If You Had COVID-19, You Might Need A Heart Exam Before Exercising Again

Whether you regularly train for a community 5K or just try to maintain an active lifestyle, you might need a heart screening before resuming exercise if you've had COVID-19, sports health professionals say (via NBC News). Doctors at a virtual conference this month sponsored by the American College of Sports Medicine, the American Orthopaedic Society for Sports Medicine, and the American Medical Society for Sports Medicine recommended the precautions because of a link between COVID-19 and heart muscle inflammation.

A study published in September in the journal JAMA Cardiology found that four out of 26 college athletes had signs of heart muscle inflammation after recovering from COVID-19. Called myocarditis, this affects the heart's pumping ability and can cause rapid or abnormal heart rhythms. Doctors also noted in the cardiology journal in October that "myocardial injury may occur in cases of COVID-19 that are asymptomatic and of mild severity." 

"Cardiac injury is quite common and prevalent among sicker patients who are hospitalized with COVID-19 infection, upwards of 20 percent prevalence of cardiac injury," said Dr. Jonathan Kim, chief of sports cardiology at Emory University in Atlanta, a team cardiologist for the Atlanta Braves and Falcons, and a co-author of both sets of recommendations. "It's important to put that in contrast of other common respiratory viral illnesses, where in even the sickest patients you only see evidence of cardiac injury about 1 percent of the time."

The doctors recommended heart screenings such as echocardiograms, electrocardiograms, and troponin blood tests after recovering from COVID-19 for high-school athletes, competitive sports athletes, and recreational "masters athletes." That last group includes people over age 35 who participate in or train for competitions such as running, cycling, swimming, or weightlifting. People who had cardiac issues or conditions such as diabetes before contracting COVID-19, regardless of the severity of infection, should talk with their doctor before resuming an exercise plan, the doctors added.

People who were otherwise healthy and had asymptomatic or mild COVID-19 likely can return to gradual exercise safely — provided that they don't overdo it, Dr. Carrie Jaworski, director of the division of primary care sports medicine at NorthShore University HealthSystem in Chicago, said at the virtual conference. Start at about 50 percent of your activity level before the infection, then gradually increase your activity by 10 percent each week, she suggested — but if you have any concerns, definitely touch base with your doctor first.

"I think it is really important for people to recognize that it's not just like getting a cold and recovering and all is good," said Dr. Jonathan Finnoff, chief medical officer for the United States Olympic and Paralympic Committee in Colorado Springs, Colorado. He advised calling your doctor immediately if you've recovered from COVID-19 and experience any of these symptoms while exercising: chest pain, heart palpitations, dizziness, unusual shortness of breath, or passing out during exercise.