During these last months, both during confinement, and once they began to go out on the street or the gyms reopened, the recommendation has been to continue doing physical exercise. Not only because it is a key point for taking care of our health, but also because it would help us to distract ourselves, and to alleviate the stress derived from the world situation.
It is also assumed that when we have the virus and are showing symptoms, even if they are mild, such as fever, cough or muscle pain, we should not and do not feel like playing sports. But what about asymptomatic people? Whether, despite not presenting symptoms clearly, we have been diagnosed with COVID or we have not even had a diagnosis, it is important that we know if it is a good idea to exercise being infected.
To know everything we need, we have spoken with the doctor Raquel Blasco (@RaquelBlascoR), Doctor of Internal Medicine, Professor of Health Science and expert in sports health.
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Being asymptomatic is also being sick
The first thing to remember is that if we test positive for COVID-19, whether we have symptoms or not, we must stay home confined until we test negative again. This means that, no matter how asymptomatic we are, we can’t exercise outside the home, not even with a mask.
In this sense, Dr. Blasco tells us: “when one is a carrier (of the virus), one is sick. (Asymptomatic patients) have the blessed fortune that either the viral load or the effect on our immune system are not sufficient important for the development of the disease to occur, but that does not mean that we are sick. This means carrier and contagion for others. ” Therefore, we must take responsibility for our actions towards our health and that of others.
What variables should be taken into account to decide whether to exercise not
Something that Raquel Blasco tells us is that it is a new virus, relatively unknown, about which we still don’t have enough information. Neither about it as a virus, nor about its effect on our body: “We are getting to know things, but we don’t know everything. For this reason, we are trying to apply the same common sense, epidemiology and immunity measures that we know of another virus that They may be similar to him, but I insist, we do not know that they are completely 100% accurate. “.
In this sense, it indicates that to give the necessary recommendations and considerations on sports and COVID, it is usually compared with a coronavirus of its lineage that makes the same alterations in the target organs that we consider most relevant when exercising: “fundamentally the system respiratory, cardiovascular and, third, musculoskeletal and articular, especially muscular “. In addition, the immune system would be “as the head and coordinator of everything,” the doctor tells us.
To exercise or not to exercise at home
Although we are asymptomatic, it is possible that the virus that we are carriers has affected any of the aforementioned organs or systems. And therefore there are certain things that we must take into account. The sports health expert tells us that what is known so far is that COVID-19 has a special appetite for the respiratory system, one of the most relevant for our physical activity: “but this special appetite that it has does not depend too much on the immunity of the individual, but of the viral load that has received “.
This means that even an asymptomatic person also has respiratory manifestations, although they are very mild, according to the doctor: “the individual who has been infected, even asymptomatic, may have respiratory manifestations, even if they are minimal.” In any case, Dr. Blasco points out that these manifestations surely limit sports activity very little and intense physical activity from the point of view of the respiratory system. But he clarifies: “one thing is that it affects very little and another thing is that it is convenient to exercise”.
These (respiratory) manifestations surely limit sports activity and intense physical activity very little from the point of view of the respiratory system.
And it is that now we enter the cardiovascular system and here things change a bit. In this sense, the doctor does not explain that it is highly unlikely that the cardiovascular system is unscathed in a person infected with COVID-19: “and it does not depend only on the viral load, but on the immune status of the person.” Contrary to what happened with the respiratory system.
“It is materially impossible for a person not to have defended (his immune system) firmly enough – sometimes even over-braking – and there has been inflammatory manifestations in your cardiovascular system“indiaca Raquel Blasco.
In the case of the musculoskeletal system, COVID seems to behave in a similar way to the cardiovascular system: “the greater the physical manifestations will occur the higher the viral load and the greater the immunological defense,” the doctor indicates.
In this sense, Dr. Blasco tells us that it is young people who are showing this muscle fatigue the most – although there are explanations such as higher mortality in older adults that have an influence – and reminds us that the heart is the most important muscle . This may lead to myocarditis in some people.
“We are seeing myocarditis in young patients already in consultation. But it is true that it is being seen in those patients who, even if they have had some clinical manifestation, even if it is mild. In asymptomatic patients, until now, we do not have any series” indicates the doctor , but he clarifies: “but we do not have series of anything, practically. The fact that we do not have series of this is just one more than we have to have there on radar to see what happens“.
In fact, she indicates that she informs her patients of what can happen in their bodies if they have had this infection – even if it has been without symptoms – so that they are aware and can value any manifestation, even a small one. In short, the doctor explains that is highly unlikely that an asymptomatic patient will pass without absolutely any clinical manifestations – except respiratory ones – and, therefore, this already restricts when exercising.
The importance of the immune system
“When we do a moderate to intense physical activity, substances of the immune system that we call natural killers. These are nonspecific and they load everything, they don’t care if it’s good or bad, they go a bit rough, but they know what they’re doing. Are they will remain elevated in the circulatory system while we do physical activity, “says Blasco.
This can be beneficial because when we stop, these substances return to their basal situation, distributing itself in those organs and systems where they can be used: “wherever: muscles, spleens, brain, spleen, even in tumor tissues” says the doctor. The problem comes when the physical exercise is too intense and too long in time, since these substances cannot return to their basal situation.
That is why the doctor indicates that: “excessive physical exercise – and it is excessive depending on the physical state of the individual – can go from being immunostimulatory to immunosuppressive, which is what we have to avoid. ”This can be applied when talking about sport in asymptomatic patients.
Exercise at home being asymptomatic, yes or no
In this case, the doctor tells us that we must specify what we mean by asymptomatic patient, since we remember that it is difficult to pass without any clinical manifestation. Therefore, in this case, we would talk about: “so few physical manifestations have been that we could consider him almost asymptomatic because he doesn’t even remember it, “says the doctor. In this case, she does recommend aerobic work.
The reason is the following: “it is the least aggressive work for the immune system and it is this that must now be pampered so that it continues to serve as an immunoprotector” recalls the doctor. The recommended intensity is one that does not reach 85% of the aerobic capacity of the individual in question, about four times a week for 45 minutes – Without spending an hour – as directed by Dr. Blasco.
The doctor’s recommendation is: “aerobic work 3/4 times a week; HIIT work 1 or 2 times a week, and the three times a week we have left we must not forget strength”.
In the case of interval work, it indicates that we can do it as well, provided that 50% of the time is effort that 85% passes and twice the time is dedicated to recovering. The specific recommendation that she makes us is: “aerobic work 3/4 times a week; I work on HIIT 1 or 2 times a week, and the three times a week that we have left we must not forget strength “.
The doctor tells us that strength training is almost mandatory: “it will help to release myokines in the muscle that will facilitate better immunity, if not that they activate and keep the substances fed natural killers of which we spoke before. “That yes, puts us on alert, and reminds us that we shouldn’t train maximum strength: “perform work that is around 70-75, even 80% of your maximum strength working large muscle groups for at least 30 hours”. Although the ideal would be about 45 minutes with breaks, says Blasco.
In short, exercise in asymptomatic patients, yes, but without forgetting, to begin with, that we cannot go outside and, later, that although we do not notice it, we will surely have some clinical manifestation. So it will be necessary and important that let’s adapt our physical activity to what we really need.
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