Long-term effects of Covid on athletes beginning to emerge

Athlete Tom Cosworth took quite some time to recover from Covid-19.
Malcolm McCausland

While probably nobody involved in sport at any level is enjoying the lockdowns necessitated by the Covid-19 pandemic, some may even suffer mentally from the absence of organised competition, evidence is emerging daily on the longer term effect of the virus on people who practise a sport.

Because of its unique entry into the body, COVID-19 is now thought of more and more as a vascular disease that spreads through respiratory pathways. That means it primarily affects not just the nose, throat, and lungs but also blood vessels, kidneys, gastrointestinal tract and crucially the heart. When COVID-19 causes heart damage, it becomes particularly scary.

Sports scientists advise that it is not just the lungs that may be affected but also the heart with a real risk of permanent damage. Myocarditis, in simple terms, is inflammation of the heart. This inflammation enlarges and weakens the heart. It can also create scar tissue which restricts the heart's ability to pump blood and circulate oxygen. Some 38% of hospitalized COVID-19 patients suffer from myocarditis to some degree.

Barefoot running legend Zola Budd (54) is one of the latest to share her experience of suffering from Covid-19, and its impact on her running. Zola said she felt compelled to share her knowledge in order to inform other runners. Taking to social media, Zola said she and her daughter had both recently been diagnosed with Covid. Fortunately, both came through the illness without any severe symptoms but that was not the end of their coronavirus experience.

"It has been four weeks now since our positive test and three weeks since I experienced any symptoms," she wrote. "I decided to start training again and am experiencing the following symptoms: elevated heart rate. My heart rate, even doing easy runs of not more than 30 minutes is about 20 beats per minute faster than normal.

"Usually, after an easy run, it takes about 1 minute for my HR to go below 120bpm. Now, it takes almost four minutes. This shows me that even after three weeks of no symptoms, my heart is still under strain," she concluded.

British Olympic walker Tom Bosworth (30) contacted the virus last March just weeks after setting new 5,000m and 10,000m British records but says he did not feel "back to normal" until early August. He had resumed light training in May but found a coronavirus "weird effect" on his body.

"Even gardening was taking me out of breath," he confessed. "A few weeks earlier, I was in the form of my life, I'd set back-to-back British records and I just couldn't believe something could take me down as quickly as it did. "I did get back to training in May and went too hard, I really pushed my body, and it all just flared back up like the effects of any virus, neural effects, joint pain, that sort of thing, it all came back.

"But then as the days went on, and I built up training - and we're just talking about training once a day, I usually train twice a day - and by the end of a few weeks of that it was back to square one and literally putting one foot in front of another was so painful."

After reducing his training for several months, the Commonwealth silver-medallist competed just before Christmas in his first 20km race walk since the 2019 World Athletics Championships in Doha, winning the event in Portugal in a time of 83:56.Winning by a margin of over a minute and a half, it was an encouraging return to action for the 30-year-old who had not raced since the England Athletics 10km Championships the previous 1 March.

These more extreme outcomes are seen most often in competitive athletes, but the Covid-19 virus seems capable of affecting all sports people. Last August, former Florida State basketball player Michael Ojo died of apparent heart complications after collapsing during training in Serbia, shortly after the 27-year-old had recovered from Covid-19.

The Nigerian-born basketball player was taken to a hospital in the Serbian capital, but doctors failed to resuscitate him, Belgrade media reported at the time.Earlier Ojo was said to have tested positive for the coronavirusbut had recovered without the need to be hospitalised. Local media reported that he died of a heart attack.

"The sudden and shocking death has deeply shaken everyone in the club," his Red Star club said in a statement.

For that reason, cardiologists in the United States have been urging caution about the return of organised sports. Looking at athletes specifically, a recent Ohio State University study found that out of the two dozen plus athletes who tested positive for COVID-19, 30% had cellular heart damage and 15% showed signs of myocarditis.

To prevent the pandemic from leading to similarly tragic heart injuries among student athletes, the doctors at Ohio State University developed a new protocol requiring any player diagnosed with Covid-19 to receive a clinical examination, blood test, electrocardiogram, and MRIbefore returning to play.

Between June and August last year, 26 men and women from the school's football, soccer, lacrosse, basketball, and track teams showed up to be screened after having recovered from Covid-19. MRIs turned up inflammation of the heart muscle, a sign of myocarditis, in four of them. Of those, two had never experienced any symptoms of Covid-19.

The lack of symptoms yet suffering the apparent effects of coronavirus is probably the most frightening aspect of the condition. A well-known northwest athlete had experience of this. Both his parents were admitted to hospital in November suffering from Covid-19. As he had been in contact with them, and although he had no symptoms, he decided to get a Covid-19 test which returned a positive result.

Sadly, he lost both his parents while sitting out the mandatory 14 days self-isolation, again without any symptoms, and returned to his daily training. However, some four weeks or so later he started to feel a general loss of energy and an elevated heart rate when he attempted any exercise. He wisely consulted his doctor who arranged various heart scans which thankfully showed no damage, and after resting from training for a few weeks he has now returned to his daily workouts, albeit at a much slower pace.

It is not just sports people themselves who should be aware of the symptoms of long-term Covid. Coaches and trainers mustalso be mindful that the same personality traits that enabled the sportsman or woman to achieve success in the field are the same ones that can betray him or her by leading them to push too hard, too fast after they feel they have recovered from the virus.

It is important to keep them focused on the long term and assure them that sitting out a few extra days, or even weeks, in the short term can ultimately enable many more training days in the mid-term and long-term future. Above all the message is listen to your body, if you are tired and listless or notice an unusually elevated heart rate when you exercise, the best place to advance your sporting career may be on the sofa.In more extreme cases, consult your doctor.

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