of COVID-19, in addition to the roles of exercise in the immunomodulatory mechanisms, host defense systems, and also prevention and treatment of COVID-19. Exercise exerts many important effects such as immunomodulation, augmented defense system on the immune system via mainly muscle derived myokines and increased cardiorespiratory endurance. COVID- 19 pandemic once again demonstrated the importance of prophylactic approaches such as healthy life, maintaining and strengthening of health, and immune system modulation. This pandemic may start a period in which humanity prioritizes healthy living principles, functional foods, maintaining health and welfare approaches, and increased effort to develop and maintain them.

Kaynakça

  • 1. COVID-19 situation reports [Internet]. World Health Organization. 2020 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  • 2. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. World Health Organization. 2020 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  • 3. Coronavirus disease 2019 [Internet]. World Health Organization. 2020 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  • 4. Coronaviridae - an overview | ScienceDirect Topics [Internet]. [kaynak 04 Mayıs 2020]. Available at: https://www.sciencedirect.com/topics/neuroscience/coronaviridae
  • 5. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity. 2020.
  • 6. Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, vd. Virology, epidemiology, pathogenesis, and control of covid-19. Viruses. 2020.
  • 7. Symptoms of Coronavirus | CDC [Internet]. Centers for Disease Control and Prevention. 2020 [04 Mayıs 2020]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
  • 8. Newton AH, Cardani A, Braciale TJ. The host immune response in respiratory virus infection: balancing virus clearance and immunopathology. Seminars in Immunopathology. 2016.
  • 9. Cao W, Li T. COVID-19: towards understanding of pathogenesis. Cell Res [Internet]. 28 Mayıs 2020 [kaynak 04 Mayıs 2020];30(5):367–9. Available at: http://www.nature.com/articles/s41422-020-0327-4
  • 10. Mason RJ. Pathogenesis of COVID-19 from a cell biologic perspective. The European respiratory journal. 2020.
  • 11. Patel VB, Zhong JC, Grant MB, Oudit GY. Role of the ACE2/angiotensin 1-7 axis of the renin-angiotensin system in heart failure. C. 118, Circulation Research. Lippincott Williams and Wilkins; 2016. s. 1313–26.
  • 12. South AM, Diz D, Chappell MC. COVID-19, ACE2 and the Cardiovascular Consequences. American journal of physiology. Heart and circulatory physiology. 2020.
  • 13. Richard J. Simpson. Exercise, Immunity and the COVID-19 Pandemic [Internet]. American College of Sports Medicine. 2020 [kaynak 02 Mayıs 2020]. Available at: https://www.acsm.org/home/featured-blogs---homepage/acsm-blog/2020/03/30/exercise-immunity-covid-19-pandemic
  • 14. Nieman DC, Wentz LM. The compelling link between physical activity and the body’s defense system. J Sport Heal Sci. 2019;8(3):201–17.
  • 15. Simpson RJ, Katsanis E. The immunological case for staying active during the COVID-19 pandemic. Brain Behav Immun [Internet]. 2020;(April):0–1. Available at: https://doi.org/10.1016/j.bbi.2020.04.041
  • 16. Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract infection is reduced in physically fit and active adults. Br J Sports Med. 01 Eylül 2011;45(12):987–92.
  • 17. Kostka T, Berthouze SE, Lacour JR, Bonnefoy M. The symptomatology of upper respiratory tract infections and exercise in elderly people. Med Sci Sports Exerc. 2000;32(1):46–51.
  • 18. Martin SA, Pence BD, Woods JA. Exercise and Respiratory Tract Viral Infections.
  • 19. Organization WH. Supporting older people during the COVID-19 pandemic is everyone’s business [Internet]. World Health Organization; 2020 [kaynak 04 Mayıs 2020]. Available at: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/4/supporting-older-people-during-the-covid-19-pandemic-is-everyones-business
  • 20. Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis. 2020;(xxxx):9–11.
  • 21. Pollock RD, O’Brien KA, Daniels LJ, Nielsen KB, Rowlerson A, Duggal NA, vd. Properties of the vastus lateralis muscle in relation to age and physiological function in master cyclists aged 55-79 years. Aging Cell. Nisan 2018;17(2):e12735.
  • 22. Bialek S, Gierke R, Hughes M, McNamara LA, Pilishvili T, Skoff T. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep [Internet]. 10 Nisan 2020 [kaynak 04 Mayıs 2020];69(14):422–6. Available at: http://www.cdc.gov/mmwr/volumes/69/wr/mm6914e4.htm?s_cid=mm6914e4_w
  • 23. Radom-Aizik S. COVID-19, Exercise, Children and their Developing Immune System [Internet]. American College of Sports Medicine. 2020 [kaynak 02 Mayıs 2020]. Available at: https://www.exerciseismedicine.org/support_page.php/stories/?b=899
  • 24. World Health Organization. Global Recommendations on Physical Activity for Health [Internet]. 2010 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/dietphysicalactivity/publications/9789241599979/en/
  • 25. Regular exercise benefits immunity -- even in isolation -- ScienceDaily [Internet]. [kaynak 02 Mayıs 2020]. Available at: https://www.sciencedaily.com/releases/2020/03/200331162314.htm
  • 26. Turner J, Campbell JP. Regular exercise has long-term benefits for immunity – it’s important to stay active [Internet]. The Conversation. 2020 [kaynak 04 Mayıs 2020]. Available at: https://theconversation.com/regular-exercise-has-long-term-benefits-for-immunity-its-important-to-stay-active-135836
  • 27. Simpson RJ, Krüger K, Walsh NP, Campbell JP, Gleeson M, Nieman DC, vd. Can exercise affect immune function to increase susceptibility to infection? Exerc Immunol Rev. 2020;26:8–22.
  • 28. David Oliver. Coronavirus: Don’t exercise TOO much during quarantine. Here’s why [Internet]. USA TODAY. 2020 [kaynak 02 Mayıs 2020]. Available at: https://www.usatoday.com/story/life/health-wellness/2020/04/30/coronavirus-dont-exercise-too-much-during-quarantine-heres-why/3048034001/
  • 29. Pedersen BK. Muscles and their myokines. J Exp Biol. 15 Ocak 2011;214(2):337–46.
  • 30. Steensberg A. The role of il-6 in exercise-induced immune changes and metabolism. C. 9, Exercise Immunology Review. 2003. s. 40–7.
  • 31. Karstoft K, Pedersen BK. Exercise and type 2 diabetes: Focus on metabolism and inflammation. Immunology and Cell Biology. 2016.
  • 32. Cerqueira É, Marinho DA, Neiva HP, Lourenço O. Inflammatory Effects of High and Moderate Intensity Exercise—A Systematic Review. Front Physiol [Internet]. 09 Ocak 2020 [kaynak 02 Mayıs 2020];10:1550. Available at: https://www.frontiersin.org/article/10.3389/fphys.2019.01550/full
  • 33. Duggal NA, Niemiro G, Harridge SDR, Simpson RJ, Lord JM. Can physical activity ameliorate immunosenescence and thereby reduce age-related multi-morbidity? Nat Rev Immunol. 01 Eylül 2019;19(9):563–72.
  • 34. Adams GR, Zaldivar FP, Nance DM, Kodesh E, Radom-Aizik S, Cooper DM. Exercise and leukocyte interchange among central circulation, lung, spleen, and muscle. Brain Behav Immun. 01 Mayıs 2011;25(4):658–66.
  • 35. Lancaster GI, Febbraio MA. The immunomodulating role of exercise in metabolic disease. C. 35, Trends in Immunology. Elsevier Ltd; 2014. s. 262–9.
  • 36. Trochimiak T, Hübner-Woźniak E. Effect of exercise on the level of immunoglobulin a in saliva. Biol Sport. 2012;29(4):255–61.
  • 37. Mohamed A, Alawna M. Role of increasing the aerobic capacity on improving the function of immune and respiratory systems in patients with coronavirus (COVID-19): A review. Diabetes Metab Syndr Clin Res Rev [Internet]. 2020; Available at: https://doi.org/10.1016/j.dsx.2020.04.038
  • 38. Booth FW, Roberts CK, Thyfault JP, Ruegsegger GN, Toedebusch RG. Role of inactivity in chronic diseases: Evolutionary insight and pathophysiological mechanisms. C. 97, Physiological Reviews. American Physiological Society; 2017. s. 1351–402.
  • 39. Zhu W. Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods. J Sport Heal Sci. 2020;
  • 40. İNAL İNCE D, VARDAR YAĞLI N, SAĞLAM M, ÇALIK KÜTÜKCÜ E. Yeni Tip Koronavirüs Kaynaklı COVID-19 (SARS-Cov-2) Enfeksiyonunda Akut Dönem ve Postakut Dönemde Fizyoterapi ve Rehabilitasyon. Türk Fiz ve Rehabil Derg [Internet]. 17 Nisan 2020 [kaynak 04 Mayıs 2020];31(1):81–93. Available at: https://dergipark.org.tr/tr/doi/10.21653/tjpr.718877
  • 41. Kurtai̇ş Aytür Y, Füsun KÖSEOĞLU B, Özyemi̇şçi̇ Taşkiran Ö, Kutay ORDU GÖKKAYA N, Ünsal Deli̇ali̇oğlu S, Sonel Tur B, vd. SARS-COV-2 (COVİD-19) SONRASI PULMONER REHABİLİTASYON PRENSİPLERİ: AKUT VE SUBAKUT SÜRECİN YÖNETİMİ İÇİN REHBER. 2020.
  • 42. Kohl HW, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, vd. The pandemic of physical inactivity: Global action for public health. Lancet. 21 Temmuz 2012;380(9838):294–305.
  • 43. Staying Physically Active During the COVID-19 Pandemic [Internet]. World Health Organization. 2020. Available at: https://www.acsm.org/read-research/newsroom/news-releases/news-detail/2020/03/16/staying-physically-active-during-covid-19-pandemic
  • 44. Hall G, Laddu DR, Phillips SA, Lavie CJ, Arena R. A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Prog Cardiovasc Dis. 2020;(xxxx):4–6.

Covid-19 Salgınında Egzersizin Bir Tedavi ve Önleyici Strateji Olarak Rolü

Yıl 2020, Sayı: Special Issue on COVID 19, 238 - 245, 20.03.2020
https://doi.org/10.21673/anadoluklin.731902

Öz

11 Mart 2020’de Dünya Sağlık Örgütü (WHO) COVID-19 küresel salgınını ilan etti. COVID-19 genellikle kendi kendini sınırlayan bir enfeksiyon olduğu halde yaşlılarda ve komorbiditesi olan bireylerde çok daha ciddi ve ölümcül seyretmektedir. Virüsün özellikleri ve konağın genel sağlık durumu hastalığın nasıl seyredeceğini belirlemektedir. Bilim adamları bu hastalığın fizyopatolojisini açıklamak, teşhis yöntemlerini, etkili tedavi protokollerini ve aşısını geliştirmek için çalışıyorlar. Önleyici stratejiler tedavi yöntemleri kadar önemlidir. Bu derleme COVID-19 fizyopatolojisine, ve egzersizin immünomodülatör mekanizmalarda, konakçı savunma sistemlerinde ve COVID-19’un önlenmesinde ve tedavisindeki rollerine odaklanmaktadır. Egzersiz kardiyopulmoner dayanıklılığı ve kaslardan miyokinlerin üretimini artırarak immün sistemi güçlendirir ve immün yanıtı düzenler. COVID-19 salgını, sağlıklı yaşam, sağlığın korunması ve güçlendirilmesi ve bağışıklık sistemi modülasyonu gibi profilaktik yaklaşımların önemini bir kez daha göstermiştir. Bu salgın, insanoğlunun sağlıklı yaşam prensiplerini, fonksiyonel gıdaları, sağlığını korumayı ve refah yaklaşımlarını daha ön planda tuttuğu, ve bunları geliştirme ve sürdürme çabalarının arttığı bir dönemi başlatabilir.

Kaynakça

  • 1. COVID-19 situation reports [Internet]. World Health Organization. 2020 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  • 2. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. World Health Organization. 2020 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  • 3. Coronavirus disease 2019 [Internet]. World Health Organization. 2020 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  • 4. Coronaviridae - an overview | ScienceDirect Topics [Internet]. [kaynak 04 Mayıs 2020]. Available at: https://www.sciencedirect.com/topics/neuroscience/coronaviridae
  • 5. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity. 2020.
  • 6. Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, vd. Virology, epidemiology, pathogenesis, and control of covid-19. Viruses. 2020.
  • 7. Symptoms of Coronavirus | CDC [Internet]. Centers for Disease Control and Prevention. 2020 [04 Mayıs 2020]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
  • 8. Newton AH, Cardani A, Braciale TJ. The host immune response in respiratory virus infection: balancing virus clearance and immunopathology. Seminars in Immunopathology. 2016.
  • 9. Cao W, Li T. COVID-19: towards understanding of pathogenesis. Cell Res [Internet]. 28 Mayıs 2020 [kaynak 04 Mayıs 2020];30(5):367–9. Available at: http://www.nature.com/articles/s41422-020-0327-4
  • 10. Mason RJ. Pathogenesis of COVID-19 from a cell biologic perspective. The European respiratory journal. 2020.
  • 11. Patel VB, Zhong JC, Grant MB, Oudit GY. Role of the ACE2/angiotensin 1-7 axis of the renin-angiotensin system in heart failure. C. 118, Circulation Research. Lippincott Williams and Wilkins; 2016. s. 1313–26.
  • 12. South AM, Diz D, Chappell MC. COVID-19, ACE2 and the Cardiovascular Consequences. American journal of physiology. Heart and circulatory physiology. 2020.
  • 13. Richard J. Simpson. Exercise, Immunity and the COVID-19 Pandemic [Internet]. American College of Sports Medicine. 2020 [kaynak 02 Mayıs 2020]. Available at: https://www.acsm.org/home/featured-blogs---homepage/acsm-blog/2020/03/30/exercise-immunity-covid-19-pandemic
  • 14. Nieman DC, Wentz LM. The compelling link between physical activity and the body’s defense system. J Sport Heal Sci. 2019;8(3):201–17.
  • 15. Simpson RJ, Katsanis E. The immunological case for staying active during the COVID-19 pandemic. Brain Behav Immun [Internet]. 2020;(April):0–1. Available at: https://doi.org/10.1016/j.bbi.2020.04.041
  • 16. Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract infection is reduced in physically fit and active adults. Br J Sports Med. 01 Eylül 2011;45(12):987–92.
  • 17. Kostka T, Berthouze SE, Lacour JR, Bonnefoy M. The symptomatology of upper respiratory tract infections and exercise in elderly people. Med Sci Sports Exerc. 2000;32(1):46–51.
  • 18. Martin SA, Pence BD, Woods JA. Exercise and Respiratory Tract Viral Infections.
  • 19. Organization WH. Supporting older people during the COVID-19 pandemic is everyone’s business [Internet]. World Health Organization; 2020 [kaynak 04 Mayıs 2020]. Available at: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/4/supporting-older-people-during-the-covid-19-pandemic-is-everyones-business
  • 20. Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis. 2020;(xxxx):9–11.
  • 21. Pollock RD, O’Brien KA, Daniels LJ, Nielsen KB, Rowlerson A, Duggal NA, vd. Properties of the vastus lateralis muscle in relation to age and physiological function in master cyclists aged 55-79 years. Aging Cell. Nisan 2018;17(2):e12735.
  • 22. Bialek S, Gierke R, Hughes M, McNamara LA, Pilishvili T, Skoff T. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep [Internet]. 10 Nisan 2020 [kaynak 04 Mayıs 2020];69(14):422–6. Available at: http://www.cdc.gov/mmwr/volumes/69/wr/mm6914e4.htm?s_cid=mm6914e4_w
  • 23. Radom-Aizik S. COVID-19, Exercise, Children and their Developing Immune System [Internet]. American College of Sports Medicine. 2020 [kaynak 02 Mayıs 2020]. Available at: https://www.exerciseismedicine.org/support_page.php/stories/?b=899
  • 24. World Health Organization. Global Recommendations on Physical Activity for Health [Internet]. 2010 [kaynak 04 Mayıs 2020]. Available at: https://www.who.int/dietphysicalactivity/publications/9789241599979/en/
  • 25. Regular exercise benefits immunity -- even in isolation -- ScienceDaily [Internet]. [kaynak 02 Mayıs 2020]. Available at: https://www.sciencedaily.com/releases/2020/03/200331162314.htm
  • 26. Turner J, Campbell JP. Regular exercise has long-term benefits for immunity – it’s important to stay active [Internet]. The Conversation. 2020 [kaynak 04 Mayıs 2020]. Available at: https://theconversation.com/regular-exercise-has-long-term-benefits-for-immunity-its-important-to-stay-active-135836
  • 27. Simpson RJ, Krüger K, Walsh NP, Campbell JP, Gleeson M, Nieman DC, vd. Can exercise affect immune function to increase susceptibility to infection? Exerc Immunol Rev. 2020;26:8–22.
  • 28. David Oliver. Coronavirus: Don’t exercise TOO much during quarantine. Here’s why [Internet]. USA TODAY. 2020 [kaynak 02 Mayıs 2020]. Available at: https://www.usatoday.com/story/life/health-wellness/2020/04/30/coronavirus-dont-exercise-too-much-during-quarantine-heres-why/3048034001/
  • 29. Pedersen BK. Muscles and their myokines. J Exp Biol. 15 Ocak 2011;214(2):337–46.
  • 30. Steensberg A. The role of il-6 in exercise-induced immune changes and metabolism. C. 9, Exercise Immunology Review. 2003. s. 40–7.
  • 31. Karstoft K, Pedersen BK. Exercise and type 2 diabetes: Focus on metabolism and inflammation. Immunology and Cell Biology. 2016.
  • 32. Cerqueira É, Marinho DA, Neiva HP, Lourenço O. Inflammatory Effects of High and Moderate Intensity Exercise—A Systematic Review. Front Physiol [Internet]. 09 Ocak 2020 [kaynak 02 Mayıs 2020];10:1550. Available at: https://www.frontiersin.org/article/10.3389/fphys.2019.01550/full
  • 33. Duggal NA, Niemiro G, Harridge SDR, Simpson RJ, Lord JM. Can physical activity ameliorate immunosenescence and thereby reduce age-related multi-morbidity? Nat Rev Immunol. 01 Eylül 2019;19(9):563–72.
  • 34. Adams GR, Zaldivar FP, Nance DM, Kodesh E, Radom-Aizik S, Cooper DM. Exercise and leukocyte interchange among central circulation, lung, spleen, and muscle. Brain Behav Immun. 01 Mayıs 2011;25(4):658–66.
  • 35. Lancaster GI, Febbraio MA. The immunomodulating role of exercise in metabolic disease. C. 35, Trends in Immunology. Elsevier Ltd; 2014. s. 262–9.
  • 36. Trochimiak T, Hübner-Woźniak E. Effect of exercise on the level of immunoglobulin a in saliva. Biol Sport. 2012;29(4):255–61.
  • 37. Mohamed A, Alawna M. Role of increasing the aerobic capacity on improving the function of immune and respiratory systems in patients with coronavirus (COVID-19): A review. Diabetes Metab Syndr Clin Res Rev [Internet]. 2020; Available at: https://doi.org/10.1016/j.dsx.2020.04.038
  • 38. Booth FW, Roberts CK, Thyfault JP, Ruegsegger GN, Toedebusch RG. Role of inactivity in chronic diseases: Evolutionary insight and pathophysiological mechanisms. C. 97, Physiological Reviews. American Physiological Society; 2017. s. 1351–402.
  • 39. Zhu W. Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods. J Sport Heal Sci. 2020;
  • 40. İNAL İNCE D, VARDAR YAĞLI N, SAĞLAM M, ÇALIK KÜTÜKCÜ E. Yeni Tip Koronavirüs Kaynaklı COVID-19 (SARS-Cov-2) Enfeksiyonunda Akut Dönem ve Postakut Dönemde Fizyoterapi ve Rehabilitasyon. Türk Fiz ve Rehabil Derg [Internet]. 17 Nisan 2020 [kaynak 04 Mayıs 2020];31(1):81–93. Available at: https://dergipark.org.tr/tr/doi/10.21653/tjpr.718877
  • 41. Kurtai̇ş Aytür Y, Füsun KÖSEOĞLU B, Özyemi̇şçi̇ Taşkiran Ö, Kutay ORDU GÖKKAYA N, Ünsal Deli̇ali̇oğlu S, Sonel Tur B, vd. SARS-COV-2 (COVİD-19) SONRASI PULMONER REHABİLİTASYON PRENSİPLERİ: AKUT VE SUBAKUT SÜRECİN YÖNETİMİ İÇİN REHBER. 2020.
  • 42. Kohl HW, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, vd. The pandemic of physical inactivity: Global action for public health. Lancet. 21 Temmuz 2012;380(9838):294–305.
  • 43. Staying Physically Active During the COVID-19 Pandemic [Internet]. World Health Organization. 2020. Available at: https://www.acsm.org/read-research/newsroom/news-releases/news-detail/2020/03/16/staying-physically-active-during-covid-19-pandemic
  • 44. Hall G, Laddu DR, Phillips SA, Lavie CJ, Arena R. A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Prog Cardiovasc Dis. 2020;(xxxx):4–6.
Toplam 44 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm DERLEME
Yazarlar

Meltem Yalçın 0000-0001-8474-6464

Elif Koçak 0000-0002-0042-0633

Mehtap Kacar 0000-0002-1572-4787

Yayımlanma Tarihi 20 Mart 2020
Kabul Tarihi 22 Mayıs 2020
Yayımlandığı Sayı Yıl 2020 Sayı: Special Issue on COVID 19

Kaynak Göster

Vancouver Yalçın M, Koçak E, Kacar M. The Role of Exercise as a Treatment and Preventive Strategy during Covid-19 Pandemic. Anadolu Klin. 2020;25(Special Issue on COVID 19):238-45.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.