Anti-Inflammatory and Antioxidant Effects of HIIT in Individuals with Long COVID: Insights into the Potential Role of Triphala
Question
Does supervised HIIT, alone or combined with Triphala supplementation, reduce inflammatory and oxidative-stress biomarkers in adults with long COVID?
Summary
In screened adults with long COVID symptoms, 8 weeks of supervised cycling HIIT with or without Triphala was associated with within-group reductions in inflammatory and oxidative-stress biomarkers, but between-group interactions were not significant. Minor symptoms occurred in a few HIIT participants and no serious adverse events were reported.
Methodology
- Adults with prior COVID-19 and persistent long COVID symptoms/post-exertional malaise symptoms.
- 104 participants.
- Stationary cycling.
- Work intervals: 4 min at 85% HRpeak.
- Recovery: 3 min active recovery at 60% HRpeak.
- Intensity: 85% HRpeak work, 60% HRpeak recovery, 50-60 rpm.
- About 38 min including 5 min warm-up and 5 min cool-down.
- 3 sessions/week.
- 8 weeks.
- Randomized controlled trial with control/placebo, HIIT, and HIIT plus Triphala groups
- Inflammatory cytokines, Oxidative stress, Safety labs, and Exercise symptoms were tracked.
Outcomes
Inflammation
HIIT arms had within-group IFN-gamma and TNF-alpha reductions, but interactions were nonsignificant.
IFN interactions p=0.837; TNF interactions p=0.175.
Oxidative stress
MDA and protein carbonyls decreased within exercise groups, but between-group interactions were nonsignificant.
MDA interaction p=0.710; protein carbonyl interaction p=0.968.
Safety
No serious adverse events or ALT/creatinine changes; four minor symptom events occurred.
ALT p=0.315; creatinine p=0.249; minor events in 4 participants (5.97%).
Insights
- A clinical 4 x 4 cycling format can be monitored with HRpeak, RPE, dyspnea, and symptom checks.
- For long COVID, absence of serious events in a screened lab sample does not establish safety for unsupervised use.
- Between-group nonsignificance should temper biomarker benefit claims.
Limitations
- Young highly screened long-COVID sample
- Nonsignificant group-by-time interactions
- No PESE/PEM diary
- No Triphala-only group
- Limited biomarker panel
- Variable compliance
- Clinical supervision limits generalizability
Safety
- No serious adverse events were reported.
- Four participants (5.97%) experienced minor events in the final week during the fourth HIIT cycle: leg muscle fatigue, dizziness, and transient hypotension; none discontinued.
- The protocol was supervised by licensed physical therapists with continuous adverse-event monitoring, but post-exertional symptom exacerbation within 24 h was not measured.