It is not advisable to exercise while actively infected with COVID-19. Exercising during an active infection can worsen symptoms and lead to severe health complications. Resting and allowing the body to recover fully is important before returning to any exercise routine.
Risks of Exercising While Infected
Exercising with an active COVID-19 infection carries notable risks, particularly concerning the cardiovascular and respiratory systems. A serious complication is myocarditis, inflammation of the heart muscle. Though rare, this can occur even in individuals with mild or asymptomatic COVID-19. Exercising with an inflamed heart can exacerbate the condition, potentially leading to heart failure, abnormal heart rhythms, or, in severe cases, sudden cardiac arrest.
Beyond cardiac concerns, the respiratory system can also be negatively impacted. COVID-19 primarily affects the lungs, and exercising during an infection can intensify lung inflammation and prolong respiratory symptoms such as shortness of breath, cough, and chest tightness. While initial reports emphasized lung damage, post-COVID exercise intolerance may also stem from factors like muscle weakness or impaired oxygen extraction by tissues, even when lung function appears normal. Pushing the body too hard during an active infection can also increase the risk of developing long COVID symptoms, including persistent fatigue and reduced exercise capacity.
When to Resume Exercise Safely
Before returning to exercise after a COVID-19 infection, ensure acute symptoms have fully resolved. Most individuals can gradually resume physical activity 7 to 10 days after symptoms first appeared, provided they have been symptom-free for 24-48 hours without fever-reducing medication. For asymptomatic COVID-19 cases, at least three days of rest after a positive test is recommended before gradually reintroducing activity.
Individuals who experienced more severe COVID-19 illness, such as those requiring hospitalization or having pre-existing heart or lung conditions, should seek medical clearance from a healthcare professional before resuming any exercise. This medical evaluation helps assess for any underlying complications or persistent issues that might make exercise unsafe. The decision to return to activity should be guided by the resolution of symptoms and a feeling of general well-being, rather than a fixed timeline alone.
Gradual Return to Activity
Once the criteria for safe return are met, a gradual, phased approach to exercise is recommended to prevent setbacks and allow the body to re-adapt. Start with very light activity, such as short walks or gentle stretching. Begin with approximately 15 minutes of activity at around 50% of your usual intensity, ensuring you can comfortably hold a conversation throughout the exercise.
Maintain this low intensity for a few days, typically two to three, before increasing duration or intensity. Over the next several weeks, gradually increase the intensity to about 75% of your pre-COVID level, extending the duration as tolerated. Listen closely to your body and avoid pushing through any new or worsening fatigue, shortness of breath, or other symptoms. Incorporate rest days for recovery and adaptation.
Warning Signs and When to Seek Medical Advice
During the process of returning to exercise, certain symptoms serve as important warning signs that warrant immediate cessation of activity and medical consultation. These include chest pain, persistent or severe shortness of breath disproportionate to activity, or heart palpitations and irregular heartbeats. Dizziness, lightheadedness, or feeling faint are also red flags.
Other concerning symptoms include unusual or overwhelming fatigue that does not improve with rest, and swelling in the legs, ankles, or feet. If any of these symptoms occur, stop exercising and seek prompt medical attention. Consulting a healthcare professional is also advisable if you experience a prolonged inability to return to your previous exercise levels, or if fatigue persists for more than a month after your initial recovery from COVID-19.