Covid-19: How to Improve Your Immunity and Prepare Your Lungs

The COVID-19 pandemic has been coined the “most crucial global health calamity of the century”, impacting the lives of millions of people around the globe. Due to its sudden appearance and rapid spreading, scientists called all hands on deck to quickly identify ways to ward this attack on our immune system and to overcome the pandemic. Recently, scientists have focused on the role of the lungs at the onset, during, and after respiratory infections, such as COVID-19, and have provided guidelines on how to best prepare your lungs for the battle with the virus enemy.

How COVID-19 affects us

The pandemic of COVID-19, caused by the SARS-CoV-2 virus, has spread to more than 150 countries around the world, causing immense economic, environmental, social and health challenges to the population. Transmission of the virus particles from person to person seems to mostly occur via droplet infection. Droplets with virus material are produced by coughing or sneezing, and may be either transferred to a new host directly, or via a surface, such as a shopping cart or a door handle, to then get picked up by the new host. The asymptomatic incubation period, during which the virus enters the body and replicates, producing many more virus particles, may take up to 14 days, during which time the virus can be transmitted to uninfected people.

While most people only develop mild symptoms, in about 14% of cases the diseases can progress to a more severe form, and in about 3% of cases, cause death. People with hypertension, cardiovascular disease, and diabetes are at an increased risk of developing severe symptoms [1–3]. Currently, there is no cure for COVID-19, and clinical studies are ongoing to identify effective treatment options.

What is the role of the lungs during COVID-19?

SARS-CoV-2 is a respiratory pathogen, which enters the body via the epithelium in our lower respiratory tract (lower lungs). The alveoli, in which the gas exchange that removes the carbon dioxide (CO2) from the bloodstream and replaces it with oxygen (O2) to fuel the body takes place, appear to be the most affected, particularly if the COVID-19 infection progresses to a more severe form. Fever, cough, fatigue and dyspnea (breathlessness) are common symptoms of COVID-19.

As the lung tissue is affected by the virus attack, the lungs start to work less effectively, while the infection is causing inflammation and activation of the local immune system of the lung. If the disease progresses, acute respiratory distress syndrome (ARDS) and potentially respiratory failure may occur, at which point the lungs are unable to meet the demand for ventilation and gas exchange, and are unable to provide the body with the essential oxygen.

The lungs therefore play an important role during all stages of the COVID-19 infection. They can also play a critical part in preparing for a potential infection, as well as during recovery.

Strengthening the respiratory system may help fight COVID-19

Recently, an interesting article published in the American Journal of Medicine suggested that poor performance of the respiratory muscles may contribute to a severe progression of respiratory infections such as COVID-19 [4]. The team around Richard Severin from the University of Illinois at Chicago argued that during respiratory infections, especially as the disease worsens, the respiratory pressure needed to do the work of breathing increases. If the respiratory muscles are impaired, either by age, or by diseases such as obesity, chronic lung disease or heart disease, the lungs are not unable to meet the increasing pressure demand, leading to a more rapid route to respiratory complications and distress.

Strengthening the respiratory muscles by respiratory muscle training (RMT) can therefore help to keep the balance of pressure and work of breathing positive for longer, potentially averting a worsening of disease. RMT using the Breather may be a good way to build up the lungs before potential infections, for example before flu season, or in the face of a pandemic.

Rebuilding respiratory function can help recovery after COVID-19

As COVID-19 and other respiratory pathogen infections affect the lungs and the respiratory system, rehabilitation is important to build up respiratory function again after the acute stage of infection or disease. Respiratory disorders can result in respiratory muscle weakness. Reconditioning of the breathing muscles by targeted strengthening exercises, such as respiratory muscle training (RMT) is therefore important for recovery of normal breathing function.

A clinical study investigated the effect of pulmonary rehabilitation including RMT in elderly people recovering from COVID-19. They found that people who received 6 weeks of pulmonary rehabilitation after a COVID-19 infection had better lung function and exercise capacity than those who did not. Rehabilitation and RMT also improved quality of life and reduced the levels of anxiety, which underlines how important full breathing function is for emotional health and wellbeing [5]. Based on these and similar findings, pulmonary rehabilitation and RMT have been recommended as an integral part of rehabilitation in COVID-19 survivors [2].

Conclusion

Strengthening the respiratory muscles by RMT supports strong pulmonary function, which can:

• help prepare the lungs for increased work of breathing during infection
• help overcome infections easier
• promote quicker recovery from infections

The Breather is a respiratory muscles trainer that strengthens all muscle groups used for breathing, coughing, speech and swallow. Using the Breather regularly may therefore contribute to optimizing lung function before a potential infection, as well as in the recovery phase after an infection.

References

1. Khoury M, Cuenca J, Cruz FF, Figueroa FE, Rocco PRM, Weiss DJ. Current Status of Cell-Based Therapies for Respiratory Virus Infections: Applicability to COVID-19. Eur Respir J. 2020. doi:10.1183/13993003.00858-2020
2. Sheehy LM. Considerations for Post-acute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill. 2020. doi:10.2196/19462
3. Ahn D-G, Shin H-J, Kim M-H, Lee S, Kim H-S, Myoung J, et al. Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19). J Microbiol Biotechnol. 2020;30: 313–324
4. Severin R, Arena R, Lavie CJ, Bond S, Phillips SA. Respiratory Muscle Performance Screening for Infectious Disease Management Following COVID-19: A Highly Pressurized Situation. Am J Med. 2020. doi:10.1016/j.amjmed.2020.04.003
5. Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020;39: 101166