Physical exercise in the fight against long-lasting Covid – 01/06/2023 – Bruno Gualano

Still in 2020, while the macabre Placar da Vida celebrated the survivors of Covid-19 to cover up the ongoing slaughter, the first evidence appeared that the consequences of the disease would drag on in time, opposing, once again, the Bolsonarist notion of ” little flu”.

Today we know that the long Covid –as this condition is called– is capable of causing more than 200 symptoms, affecting virtually all organ systems. There are 65 million people affected around the world. At least 10% of the population infected. Among those hospitalized, the prevalence can reach 70%. Individuals between 36 and 50 years old and with a mild acute condition represent the majority of cases.

In mid-2022, aware of the profound impacts of the long Covid on collective health, the United States announced Recover – a national research plan to identify symptoms, elucidate mechanisms and develop treatments for this condition. In the initiative, US$ 1.15 billion was invested, something around R$ 7.5 billion. However, the conduct of clinical trials has been criticized for alleged slowness and disorganization.

The rush is justified. There are still no proven treatments for long Covid. And in the void of the unknown lives charlatanism. Patients have pinned their hopes on pseudoscientific therapies, most notably ivermectin party turkeys, multivitamin supplements, and satellite cells.

Behold, in this desert of news, hope emerges. Not exactly new, as we’ll see.

Since October 2020, our research laboratory at the Faculty of Medicine at USP has been treating patients who survived severe cases of Covid-19 with physical exercises at home. A group of patients randomly selected not to receive the intervention serves as a control.

Results of this study were recently released. Patients who underwent physical training –a four-month program with the remote supervision of a qualified professional— showed a significant improvement in their quality of life, notably in domains related to physical and functional health.

In addition, the proportion of long-term Covid symptoms was lower among those who exercised. Complaints of muscle pain, weakness and fatigue dropped. Promising data also point to improvements in muscle function and cardiac, respiratory, ventilatory and circulatory responses during physical exertion. During the study, no adverse events were identified.

As the prudent scientist’s booklet states, we need to recognize that further studies are needed, above all to confirm the viability of implementing programs of this nature in the SUS, from primary to specialized care.

The good news is that physical exercise is undeniable in public health. Its security profile is great. Its benefits, systemic. Its cost, very low. Here’s a good intervention recipe for the masses.

While investments in science do not materialize in innovative treatments for the long Covid, it is comforting to have an old ally.

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