Como cuidar do seu coração na pandemia do COVID-19: recomendações para a prática do exercício físico e respiratórios

Abstract

The first cases of Coronavirus (COVID-19) were reported in December 2019 in Wuhan Province (China) and the infection quickly spread throughout the world, despite the strategies adopted by the Chinese Government to stop this epidemiological phenomenon. Four months later, on April 14, 2020, COVID-19 became a worldwide pandemic with more than 1 million confirmed cases and almost 107,000 deaths worldwide (1). In Brazil, until April 14, 2020, 25,263 cases and 1,532 deaths were confirmed with a lethality rate of 4.6% (1). Most experts in epidemiology and infectology agree that much of the success in containing the virus in China is due to the rapid measures taken by authorities in imposing quarantine on the majority of the population. In this sense, weeks later, other countries that were also so seriously affected - such as Italy, Spain and the United States of America - adopted the most severe social quarantine strategies. Additionally, based on world information and as the pandemic progressed, some characteristics of the population at greatest risk for COVID-19 were identified. In this sense, epidemiological data showed that elderly individuals, those with pre-existing heart diseases, diabetics, with risk factors for cardiovascular diseases (CVD), and patients with respiratory diseases were more susceptible to more serious outcomes caused by COVID- 19 (1). In this context, the quarantine period establishing itself as the most appropriate strategy to slow the rapid spread of COVID-19, especially in Brazil - where the possibility of testing suspected cases, geographically identifying and isolating patients is small - this can have side effects about other health dimensions of patients and isolated individuals and, mainly, in those mentioned being in the risk group. Starting a sudden state of quarantine implies a radical change in the lifestyle of the population. In many cases, they can impact the level of physical activity (PA) and physical exercise to maintain an adequate state of health (2), with a negative impact on the control of certain diseases (3), such as diabetes, hypertension, CVD, respiratory diseases or simply to guarantee active aging, reduce the risk of frailty, sarcopenia and dementia, such as diseases associated with the elderly (4,5). In addition, the negative psychological impact of quarantine has recently been described (6). In this context, individuals are subjugated to post-traumatic stress, symptoms of confusion and anger. In addition, stressors that have become more prevalent with the longest quarantine duration have been identified, among which were identified: (i) fear of infection; (ii) frustration; (iii) boredom; (iv) lack of supplies; (v) inadequate information; (vi) financial losses; and, (vii) stigmas. On the other hand, PA and physical exercise have been shown to be an effective therapy for most chronic diseases with direct effects on mental and physical health (2-10). Considering biological mediators, physical exercise has been considered an effective approach to preventive and / or therapeutic benefits on human biological processes (2,8,10). The elderly person deserves special attention, because in this group of individuals, PA and physical exercise induce positive biological responses with additional effects on the characteristics of aging and associated diseases (11). In this sense, exercise in the elderly is able to prevent frailty, sarcopenia / dinapenia, risk of falls, self-esteem and cognitive impairment or decline (11,12). Therefore, in order not to interrupt or totally change people's lifestyle during quarantine and maintain an active lifestyle at home, it is important to consider the feasibility of maintaining the practice of physical exercise, even in small physical spaces, for the health of the population. in general, but mainly for those with risk factors for COVID-19 and the elderly.