If you are one of the millions who contracted COVID-19 in the past year, you may still be in the process of regaining the physical fitness lost from when the virus forced you to slow down and heal.
Joseph Herrera, DO, Chair of Rehabilitation and Human Performance for the Mount Sinai Health System, and cardiology fellow Saman Setareh-Shenas, MD, explain how those who have recovered from COVID-19 can get back into their pre-illness shape and how the Mount Sinai Post-COVID Care Center can assist them on their road to recovery. Two key takeaways: Take it slow and consider seeing a specialist if you encounter any hurdles along the way.
How does the effect of COVID-19 on the body influence my recovery?
Joseph Herrera, DO: We are seeing a range of symptoms, from mild to severe, in patients after being infected with COVID-19. The virus affects them both physically and cognitively, everything from increased fatigue, shortness of breath, and tachycardia, a medical term of a rapid heartbeat, and difficulty concentrating, also known as brain fog. Because of this, some patients find it difficult to get back to their pre-COVID level of physical activity.
What about athletes? Does COVID-19 affect them differently?
Dr. Herrera: We’ve seen a range of people who have been impacted by COVID-19, from recreational athletes to marathon runners and professional athletes. I would say that they, similar to the general population, have a range of symptoms, some very mild all the way to severe. Overall, I don’t think your pre-infection conditioning really prevents anything.
Saman Setareh-Shenas, MD: COVID-19 doesn’t discriminate between athletes and non-athletes. We have seen major effects from the virus as well as post-COVID syndrome in very healthy athletes.
When is it safe to resume physical activity after recovering from COVID-19?
Dr. Herrera: We’ve been advising symptom-free patients to resume activity as tolerated. If they’ve been hospitalized due to COVID-19 or have spent a prolonged time in bed while recovering, whether in an intensive care unit bed or in their home, we want to make sure that they can return to normal activity before progressing to exercise.
Dr. Setareh-Shenas: Early on in the pandemic as the initial wave of patients were recovering, we started noticing a lot of our patients were not immediately able to go back to their baseline exercise level.
At the Mount Sinai Post-COVID Care Center, we help patients regain their pre-COVID strength and conditioning by using recommendations based on guidelines by the Leadership Council of the Sports and Exercise Cardiology Section of the American College of Cardiology and findings by British researchers. These guidelines advise those in recovery to return to exercise very gradually. Don’t go back to where your baseline was. Wait at least seven to 10 days, and then take it slowly from there.
Dr. Herrera: We guide patients using the ‘rule of tens.’ For example, if a patient were lifting a hundred pounds prior to getting infected with COVID-19, we have them cut everything in half—or even a quarter—of the weight they previously lifted. Then we apply the ‘rule of tens,’ by increasing either the intensity or the duration of exercise by 10 percent every 10 days. This way, they have a gradual increase in activity.
What precautions should post-COVID patients take when getting back to physical activity?
Dr. Setareh-Shenas: In the past year, we have seen a number of patients in our post-COVID population who are experiencing heart racing, palpitations, or a new arrhythmia. So, as a precaution, I would say that patients recovering from COVID-19 who have chest pains or shortness of breath, should be evaluated by their physician or by an expert cardiologist at a Post-COVID Center.
For example, in our Cardiology Clinic within the Post-COVID Care Center at Mount Sinai, we evaluate patients who have complaints of chest pain or shortness of breath and conduct exercise testing to see their maximal exercise capacity and evaluate for any arrythmia during exercise. We want to know: Do they have any symptoms when exercising on the treadmill? Does their heart go under strain that’s not equivalent for their age group and their risk factors? So, patients should be mindful of this, especially if they have a history of cardiac issues.
Dr. Herrera: Most importantly, don’t push yourself too hard but do see a specialist. Get evaluated to see if you qualify for any of the programs that we offer at Mount Sinai.