By Dr. Andrew Pasternak, Silver Sage Sports & Fitness Lab
As more people, unfortunately, get infected with COVID-19, the medical community is learning more and more about the disease. Now that we’re over six months into the pandemic, researchers are discovering more about the long-term effects of COVID. While we initially focused on how COVID affected the lungs, we’re finding COVID-19 also causes inflammation in the blood vessels as well as changes in the heart and other organs for months. As a result of this new knowledge, we’re now coming up with better recommendations on when people should return to exercising and sport.
So let’s start with the heart. For patients who are acutely sick and are in the hospital, it’s common to see evidence of damage to the heart through testing. Being older, having high blood pressure, obesity, and diabetes are risk factors for COVID-related cardiac complications. Some patients will develop inflammation of the heart muscle (myocarditis). The changes to the heart are also being seen well after the acute illness. A recent article from Germany looked at 100 people who had COVID-19. A couple of months after people developed COVID, 60-78% of them had some evidence of cardiac damage depending on the lab test or imaging test used.
COVID also obviously affects the lungs. During the acute illness, one of the most significant problems we see is people developing pneumonia and getting enough oxygen. After the acute illness, some people continue to have difficulties with breathing and lung function. In one small study looking at patients with moderate to severe acute COVID, 75% needed oxygen or had reduced lung function at 30 days.
So if you’ve gotten COVID 19, what’s the best way to get back into shape?
Recent articles in the sports medicine literature are helping guide physicians making recommendations for people who have developed COVID-19. For people with mild COVID, people should wait at least ten days from symptom onset and be free of all symptoms for at least seven days before starting exercise. They also recommend that people be able to get through a typical day without any fatigue or other issues and be able to walk 500M without difficulty before starting exercise. When getting back into exercise, start with 15-30 min of exercise at very low intensities and see how you do. Measuring resting heart rate and monitoring morning fatigue symptoms can be helpful to monitor recovery. For patients with more severe acute COVID symptoms, following up with your regular doctor for labs, heart testing, and lung testing may be beneficial. Of course, the best option is to try and avoid getting COVID. Until this gets under control, keep washing your hands, maintain social distancing, and wear a mask!