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Post-Covid respiratory challenges facing elite athletes

Some professional athletes who perform in competitive sport and have been infected by the Covid-19 virus, have developed severe illnesses.

Usually the “neck check” has been used to decide if and when an athlete with a respiratory condition should train. If their symptoms are confined to the above or in the neck, he or she usually would be cleared to train and play. However, Covid-19 is cause for concern because in some people, the illness can seem benign at first, then they rapidly go downhill.

Royal Brompton Hospital’s respiratory expert, Dr James Hull, explains: “Due to the potential disease trajectory, it’s important athletes do not resume very rapidly to vigorous exercise when symptoms start to initially to improve, especially in those first seven days.”

Instead, it is recommended athletes who have tested positive for the coronavirus, or suspect they might be positive, to rest without any exercise for at least 10 days from the point when they first feel symptoms. Then, assuming their illness remains mild, they should continue to rest for another week, even after their symptoms resolve. After this, they can return to a graduated training strategy.

Return to training after Covid-19
It is advisable athletes who have tested positive for the virus but have mild or no symptoms, to stay home and rest for a minimum of two weeks from the date of their first symptoms or positive test. After this period, and assuming symptoms have improved, they should return to exercise training with caution.

Some athletes have pre-existing asthma or respiratory issues, so it is important these are well managed and diagnostic testing is carried out before returning to training.

If an individual has symptoms below the neck, such as chest pain, breathlessness, production of sputum, or a fever, then it is recommended they do not continue to exercise. Any athletes who have been hospitalised or bedridden by the virus should seek extensive pulmonary and cardiac testing and clearance from their physicians before working out again.

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