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Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases During COVID-19: a Complex Combination

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Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases During COVID-19: a Complex Combination International Journal of Environmental Research and Public Health Review Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases during COVID-19: A Complex Combination Olga Scudiero 1,2,3,† , Barbara Lombardo 1,3,† , Mariarita Brancaccio 4 , Cristina Mennitti 1 , Arturo Cesaro 5,6 , Fabio Fimiani 7, Luca Gentile 3, Elisabetta Moscarella 5,6, Federica Amodio 5 , Annaluisa Ranieri 3, Felice Gragnano 5,6, Sonia Laneri 8, Cristina Mazzaccara 1,2 , Pierpaolo Di Micco 9, Martina Caiazza 10, Giovanni D’Alicandro 11, Giuseppe Limongelli 12 , Paolo Calabrò 5,6,* , Raffaela Pero 1,2,* and Giulia Frisso 1,2,* 1 Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; [email protected] (O.S.); [email protected] (B.L.); [email protected] (C.M.); [email protected] (C.M.) 2 Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy 3 Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy; [email protected] (L.G.); [email protected] (A.R.) 4 Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, 80121 Naples, Italy; [email protected] 5 Department of Translational Medical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; [email protected] (A.C.); [email protected] (E.M.); [email protected] (F.A.); [email protected] (F.G.) 6 Citation: Scudiero, O.; Lombardo, B.; Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy 7 Brancaccio, M.; Mennitti, C.; Cesaro, Unit of Inherited and Rare Cardiovascular Diseases, Azienda Ospedaliera di Rilievo Nazionale AORN Dei Colli, “V.Monaldi”, 80122 Naples, Italy; fi[email protected] A.; Fimiani, F.; Gentile, L.; Moscarella, 8 Department of Pharmacy, University of Naples Federico II Via Montesano, 80131 Naples, Italy; E.; Amodio, F.; Ranieri, A.; et al. [email protected] Exercise, Immune System, Nutrition, 9 Department of Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Respiratory and Cardiovascular 80123 Naples, Italy; [email protected] Diseases during COVID-19: A 10 Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Complex Combination. Int. J. Environ. Campania “Luigi Vanvitelli”, Monaldi Hospital, 81100 Naples, Italy; [email protected] Res. Public Health 2021, 18, 904. 11 Department of Neuroscience and Rehabilitation, Center of Sports Medicine and Disability, AORN, https://doi.org/ijerph18030904 Santobono-Pausillipon, 80122 Naples, Italy; [email protected] 12 Department of Cardio-Thoracic and Respiratory Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; [email protected] Academic Editors: Han C. G. Kemper * Correspondence: [email protected] (P.C.); [email protected] (R.P.); [email protected] (G.F.); and Stuart Fairclough Tel.: +39-328-434-6963 (P.C.); +39-339-459-6163 (R.P.); +39-347-240-9595 (G.F.) Received: 13 November 2020 † These authors equally contributed to this work. Accepted: 19 January 2021 Published: 21 January 2021 Abstract: Coronaviruses (CoVs) represent a large family of RNA viruses that can infect different living species, posing a global threat to human health. CoVs can evade the immune response, replicate within Publisher’s Note: MDPI stays neutral the host, and cause a rapid immune compromise culminating in severe acute respiratory syndrome. In with regard to jurisdictional claims in humans, the immune system functions are influenced by physical activity, nutrition, and the absence of published maps and institutional affil- iations. respiratory or cardiovascular diseases. This review provides an in-depth study between the interactions of the immune system and coronaviruses in the host to defend against CoVs disease. Keywords: coronavirus; physical exercise; immune system; nutrition; respiratory infection; cardio- vascular disorders Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and 1. Introduction conditions of the Creative Commons Attribution (CC BY) license (https:// In recent years, new coronaviruses have emerged in various areas of the world, causing creativecommons.org/licenses/by/ severe epidemics. Severe acute respiratory syndrome coronavirus (SARS-CoV) was first 4.0/). identified in Guangdong, China, in February 2003. The infection spread during the time Int. J. Environ. Res. Public Health 2021, 18, 904. https://doi.org/10.3390/ijerph18030904 https://www.mdpi.com/journal/ijerph Int. J. Environ. Res. Public Health 2021, 18, x FOR PEER REVIEW 2 of 19 In recent years, new coronaviruses have emerged in various areas of the world, caus- Int. J. Environ. Res. Public Health 2021, ing18, 904 severe epidemics. Severe acute respiratory syndrome coronavirus (SARS-CoV2) ofwas 20 first identified in Guangdong, China, in February 2003. The infection spread during the time period from November 2002 to July 2003, which infected around 8422 people world- periodwide, 916 from of Novemberwhom died. 2002 to July 2003, which infected around 8422 people worldwide, 916 ofMiddle whom East died. respiratory syndrome coronavirus (MERS-CoV) was first identified in Jeddah,Middle Saudi East Arabia, respiratory in 2012 syndrome [1]. There coronaviruswere 1401 people (MERS-CoV) affected, waswith first 543 identifieddeaths [2– in5]. Jeddah,Today, we Saudi are Arabia, facing ina new 2012 coronavirus: [1]. There were between 1401 peoplethe end affected, of 2019 withand 543the deathsbeginning [2– 5of]. Today,2020, the we Chinese are facing city a new of Wuhan coronavirus: became between the center the end of an of 2019outbreak and theof pneumonia beginning of of 2020, un- theknown Chinese cause. city In ofJanuary Wuhan 2020, became Chinese the scientists center of anisolated outbreak a new of coronavirus, pneumonia ofcalled unknown Severe cause.acute r Inespira Januarytory 2020,syndrome Chinese coronavirus scientists 2 isolated (SARS- aCoV new-2, coronavirus, known as 2019 called-nCoV) Severe, from acute af- respiratoryfected patients syndrome [6]. Lastly, coronavirus in February 2 (SARS-CoV-2, 2020, the virus known wasas designated 2019-nCoV), 2019 from coronavirus affected patientsdisease (COVID [6]. Lastly,-19) in by February the World 2020, Health the virusOrganization was designated [7]. 2019 coronavirus disease (COVID-19)COVID by-19 thehas World reached Health humans Organization through [a7 ].spillover, a natural process whereby an animalCOVID-19 pathogen has evolves reached and humans becomes through able to infect, a spillover, reproduce, a natural and processtransmit whereby itself within an animalthe human pathogen species. evolves This evolutionary and becomes phenomenon able to infect, is reproduce, found mainly and transmitin RNA viruses, itself within such theas c humanoronaviruses species. when This they evolutionary have a higher phenomenon mutation is frequency found mainly than inDNA RNA viruses viruses, [8,9 such]. as coronavirusesCoronaviruses when have they a single have- astranded higher mutation linear RNA frequency genome than with DNA the positive viruses [polarity8,9]. of 27Coronaviruses–32 Kb. They are have spherical a single-stranded virions with linear a diameter RNA genome between with 80 theand positive 220 nm polarity formed ofby 27–32 a phospholipid Kb. They areenvelope, spherical the virionspericapsid, with which a diameter has distal between projections 80 and called 220 nm peplomers formed bythat a phospholipidgive the virus envelope, a crown appearance the pericapsid, (Figure which 1). has These distal viruses projections consist called of different peplomers pro- thatteins: give (i) p therotein virus N (5 a0 crown–60 kDa appearance ) stabilizes (Figure RNA; 1().ii) Theseglycoprotein viruses S consist(80–220 of kDa different ) forms proteins:pleplomers, (i) protein which favor N (50–60 the kDaattack ) stabilizesof the virus RNA; and (ii) fusion glycoprotein with the Shost (80–220’s cell kDa membrane ) forms; pleplomers,(iii) glycoprotein which M favor (20–30 the kDa attack ) interacts of the viruswith andthe nucleocapsid fusion with the; (iv) host’s protein cell E membrane; (9–12 kDa) (iii)is a glycoproteinconstituent of M the (20–30 envelope kDa ) interactsand interacts with with the nucleocapsid; the glycoprotein (iv) proteinM to stimulate E (9–12 kDa)bud- isding a constituent; (v) hemagglutin of the envelopein-HE (12 and0–140 interacts kDa ) withis involved the glycoprotein in the release M to of stimulate the virus budding; (Figure (v)1). hemagglutinin-HE (120–140 kDa ) is involved in the release of the virus (Figure1). FigureFigure 1.1. MorphologicalMorphological organizationorganization ofof thethe coronavirus.coronavirus. FromFrom aa genotypicgenotypic andand serologicalserological typing,typing, CoVsCoVs areare divideddivided intointo fourfour categories:categories:α α,, β β,, Gɣ,, andand δδ.. InIn addition,addition, thethe ββ-CoVs-CoVs areare subdividedsubdivided intointo fourfour otherother lineageslineages A,A, B,B, C,C, D.D. TheseThese virusesviruses cancan causecause aa varietyvariety ofof respiratoryrespiratory conditions,conditions, rangingranging fromfrom thethe commoncommon coldcold toto Middle Eastern respiratory syndrome (MERS) to severe respiratory syndrome (SARS) [2–5]. The most common symptoms are
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