PREVENTION OF NEUROLOGICAL COMPLICATIONS OF COVID-19 BY PHYSICAL EXERCISE

Abstract

The paper hypothesizes that atherosclerosis and / or heart failure may favor the neurological complications of COVID-19 via cerebral hypoxia -with the most affected structures being those that naturally express increased amounts of ACE2 in the brain and those adjacent to them. The hypothesis is supported by clinical and imaging arguments, as well as by the higher incidence of neurological complications of COVID-19 in patients with pre-existing neurological pathology and congestive heart failure. Prevention could be done once the SARS-CoV-2 infection has set in by multiple means e.g. medically (e.g. vasodilators, ACE2 blockers), use of oxygen therapy (however, the effectiveness and safety of administration are debatable) but especially before diagnosing the infection, by moderate intensity physical exercise, that activate genes /metabolic pathways promoting resistance of neurons to hypoxia. Aerobic exercise combined with breathing exercises can also prevent the expression of NRP1 and therefore the infection of astrocytes. Moderate intensity exercise could also be an effective secondary prophylaxis method, as it has been shown that COVID-19 could be a trigger for the atherosclerotic process.