NHL: Canucks must be careful about heart health as they return from COVID
The Vancouver Canucks, recovering from a COVID-19 outbreak in which at least 21 players and four coaching staff members got sick with the virus, were planning their first full practice in more than three weeks Thursday but their return to games was still on hold.
The NHL postponed the Canucks’ game Friday against the Edmonton Oilers and, according to an industry source, was planning to move the Maple Leafs’ games in Vancouver from Saturday and Monday to Sunday and Tuesday.
The league is expected to update its schedule by Friday. The Canucks, who last played March 24, had been slated to play 19 games in 30 days before the Friday postponement.
Vancouver forward J.T. Miller, who did not test positive, had said Wednesday that it would be “very challenging and not very safe” for he and his teammates to play Friday because the team has not had enough time to recover and get back in shape. “The No. 1 priority is the players’ health and the families’ safety, and it’s almost impossible to achieve that with what they’ve asked us to do here on our return,” Miller said.
The Canucks likely are looking at a gruelling sequence of recoveries and setbacks. Sports doctors know that returning to high-energy play is a crucial and potentially dangerous time for former COVID-19 patients, and that applies to professionals like the Canucks and amateur exercisers alike.
“Pains in the chest, increased breathing problems, a marked decrease in performance, unexplained fast heart rates, fainting or near fainting,” said Jame McKinney a cardiologist with Sports Cardiology B.C. “If you have those type of symptoms, you need to say ‘something’s wrong here’ and let your coach know, or if you’re a weekend warrior, see your general practitioner and get a referral.”
What could be wrong is that the COVID-19 virus attacked and caused inflammation or scarring around the heart muscle. It’s something that occasionally happens when people get viruses such as colds and influenza, and can be diagnosed as the condition myocarditis. Most people heal from the heart injury over time by staying away from high-intensity exercise but, in the worst cases, athletes can experience sudden death due to heart attack during
high-intensity exercise.
McKinney closely followed updates on whether COVID-19 could cause myocarditis from the earliest days of the pandemic. Reports from China showed it did. So he and a team of cardiologists across the country set out to form guidelines around returning to sport after COVID-19. They were working on a lot of common-sense assumptions, since there is much to be studied still on the link between the virus and heart health. Limited studies conducted with college and professional athletes in the U.S. showed incidence of serious heart injury such as myocarditis in elite athletes was uncommon — likely less than one per cent of COVID-positive patients.
What McKinney and the team of experts agreed was that athletes should refrain from returning to exercise for at least a week after their recovery. Then, they should watch closely for potential heart-related symptoms and go to their doctor if they appear.
That’s the moment the Canucks are at now. McKinney said that, if the early studies from the U.S. are right, the Canucks shouldn’t expect any player to have a myocarditis case serious enough to cause spontaneous death. But, anecdotally, athletes have reported difficulties getting back to their pre-COVID levels of fitness.
That includes Raptors player Fred VanVleet, who said that recovering from the virus had created a “conditioning wall” for himself and the team. “There’s spurts where we play high-level basketball and spurts where we suck, and it’s just fighting uphill,” he said this month.
Non-elite athletes who have had COVID-19 have reported similar struggles about getting back into their exercise regimens. Gavin Hermanson, a 23-year-old student at Concordia University in Montreal, said that before getting COVID-19 in September, he had a regular, intense exercise routine. He would lift weights at home and go on long cycling rides every week of about 100 kilometres.
His symptoms were relatively mild. But after he was over the illness and out of quarantine, he got a rude awakening.
“On the third or fourth day after I was allowed out, I hopped on a bike to pick up a package that had been waiting for me,” Hermanson said. “On this low intensity bike ride of about five kilometres, I had to stop like three times.”
He stopped all exercise except walking for several months. Even on walks his fitness tracker measuring his heart rate showed that it was up to the same level he would normally expect from more intense exercise like riding his bike.
“Cycling is the thing that brings me the most joy in the world,” he said. “It was scary and frankly depressing for the whole fall until my heart started feeling better.”