Myocarditis and COVID-19 | How Exercise Affects COVID-19

For runners like O’Shea Rivera and other active people who generally turn to physical activity to boost circulation and feel better faster when they’re a little under the weather, this is new and urgent news, says Jordan Metzl, M.D., a sports medicine physician at Hospital for Special Surgery or (HSS) in New York City.“This goes against my personal exercise philosophy that burpees cure pretty much everything and the advice I have given for 20 years that it’s okay to exercise through minor sickness symptoms,” Metzl says. “You need to be a very good body listener right now,” Metzl says.Be especially mindful of unusual symptoms, adds Sunal Makadia, M.D., LifeBridge Health Director of Sports Cardiology in Baltimore.“Check in with your doctor if you have shortness of breath, chest pain, heart palpitations like a fluttering or rapid heartbeat, lightheadedness, leg swelling, muscle pains, and/or unexplainable fatigue,” Makadia says. If that happens the higher viral load may increase your risk of cardiac harm in the form of myocarditis, arrhythmias, and heart failure,” he says.It’s important to stop exercising immediately at the first sign of potential cardiac symptoms and get checked out by your doctor, advises Makadia.Metzl agrees. Hydration is key, as is early testing if you have COVID-19 symptoms, so that doctors can monitor clotting proteins in the blood.”Though you want to take it easy and avoid working out if you’re COVID-19 positive, low-intensity activity like easy walking, or at least avoiding prolonged sitting, can provide some protection against DVT.Calf pain, swelling, and/or tenderness are red flags to get checked. That’s why doctors like Metzl have started creating guidelines for the medical community to follow as we work our way through the pandemic.“Everyone is unique and this disease affects everyone uniquely and can affect the whole body in many ways, so there is no absolute algorithm for resuming activity as there is for a sprained ankle,” Metzl, who authored a recently published review article titled Considerations for Return to Exercise Following Mild-to-Moderate COVID-19 in the Recreational Athlete. “This is true for athletes who have had COVID-19 to any degree,” Metzl writes.If you’ve had a mild case, then Metzl and his coauthors recommend working with your doctor and following a gradual guided activity modification plan such as the 50/30/20/10 rule developed by the National Strength and Conditioning Association and Collegiate Strength and Conditioning Coaches Association Joint committee.In that plan, the first week back, you resume activity at a level that is reduced by at least 50 percent of your normal exercise load.