COVID-19 has significantly impacted sports globally, with event postponements, trainingdisruptions, and wide-ranging concerns. SARS-CoV-2 infection can result inhyperinflammation and cardiopulmonary changes, with hypoxia as an aggravating sign.Hypoxia triggers complex immunometabolic mechanisms, including activation of HIF-1α andinduction of HLA-G expression. Hypoxia training protocols benefit aerobic capacity andsports performance, with potential immunological impact. Studying immunometabolic markersin this context can improve athletic preparation and athletes' general health.
Covid-19, caused by SARS-CoV-2, can progress to pulmonary hyperinflammation and
cardiopulmonary changes, with hypoxia being one of the main signs of worsening. In
hypoxia, there is activation of HIF-1 that induces the expression of HLA-G, an
immuno-tolerogenic molecule that inhibits the hyperinflammatory response. Hypoxia
training protocols can promote cardiopulmonary benefits and increase the expression of
anti-inflammatory cytokines, HIF-1 and HLA-G. Immunometabolic markers have the potential
to be used in the prevention, diagnosis, and treatment of diseases with inflammatory
mechanisms. The objective of this study is to evaluate the influence of physical training
protocols in hypoxic, normobaric, and hypobaric environments, on the immune, and
metabolic response and cardiopulmonary behavior in athletes post covid-19, to identify
potential biomarkers and better clarify the impact of exercise on immunometabolism
post-covid-19. The study will consist of a randomized and controlled intervention, with
training using different normobaric hypoxic methods; and an observational study at
natural altitude (hypobaric hypoxia). In the normobaric hypoxia trial, participants will
be divided into a control group that will carry out a training plan of repeated sprints
in normoxia; and two other groups that will perform the same training sessions in
normobaric hypoxia and with low lung volume voluntary hypoventilation. In the
observational study with hypobaric hypoxia, high-performance resistance athletes will be
recruited, who will comply with the training plan proposed by the team's coach at
altitude. Cardiorespiratory, immunometabolic, neuromuscular, and autonomic fatigue,
hematological indicators, plasma levels of lipid mediators, sHLA-G and cytokines, and the
expression of HIF-1α in leukocyte cells will be evaluated. The analysis of the effect of
the training methods will be carried out by ANOVA for repeated measures (parametric or
non-parametric), or means comparison tests for paired samples (t or Wilcoxon) after
evaluating the assumptions and the identification of associations between variables will
be carried out by Binomial Logistic Regression Analysis.
Other: Repeated sprint
- Duration of the study: 8 weeks of participation.
- Each repeated sprint training protocol: 2 training sessions per week for 4 weeks.
- Collection sessions: 3 collection sessions will be carried out: before the start of
the training protocol - T0; at the end of the protocol, in week 4 - T1; and late, 4
weeks after the end of the protocol, in week 8 - T2.
- Training sessions: will be carried out on an ergometer and will consist of 3 sets of
5 sprints of 10s all-out with 20s of rest between sprints, and 5 minutes of rest
between sets.
Inclusion Criteria:
- more than 5 years of training experience in an resistance modality;
- participates in national or international championships regularly;
- athletes convalescing from covid-19, at least 30 days after diagnosis and/or
hospital discharge;
- manifested mild to severe symptoms;
- vaccinated or not against SARS-CoV-2;
- antigen self-test for SARS-CoV-2 negative.
Exclusion Criteria:
- athletes who have had an acclimatization experience or exposure to altitude lasting
more than 10 days in the last 6 months;
- contain signs or symptoms of acute covid-19;
- present a positive SARS-CoV-2 antigen self-test;
- pregnant or postpartum women;
- use anti-inflammatory or immunosuppressive medications.
Faculty of Human Kinetics
Lisbon, Portugal
Investigator: Cristina P Monteiro, PhD
Contact: 00351214149174
cmonteiro@fmh.ulisboa.pt
Cristina Monteiro, PhD
00351214149174
cmonteiro@fmh.ulisboa.pt
Joana Reis, PhD
00351214149174
joanareis@fmh.ulisboa.pt
Not Provided