Higher risk of upper respiratory tract infection post marathon running: when physical exercise becomes a threat to the immune system.

IF 3.5 4区 医学 Q2 IMMUNOLOGY Exercise Immunology Review Pub Date : 2024-01-01
Amanda Veiga Sardeli, Rafaela Bertini de Araujo, Jeffrey A Woods, Janet M Lord, Mara Patrícia Traina Chacon-Mikahil
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Abstract

Background: Several studies have reported that marathon runners have a higher risk of upper respiratory tract infections (URTI) post marathon than non-exercising controls. However, other studies did not find a higher risk of URTI in the same participants before and after a marathon, precluding a conclusive consensus. Besides the between-subjects effects, another important confounding factor in these results is the different pre and post follow-up time to track URTI.

Objectives: Identify by meta-analysis whether a marathon Running increases the risk of URTI, adjusting the follow-up time to track URTI.

Data sources: We searched for articles using MEDLINE (PubMed), Embase, Scopus, Web of Science, the Cochrane Library, and EBSCOhost, combining the marathon and respiratory infection descriptor synonyms, on 1st December 2022.

Eligibility criteria: The PICOS framework included human population, comparison between pre and post marathon running, of URTI symptoms (assessed from one to 4 weeks), in noncontrolled intervention studies.

Data synthesis: Because follow-up was longer before the marathon in many studies, we adjusted the number of subjects with infections before marathon to the equivalent post-marathon follow-up duration. There was 18% higher incidence of URTI post-marathon (OR 1.18 95%CI [1.05-1.33], p= 0.005) in a very consistent meta-analysis (I2 = 0%, p = 0.69), with no risk of publication bias (Egger test p-value = 0.82) for the 7 studies included. The main issues with quality of the studies were bias in measuring the outcome, bias in classification of intervention (participation in the marathon) and time-varying confounding (corrected for analysis), and therefore the quality of evidence was moderate (GRADE approach = 3).

Limitations: The need for follow-up time adjustment is a limitation, since the number of URTI recorded could be different if the original studies had used the same follow-up time pre and post marathon. The subjectivity of the URTI assessments is another limitation in this field.

Conclusions: There is an increased risk of URTI post marathon running and research on this topic to understand mechanisms might support runners to find efficient interventions to reduce this risk.

Protocol: Protocol registration on in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42022380991.

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马拉松比赛后上呼吸道感染的风险更高:当体育锻炼对免疫系统构成威胁时。
背景:有几项研究报告称,马拉松运动员在马拉松比赛后患上呼吸道感染(URTI)的风险高于非运动对照组。然而,其他研究并未发现同一参与者在马拉松比赛前后发生上呼吸道感染的风险更高,因此无法达成结论性共识。除了受试者之间的影响外,这些结果的另一个重要干扰因素是跟踪 URTI 的前后随访时间不同:通过荟萃分析确定马拉松长跑是否会增加URTI的风险,同时调整跟踪URTI的随访时间:我们于 2022 年 12 月 1 日使用 MEDLINE (PubMed)、Embase、Scopus、Web of Science、Cochrane Library 和 EBSCOhost 搜索文章,结合马拉松和呼吸道感染描述符同义词:PICOS框架包括非对照干预研究中的人群、马拉松比赛前后URTI症状(评估时间为1至4周)的比较:由于许多研究在马拉松比赛前的随访时间较长,我们将马拉松比赛前感染的受试者人数调整为马拉松比赛后的同等随访时间。在一项非常一致的荟萃分析(I2 = 0%,p = 0.69)中,马拉松后 URTI 的发病率比马拉松前高 18%(OR 1.18 95%CI [1.05-1.33],p= 0.005),纳入的 7 项研究无发表偏倚风险(Egger 检验 p 值 = 0.82)。研究质量的主要问题是测量结果的偏差、干预分类(参加马拉松比赛)的偏差和时变混杂因素(经分析校正),因此证据质量为中等(GRADE方法=3):需要对随访时间进行调整是一个局限,因为如果原始研究在马拉松比赛前后使用相同的随访时间,记录的 URTI 数量可能会不同。URTI评估的主观性是该领域的另一个局限性:结论:马拉松比赛后患尿路感染的风险增加,对这一问题进行研究以了解其机理可能有助于跑步者找到有效的干预措施来降低这一风险:协议已在国际系统综述前瞻性注册中心(PROSPERO)注册:CRD42022380991。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Exercise Immunology Review
Exercise Immunology Review 医学-免疫学
CiteScore
16.00
自引率
0.00%
发文量
7
期刊介绍: Exercise Immunology Review (EIR) serves as the official publication of the International Society of Exercise and Immunology and the German Society of Sports Medicine and Prevention. It is dedicated to advancing knowledge in all areas of immunology relevant to acute exercise and regular physical activity. EIR publishes review articles and papers containing new, original data along with extensive review-like discussions. Recognizing the diverse disciplines contributing to the understanding of immune function, the journal adopts an interdisciplinary approach, facilitating the dissemination of research findings from fields such as exercise sciences, medicine, immunology, physiology, behavioral science, endocrinology, pharmacology, and psychology.
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