Exercise modulates the immune system in cardiorespiratory disease patients: Implications for clinical practice during the COVID-19 pandemic.
Snehil Dixit, Audrey Borghi-Silva, Kumar Gular and 5 others
PMID 36219921WHAT IT FOUND
Moderate exercise may support immune function, but high-intensity work can temporarily raise infection risk.
Evidence on reducing inflammation in heart and lung disease is inconsistent, and most included studies had poor quality.
Key findings
01The review found that moderate-intensity exercise can enhance immune function, while vigorous exercise may suppress it and increase infection risk.
02The bias risk assessment showed poor internal validity, with most included studies rated as having no or unclear safeguards against bias.
03Exercise training results on inflammatory markers were inconsistent, with some studies showing reductions and others showing no significant change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most included studies had poor internal validity, with unclear or absent randomization and blinding. The review included a mix of study designs (RCTs, case-control, pre-post), which limits the ability to draw firm conclusions about causality. There was a lack of data on long-term effects of exercise and nutrition on immune biomarkers. Many studies did not report adherence rates or adverse events clearly. The findings are based on a narrative synthesis of 28 studies, not a meta-analysis, so statistical pooling of results was not performed.
Declared interests
The study was funded by King Khalid University. The authors declared no competing interests.
The easy way to misread this
Do not assume that exercise universally improves immune function in cardiorespiratory patients. The review highlights that high-intensity exercise can temporarily suppress immunity and increase infection risk, and the overall evidence quality is low due to poor internal validity in most included studies.