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BackgroundMyokines, released from the contracting muscle, enable communication between the working muscles and other tissue. Their release during physical exercise is assumed to depend on mode, duration, and intensity.ObjectiveThe aim is to examine the acute changes in circulating levels of the myokines IL-6, IL-10, and IL-1ra induced by a bout of resistance exercise and to consider potential moderators of the results.MethodsSystematic literature search was conducted for resistance exercise intervention studies measuring IL-6, IL-10, or IL-1ra before and immediately after resistance exercise in healthy individuals. Random effects meta-analysis was performed for each myokine.ResultsA small to moderate positive effect of resistance exercise for IL-6 and a moderate to large positive effect for IL-1ra were detected. This could not be shown for IL-10. No moderators of the results were detected.ConclusionThis systematic review and meta-analysis clearly showed the immediate positive effects of an acute resistance exercise session on IL-6 and IL-1ra levels.

Long Covid kann nicht mit einem klassischen Verlust der Kondition durch Trainingspause nach Infektionserkrankungen verglichen werden. Die Wiederaufnahme sportlicher Aktivitäten stellt hinsichtlich der Symptomatik der Betroffenen und den assoziierten Pathomechanismen spezielle Herausforderungen. Ein Überblick über den aktuellen Wissensstand.

BackgroundRecovery from coronavirus disease 2019 (COVID-19) can be impaired by the persistence of symptoms or new-onset health complications, commonly referred to as Long COVID. In a subset of patients, Long COVID is associated with immune system perturbations of unknown etiology, which could be related to compromised immunoregulatory mechanisms.ObjectiveThe aim of this scoping review was to investigate if regulatory T cell (Treg) dysregulation is observable beyond the acute illness and if it might be involved in Long COVID immunopathology.DesignA systematic search of studies investigating Tregs during COVID-19 convalescence was conducted on MEDLINE (via Pubmed) and Web of Science.ResultsThe literature search yielded 17 relevant studies, of which three included a distinct cohort of patients with Long COVID. The reviewed studies suggest that the Treg population of COVID-19 patients can reconstitute quantitatively and functionally during recovery. However, the comparison between recovered and seronegative controls revealed that an infection-induced dysregulation of the Treg compartment can be sustained for at least several months. The small number of studies investigating Tregs in Long COVID allowed no firm conclusions to be drawn about their involvement in the syndrome’s etiology. Yet, even almost one year post-infection Long COVID patients exhibit significantly altered proportions of Tregs within the CD4+ T cell population.ConclusionsPersistent alterations in cell frequency in Long COVID patients indicate that Treg dysregulation might be linked to immune system-associated sequelae. Future studies should aim to address the association of Treg adaptations with different symptom clusters and blood parameters beyond the sole quantification of cell frequencies while adhering to consensualized phenotyping strategies.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative virus for the pandemic coronavirus disease 2019 (COVID-19). After more than one year it becomes apparent that for some patients the acute symptoms can persist for several months. Post-acute COVID-19 is defined as the persistence of symptoms and/or long-term complications beyond 4 weeks from the onset of the acute symptoms. Even though the evidence is preliminary, the prevalence in the general population is reported to range from 15 to 30%. The symptoms can be assigned to numerous organ systems and are described as very heterogenous with regards to their number, duration and severity. To this day it is not exactly known what causes the subacute and chronic manifestation of acute COVID-19. The treatment should be guided by the individual symptoms of the patients. To prevent setbacks, it is recommended to plan and monitor physical activity carefully. Athletes returning to sports with or recovered from post-acute COVID-19 require a thorough physical examination and a stepwise increase of training load to prevent long-term organ damage and a reduction in physical capacity. The aim of the scoping review is to summarize ongoing symptoms and possible causes for post-acute COVID-19 (“long-COVID”) and to classify essential aspects for post-acute COVID-19 management to regain physical fitness on the basis of current evidence. © 2021 Das schwere akute respiratorische Syndrom Coronavirus 2 (SARS-CoV-2) ist der Erreger der pandemischen Erkrankung COVID-19, fur die nach mehr als einem Jahr erkennbar ist, dass nach einer uberstandenen akuten Erkrankung andauernde Symptome existieren konnen. Als post-akutes COVID-19 werden das Anhalten klinischer Symptome und/oder das Auftreten langfristiger Komplikationen uber 4 Wochen nach der akut symptomatischen Krankheitsphase hinaus definiert. Aussagen uber die Pravalenz sind vorlaufig und abhangig vom Betrachtungszeitraum und untersuchter Bevolkerungsgruppe. In der Allgemeinbevolkerung wird das Auftreten derzeit mit einem Anteil von 15-30% der Infizierten angegeben. Die angegebenen Symptome lassen sich einer Vielzahl von Organsystemen zuordnen und weisen, was Anzahl, Dauer und Schweregrad anbelangt, teilweise grose, interindividuelle Unterschiede auf. Die Ursachen fur die subakute und chronische Manifestation der Symptome sind noch ungeklart und verschiedene Mechanismen, wie funktionelle Einschrankungen multipler Organsysteme durch Gewebeschadigung sowie eine postivirale Autoimmunitat werden diskutiert. Cluster aus moglichen individuellen Risikofaktoren, wie Alter und Geschlecht, kombiniert mit den Symptomen in der Akutphase zeigen sich am vielversprechendsten, um die Entwicklung von post-akutem COVID-19 zu prognostizieren. Ziel des Scoping Reviews ist es, andauernde Symptome und mogliche Ursachen fur post-akutes COVID-19 (”long-COVID“) zusammenzufassen und wesentliche Aspekte fur ein post-akutes COVID-19-Management zur Wiedererlangung der korperlichen Leistungsfahigkeit evidenzbasiert einzuordnen. © 2021

The nervous system integrates the immune system in the systemic effort to maintain or restore the organism's homeostasis. Acute bouts of exercise may alter the activity of specific pathways associated with neuroendocrine regulation of the immune system.To examine the acute effects of heavy resistance exercise on biomarkers of neuroendocrine-immune regulation in healthy adults.A systematic literature search was conducted using PubMed, Cochrane Controlled Trials Register, Web of Science and SportDiscus with no date restrictions up to March 2021. Clinical trials in English or German were included if they measured the blood plasma or serum concentrations of specific biomarkers of neuroendocrine-immune regulation (adrenaline, noradrenaline, acetylcholine, vasoactive intestinal peptide (VIP), cortisol, growth hormone, calcitonin gene-related peptide (CGRP), substance p, serotonin, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) or glia-derived neurotrophic factor (GDNF)) in a resting state prior to and no later than 60 minutes after an acute bout of heavy resistance exercise in healthy adults.7801 records were identified through literature search, of which 36 studies, with a total of 58 intervention groups, met the inclusion criteria. Evidence was found that an acute bout of heavy resistance exercise increased the levels of adrenaline (median: 185%), noradrenaline (median: 113%) and GH (median: 265%) immediately after the exercise. Mixed results were found for cortisol (median: 0%), suggesting that its response might be more sensitive to the configuration of the exercise scheme. The limited evidence regarding the effects on BDNF and ACTH allows no firm conclusions to be drawn about their response to heavy resistance exercise. The vast majority of the included studies reported a return of the biomarker concentrations to their baseline value within one hour after the termination of the exercise bout. No studies were identified that investigated the response of acetylcholine, VIP, CGRP, substance p, serotonin, NGF or GDNF to heavy resistance exercise.A bout of heavy resistance exercise alters the circulating concentrations of selected biomarkers of neuroendocrine-immune regulation. Both subject characteristics, such as sex as well as exercise parameters, such as rest intervals appear to have the potential to influence these effects.

The pandemic coronavirus disease 2019 (COVID-19) can cause multi-systemic symptoms that can persist beyond the acute symptomatic phase. The post-acute sequelae of COVID-19 (PASC), also referred to as long COVID, describe the persistence of symptoms and/or long-term complications beyond 4 weeks from the onset of the acute symptoms and are estimated to affect at least 20% of the individuals infected with SARS-CoV-2 regardless of their acute disease severity. The multi-faceted clinical picture of long COVID encompasses a plethora of undulating clinical manifestations impacting various body systems such as fatigue, headache, attention disorder, hair loss and exercise intolerance. The physiological response to exercise testing is characterized by a reduced aerobic capacity, cardiocirculatory limitations, dysfunctional breathing patterns and an impaired ability to extract and use oxygen. Still, to this day, the causative pathophysiological mechanisms of long COVID remain to be elucidated, with long-term organ damage, immune system dysregulation and endotheliopathy being among the hypotheses discussed. Likewise, there is still a paucity of treatment options and evidence-based strategies for the management of the symptoms. In sum, this review explores different aspects of long COVID and maps the literature on what is known about its clinical manifestations, potential pathophysiological mechanisms, and treatment options.