Take it easy after COVID-19 recovery

Q: My 17-year-old son plays lacrosse and basketball on his school teams (when they’re playing). In late April, he contracted a mild case of COVID-19. His symptoms have been gone for about two weeks and tests show he has COVID19 antibodies. He wants to start running and working out regularly so he can be in shape when the sports teams start up again. Is it safe for his health and for others?

The American College of Cardiology’s Sports & Exercise Cardiology Council, with input from national leaders in sports cardiology, has put out a document that outlines what we know, what can be recommended, and what cautions should be taken to protect the heart health of competitive athletes and highly active folks who have recovered from COVID-19.

They point out that evidence of acute cardiac injury is found in up to 22% of people who are hospitalized with COVID-19. In contrast, other acute viral infections trigger such heart woes in only about 1% of patients. For these folks, the experts say it’s vital they take it easy for three to six months once symptoms go away and that they be screened for any persistent cardiac abnormalities, such as irregular heartbeat. They should return to vigorous exercise only when they no longer have any biomarkers for inflammation, arrhythmias or heart valve dysfunction.

For other athletes, like your son, who had a mild case and were not hospitalized, the experts recommend a minimum of two weeks with no exercise training once symptoms have gone away and a careful evaluation that includes looking at cardiac biomarkers (such as enzymes in the heart muscle or blood) and imaging. With no symptoms and no evidence of heart problems, it’s OK to return to exercise training. Ongoing monitoring to spot popup heart problems should continue, however. Also, he might see an adult cardiologist for an enzyme test after a workout. If it’s negative, he should then follow up regularly to spot any new symptoms.