lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Physical Activity, Immune Function and Risk of Community Acquired Infectious Disease in the General Population: Systematic Review and Meta-Analysis

27 Pages Posted: 8 Oct 2020

See all articles by Sebastien Chastin

Sebastien Chastin

Glasgow Caledonian University - Department of Physiotherapy and Paramedicine

Ukachukwu Abaraogu

School of Health and Life Science, Glasgow Caledonian University

Jan Bourgois

Department of Movement and Sports Sciences, Ghent University

Philippa Dall

Glasgow Caledonian University - School of Health and Life Sciences

Jennifer Darnborough

Mott MacDonald Group - Public Health

Elaine Duncan

Glasgow Caledonian University - School of Health and Life Sciences

Jasmien Dumortier

Department of Movement and Sports Sciences, Ghent University

David Jiménez Pavón

MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences University of Cádiz

Joanna McParland

Glasgow Caledonian University - School of Health and Life Sciences

Nicola Roberts

Glasgow Caledonian University - School of Health and Life Sciences

Mark Hamer

Imperial College London - Institute Sport Exercise & Health; Loughborough University - School of Sport, Exercise and Health Sciences

More...

Abstract

Background: Regular physical activity is prime modality for the prevention of numerous non-communicable diseases and has also been advocated for resilience against COVID-19 and other infectious diseases. However, there is currently no systematic and quantitative evidence synthesis of the association between habitual physical activity and the strength of human immune system.

Methods: We conducted systemic review and meta-analysis according to PRISMA guidelines and following a pre-registered protocol (PROSPERO CRD42020178825 ). We searched seven databases (MEDLINE, Embase, Cochrane CENTRAL, Web of Science, CINAHL, PsycINFO, and SportDiscus) up to April 2020 for randomised control trials and prospective observational studies were included if they compared groups of adults with different levels of physical activity and reported immune system cell count, concentration of antibody, risk of clinically diagnosed infections, risk of hospitalisation and mortality due to infectious disease. Studies involving elite athletes were excluded. The quality of the selected studies was critically examined following the Cochrane guidelines using ROB2 and ROBINS_E. Data were pooled using a random-effects model. 

Findings: A total of 16833 abstract were screened to identify 55 studies including seven prospective studies and 48 randomised control trials. The meta-analysis showed that higher level of habitual physical activity is associated with a 31% risk reduction (HR= 0.69 CI [0.61 – 0.78]) of community acquired infectious disease and 37% risk reduction (HR= 0.64 CI [0.59 – 0.70]) of infectious disease mortality. Randomised control trials showed that physical activity interventions resulted in increased immunosurveillance cell counts (CD4+, 32 cells/µL, 95% CI 7 to 56 cells/µL), increased immunoglobulin IgA concentration (standardised mean difference 0.311, 95% CI 0.131 to 0.484) and decreased neutrophil counts (704 cells/µL, 95% CI 68 to 1340) compared to inactive controls. Physical activity increased antibody concentration after vaccination compared to vaccination without adjunct physical activity (standardised mean difference 0.210, 95% CI 0.015 to 0.406). Results differed between healthy adults, obese adults, clinical population and older adults. There appear to be no moderating effects of physical activity volume, intensity or type.

Interpretation: The practice of any type of regular, moderate to vigorous physical activity appears to be associated with enhanced immunosurveillance and mucosal immune responses. This is likely to explain the significant risk reduction of community acquired infectious diseases and infectious disease mortality, as well as an increase in the potency of vaccination.

Funding Statement: None.

Declaration of Interests: None.

Keywords: Exercise, inactivity, pneumonia, COVID19, SARS, coronavirus, HIV, upper respiratory tract infection, walking, cycling, running

Suggested Citation

Chastin, Sebastien and Abaraogu, Ukachukwu and Bourgois, Jan and Dall, Philippa and Darnborough, Jennifer and Duncan, Elaine and Dumortier, Jasmien and Jiménez Pavón, David and McParland, Joanna and Roberts, Nicola and Hamer, Mark, Physical Activity, Immune Function and Risk of Community Acquired Infectious Disease in the General Population: Systematic Review and Meta-Analysis. Available at SSRN: https://ssrn.com/abstract=3673184 or http://dx.doi.org/10.2139/ssrn.3673184

Sebastien Chastin (Contact Author)

Glasgow Caledonian University - Department of Physiotherapy and Paramedicine ( email )

Cowcaddens Road
Glasgow G4 0BA, Scotland
United Kingdom

Ukachukwu Abaraogu

School of Health and Life Science, Glasgow Caledonian University ( email )

Jan Bourgois

Department of Movement and Sports Sciences, Ghent University ( email )

Philippa Dall

Glasgow Caledonian University - School of Health and Life Sciences

Cowcaddens Road
Glasgow G4 0BA
United Kingdom

Jennifer Darnborough

Mott MacDonald Group - Public Health

Mumbai
India

Elaine Duncan

Glasgow Caledonian University - School of Health and Life Sciences

Jasmien Dumortier

Department of Movement and Sports Sciences, Ghent University ( email )

David Jiménez Pavón

MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences University of Cádiz ( email )

Joanna McParland

Glasgow Caledonian University - School of Health and Life Sciences

Cowcaddens Road
Glasgow G4 0BA
United Kingdom

Nicola Roberts

Glasgow Caledonian University - School of Health and Life Sciences

Cowcaddens Road
Glasgow G4 0BA
United Kingdom

Mark Hamer

Imperial College London - Institute Sport Exercise & Health ( email )

London
United Kingdom

Loughborough University - School of Sport, Exercise and Health Sciences ( email )

Ashby Road
Nottingham NG1 4BU
Great Britain

Click here to go to TheLancet.com

Paper statistics

Abstract Views
6,257
Downloads
964
PlumX Metrics