Acute exercise increases immune responses to SARS CoV-2 in a previously infected man

Forrest L. Baker, Kyle A. Smith, Tiffany M. Zúñiga, Helena Batatinha, Grace M. Niemiro, Charles R. Pedlar, Shane C. Burgess, Emmanuel Katsanis, Richard J. Simpson

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Evidence is emerging that exercise and physical activity provides protection against severe COVID-19 disease in patients infected with SARS-CoV-2, but it is not known how exercise affects immune responses to the virus. A healthy man completed a graded cycling ergometer test prior to and after SARS-CoV-2 infection, then again after receiving an adenovirus vector-based COVID-19 vaccine. Using whole blood SARS-CoV-2 peptide stimulation assays, IFN-γ ELISPOT assays, flow cytometry, ex vivo viral-specific T-cell expansion assays and deep T-cell receptor (TCR) β sequencing, we found that exercise robustly mobilized highly functional SARS-CoV-2 specific T-cells to the blood compartment that recognized spike protein, membrane protein, nucleocapsid antigen and the B.1.1.7 α-variant, and consisted mostly of CD3+/CD8+ T-cells and double-negative (CD4-/CD8-) CD3+ T-cells. The magnitude of SARS-CoV-2 T-cell mobilization with exercise was intensity dependent and robust when compared to T-cells recognizing other viruses (e.g. CMV, EBV, influenza). Vaccination enhanced the number of exercise-mobilized SARS-CoV-2 T-cells recognizing spike protein and the α-variant only. Exercise-mobilized SARS-CoV-2 specific T-cells proliferated more vigorously to ex vivo peptide stimulation and maintained broad TCR-β diversity against SARS-CoV-2 antigens both before and after ex vivo expansion. Neutralizing antibodies to SARS-CoV-2 were transiently elevated during exercise after both infection and vaccination. Finally, infection was associated with an increased metabolic demand to defined exercise workloads, which was restored to pre-infection levels after vaccination. This case study provides impetus for larger studies to determine if these immune responses to exercise can facilitate viral clearance, ameliorate symptoms of long COVID syndrome, and/or restore functional exercise capacity following SARS-CoV-2 infection.

Original languageEnglish (US)
Article number100343
JournalBrain, Behavior, and Immunity - Health
StatePublished - Dec 2021


  • Catecholamines
  • Cortisol
  • Exercise immunology
  • Lactate
  • Long COVID syndrome
  • Metabolic response
  • Physical activity
  • Respiratory gas exchange
  • TCR sequencing
  • Virus specific T-cells
  • α-variant

ASJC Scopus subject areas

  • Nephrology


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