Exercise effect on symptom severity, morbidity and mortality in viral infections: a systematic review and meta-analysis

Rafaela Araujo, Mara Patrícia Traina Chacon-Mikahil, Janet Lord, Amanda Veiga Sardeli*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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There is a knowledge gap regarding the consequences of exercise during acute infections in humans and contradictory findings in animal studies, compromising public health advice on the potential benefits of physical activity for immunity. Here, we carried out a meta-analysis of studies of the effects of moderate exercise (ME) and exercise until fatigue (EF) on symptom severity, morbidity and mortality during viral infection in animal models. The systematic review on PubMed, Scopus, Embase, Web of Science, Cochrane and EBSCOhost (CINAHL and SPORT Discus) identified 8 controlled studies, with 15 subgroups within them. The studies exposed the animals (mice [7 studies] and monkeys [1 study]) to exercise immediately before or after viral inoculation (HSV-1, H1N1 influenza and B.K. virus) with follow-up for 21 days. ME significantly reduced morbidity (OR 0.43 [0.19; 0.98], P = 0.04) with no change for symptom severity (SMD -3.37 [-9.01; 2.28], P = 0.24) or mortality (OR 0.48 [0.08;3.03], P = 0.43). In contrast, EF gave a trend towards increased symptom severity (SMD 0.96 [-0.06; 1.98], P = 0.07) and mortality (OR 1.47 [0.96;2.28], P =0.08) with no change in morbidity (OR 1.22 [0.60;2.5], P = 0.58). We conclude that in animals moderate exercise during infection is advantageous, whilst exercise until fatigue should be avoided. Further research is required to determine if moderate exercise may also be beneficial in humans during infection.
Original languageEnglish
Pages (from-to)133-140
Number of pages8
JournalExercise Immunology Review
Publication statusPublished - 2 Aug 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 International Society of Exercise and Immunology. All rights reserved.


  • Exercise
  • Immunity
  • Physical Activity
  • Survival
  • Virus infection

ASJC Scopus subject areas

  • Medicine(all)


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