COVID-19, the heart and exercise

Aside from the well-recognised effects on the the lungs, COVID-19 infection can affect the heart in a number of ways. Firstly, COVID-19 can make the blood more sticky leading to blood clots. This, combined with oxygen deprivation can cause a heart attack, which is where part of the heart becomes deprived of an adequate blood supply and dies off. However, it would appear that the virus can affect the heart directly, causing heart muscle damage. This can lead to heart rhythm problems and heart failure. When COVID affects the heart in this way, it is termed myocarditis. Damage to the heart at the time of COVID-19 infection is associated with a higher death rate. Many viruses can do this, and this one is no exception. The type of damage that has occurred can be determined by MRI scanning. 

It may be more common than is widely appreciated. COVID-19 infection is still a new infection and we are still at the early stages of understanding it. Although many people appear to have no or few symptoms, it’s clear that some people are severely affected and that some people have symptoms that persist for some time after infection. 

After having had COVID-infection, assuming your symptoms have not been too bad, once recovered it would be wise to wait a week to 10 days before resuming athletic activity. It is then a case of listening carefully to your body and easing back into things. It may take a bit longer before you feel completely back to normal. 

If you have had a more severe infection then you may go on to experience extreme fatigue, breathlessness and fast heart rates which can persist for some time. This “long-Covid” is poorly understood and may point towards more significant damage. In this case, it is probably wise to avoid sporting activity and seek further medical evaluation. We need to emphasise that we are in the very early stages of understanding this disease. Therefore, be aware that the advice may change frequently as more and more is found out.