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      COVID-19 pandemic: the effects of quarantine on cardiovascular risk

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          Abstract

          COVID-19 is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of COVID-19 virus, Governments have enforced restrictions on outdoor activities or even collective quarantine on the population. One important consequence of quarantine is a change in lifestyle: reduced physical activity and unhealthy diet. 2019 guidelines for primary prevention of cardiovascular disease indicate that “Adults should engage in at least 150 minute per week of accumulated moderate-intensity or 75 minute per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce ASCVD risk.” During quarantine, strategies to further increase home-based physical activity and to follow a healthy diet should be implemented. Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine a global action supporting healthy diet and physical activity is mandatory to encourage people to return to good lifestyle.

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          Most cited references32

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            Effects of stress on the development and progression of cardiovascular disease

            Cardiovascular disease remains the leading cause of disease burden globally, which underlies the continuing need to identify new complementary targets for prevention. Over the past 5-10 years, the pooling of multiple data sets into 'mega-studies' has accelerated progress in research on stress as a risk and prognostic factor for cardiovascular disease. Severe stressful experiences in childhood, such as physical abuse and household substance abuse, can damage health and increase the risk of multiple chronic conditions in adulthood. Compared with childhood stress and adulthood classic risk factors, such as smoking, high blood pressure, and high serum cholesterol levels, the harmful effects of stress in adulthood are generally less marked. However, adulthood stress has an important role as a disease trigger in individuals who already have a high atherosclerotic plaque burden, and as a determinant of prognosis and outcome in those with pre-existing cardiovascular or cerebrovascular disease. In real-life settings, mechanistic studies have corroborated earlier laboratory-based observations on stress-related pathophysiological changes that underlie triggering, such as lowered arrhythmic threshold and increased sympathetic activation with related increases in blood pressure, as well as pro-inflammatory and procoagulant responses. In some clinical guidelines, stress is already acknowledged as a target for prevention for people at high overall risk of cardiovascular disease or with established cardiovascular disease. However, few scalable, evidence-based interventions are currently available.
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              Positive affect and the other side of coping.

              Although research on coping over the past 30 years has produced convergent evidence about the functions of coping and the factors that influence it, psychologists still have a great deal to learn about how coping mechanisms affect diverse outcomes. One of the reasons more progress has not been made is the almost exclusive focus on negative outcomes in the stress process. Coping theory and research need to consider positive outcomes as well. The authors focus on one such outcome, positive affect, and review findings about the co-occurrence of positive affect with negative affect during chronic stress, the adaptive functions of positive affect during chronic stress, and a special class of meaning-based coping processes that support positive affect during chronic stress.
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                Author and article information

                Contributors
                annavittoria.mattioli@unimore.it
                Journal
                Eur J Clin Nutr
                Eur J Clin Nutr
                European Journal of Clinical Nutrition
                Nature Publishing Group UK (London )
                0954-3007
                1476-5640
                5 May 2020
                : 1-4
                Affiliations
                [1 ]ISNI 0000000121697570, GRID grid.7548.e, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, , University of Modena and Reggio Emilia, ; Modena, Italy
                [2 ]ISNI 0000000121697570, GRID grid.7548.e, Istituto Nazionale per le Ricerche Cardiovascolari, , University of Modena and Reggio Emilia, ; Modena, Italy
                Author information
                http://orcid.org/0000-0003-1487-9530
                http://orcid.org/0000-0002-9815-1338
                http://orcid.org/0000-0003-3079-8001
                http://orcid.org/0000-0003-2133-3595
                Article
                646
                10.1038/s41430-020-0646-z
                7199203
                31767988
                ea31ad6f-01ec-41de-948c-1134ffe8437c
                © Springer Nature Limited 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 30 March 2020
                : 16 April 2020
                : 22 April 2020
                Categories
                Perspective

                Nutrition & Dietetics
                risk factors,public health
                Nutrition & Dietetics
                risk factors, public health

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