Another possibility, even in not-so-sick cases of COVID-19, is adult-onset asthma. Other viruses are known to trigger the breathing condition in people who’ve never had it before, so it’s possible COVID-19 can do likewise, says Prescott. If that’s the case, you might start to experience chest tightness, wheezing, coughing, or shortness of breath, especially during physical exertion.
Most people who’ve had COVID-19, though, will likely get back to their normal lung function, Prescott says. It just might take a while to get there: It can take six weeks to feel you’re back to normal, she says (though of course it varies on an individual basis). Until then, symptoms such as cough, shortness of breath, and fatigue can persist, making your regular exercise routine feel harder than usual.
How coronavirus can affect your heart
Research on hospitalized COVID-19 patients shows that heart problems can occur with more serious cases: A study published in JAMA Cardiology of 416 hospitalized patients in Wuhan, China, found that nearly 20% experienced cardiac injury associated with the virus. With other viral illnesses, the rate is much lower, at just about 1%, according to separate research, also in JAMA Cardiology, on the return to exercise after COVID-19.
Cardiac injury is a broad term, but it refers to the release of biomarkers called troponins into the bloodstream, which serve as evidence that the heart has been weakened in some way by the virus, explains Jonathan Kim, M.D., chief of sports cardiology at Emory University and coauthor of the latter JAMA Cardiology paper. This may be due to the inflammation overload triggered by COVID-19, which can cause heart arrhythmias, blood clots (possibly leading to heart attack, stroke, or pulmonary embolism), or even a dangerous condition called myocarditis, or inflammation of the heart wall, he says.
Myocarditis—a leading cause of sudden death in athletes—is a particular concern to those who exercise. Continuing to exercise if you’re already sick with the virus (even if you’re not necessarily having symptoms) can make the existing myocarditis worse, says Kim, since it can increase virus replication in your body. This increased inflammation can potentially lead to the formation of permanent scarring on your heart, which can trigger arrhythmias.
This cardiac injury can cause exertional symptoms—extreme shortness of breath out of proportion to the activity you’re doing—racing or irregular heartbeat, chest tightness, lightheadedness, or passing out, he says.
But what does all this mean for people with more mild or moderate cases of COVID-19 who weren’t hospitalized? There’s currently no data to answer that, but the heart complications seen in sicker patients are enough to raise concern even for those not as ill, says Kim. And people with preexisting heart conditions or other medical conditions might be at even greater risk for these heart complications.
Experts also aren’t sure when in the course of COVID-19 illness heart issues might arise, but there is data to suggest you can feel relatively fine the first week, and then deteriorate with more serious issues the second week, he says. So it’s important to give yourself ample time to recover before starting to exercise again (more on that below).
When can you start exercising after coronavirus?
Because of the potential for serious complications with COVID-19—and the unknowns regarding who may be more likely to experience them—experts have recently published two separate guidelines on the return to exercising after coronavirus. And they align pretty closely in their recommendations to take a break and come back slowly.
In June respiratory experts from the U.K. recommended in The Lancet that due to a risk of deterioration around days seven to nine, athletes should hold off on resuming regular training for at least 10 days from symptom onset and seven days from symptom resolution.
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