Effects of COVID19 in athletes and sedentary folks

Wondering if the crew could spend some time going over any studies showing the effects of COVID19 on endurance athletes vs sedentary populations.

Just anecdotally I’ve spoken with about three dozen people ranging from 20-60 who have had COVID since March 2020. With the exception of 1 couple in their late 50’s, the endurance athletes I spoke to appear to have suffered more from the effects of COVID19 than the sedentary folks. By suffering I mean the athletes were generally sicker for longer than their sedentary peers.

After catching COVID19 this past Thanksgiving I’m thinking that the athletes are biased when telling me if they felt better. For instance, a sedentary person generally isn’t pushing their lungs very much in their daily life so they will “feel” better sooner than an endurance athlete, who will be much more keen on how their cardiovascular system is performing. When I got sick I was off the bike for almost a month and wasn’t back to normal until three months post illness. My inactive friend, on the other hand, said he felt back to normal after one week.

I’m wondering if there are any studies suggesting that endurance athletes recover faster physically from COVID19 than sedentary folks, but report longer cardiovascular symptoms due to their exercise habits.

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The cyclists I have known who have caught covid have been the exact opposite. There first ride after isolation is a bit ropey, maybe the 2nd too but within a month they are back to as strong as ever. My mate who got it January usually wins open TTs or podiums (I think at the last, pre covid, amateur UCI worlds he was 7th and first Brit) and although the season hasn’t started here within a few weeks he was back to delivering his phenomenal power.

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That would indeed be interesting to know, I’ve been wondering about the same thing. Due to Covid I was 3 weeks off the bike. Started training again this week, so can’t say yet how fast I will be back to normal. But it’s clear I lost a lot of fitness and an easy session had me go to bed at 8 pm. I have this big event in June and am trying hard not to freak out over the amount of fitness I’ve lost. We’ll see.

In every day life I feel perfectly fine - so yes, I only notice after effects when training.

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So the point I’m arguing is that sedentary people don’t have the same recovery goals that endurance athletes have. For example if Joe is a couch potato and his friend Bob is an endurance athlete, Joe is going to feel “back to normal” before Bob because his idea of normal is not the same Bob. Joe will be back to his minimal level of activity while Bob will be wondering why his heart rate is still elevated doing zone 2 rides three weeks after recovering from Covid.

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COVID put me flat on my back. Whilst the initial symptoms cleared up relatively quickly, I have not been able to perform at anywhere near my past levels.

I’ve reduced training load, tweaked my rest and recovery and even taken all of my events off my calendar, in an effort to reduce both physical and mental fatigue.

To a degree, this has been successful. I don’t feel stressed. On the other hand, I also don’t feel like I’m able to start increasing my training load and there have been zero performance improvements.

If I’m honest, I’ve accepted that something isn’t right and for now, racing a bike is not the most important thing. I’ve had fun whilst it lasted and I’m 45 this year so, I do need to respect my body and realise I’m not that teenager anymore :laughing:

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This is exactly how it has been for me. My hr is elevated and im only doing 60% ftp. It has now been for this like 2 months and my expectations for this season is kind of pretty low.

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For such a study to exist you’d need some kind of baseline to measure recovery against. What would that baseline look like? For an active person you might be able to use their training / exercise history as a baseline. What are you going to use for the sedentary person?

Our health systems, certainly in the UK, are fairly reactive, and not preventative. They don’t do much about establishing what the baseline are for each individual. Thus if a patient is seen, are any results outside their baseline or not? A simple example is heart rate. If my resting heart rate was 60 or above I would be very concerned. A doctor seeing that might not be concerned as it’s in their population level of normal 60-100 bpm. Imagine they baselined your blood markers as well. Baselined blood pressure, baselined lung capacity, baselined kidney function etc. What is normal for you, what’s your baseline? Never mind population ranges.

You also have to be careful using exercise history. Some of the fitness loss will simply be due to time not training, and some due to Covid-19. Do you have a baseline for how much fitness a person loses if not ill, simply not training? Probably not. Then how do you separate the two?

One thing that has come out of ageing research is that life long exercisers pretty much preserve immune function. But as we have all seen, and must realise, our immune systems are all different. Just like our genetic potential for exercise capacity, some will have a high performance immune system and some will have a middle of the road immune system, and some a weak immune system. Exercise just helps tune the immune system you have.

I think you are down to anecdotes and opinions. Personally I think an active person will be more in tune with their body and pick up if something isn’t right whenever they exercise. Having said that, you hear of constant examples of people overtraining and pushing on when all the signs said they shouldn’t. They only see these signs in hindsight, or with the help of others, so maybe not all active people are tuned into how their are feeling and whether anything isn’t quite right?

One of the major risk factors for poor covid outcome is metabolic syndrome/insulin insensitivity/high blood sugar and as it so happens to be many very fit endurance athletes have (pre-)diabetic blood sugar levels

Hmm, the study was 10 individuals, and claims they did over 6 hours of exercise a week. Yet 2 individuals only averaged 20-24 mins a day during the study period, which falls far short of that.

They failed to measured BMR for two of the study subjects.

Exercise was also self reported rather than captured from any measuring device. Isn’t improved glucose sensitivity brought about by the lots of 60-75% max HR intensity of exercise according to ISM?.

A number of the plots in the full text only show 5 of the subjects, why is this?

Also they don’t really state what they mean by sub elite. You might think, it means they are at national level or something in their sport but nothing on that either. Sub elite just seems to mean not elite. Certainly 20-24 mins a day (of what exercise intensity we know not) is at a bare minimum kind of level and not what I’d associate with a sub elite athlete. The VO2max reported is average for males for the age range covered, from the tables I been able to find, not excellent,

Quite a few questions and limitations. Agree that insulin sensitivity is a problem but not sure how much you can draw about the role of exercise in (not) improving it from the study linked.

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To proof black swans exist you don’t need to proof the existence of 10 black swans, just 1 suffices. The fact that they measured something that contradicts the current theory is enough to discard the current theory: ver fit endurance athletes can be prediabetic and that is conclusively shown

Ah but we don’t know they are very fit endurance athletes. We know very little about the 10 and we know that two were only managing an average of 2.5 hours exercise per week. We know nothing of the intensity distribution or frequency of the exercise. The reported VO2max is average for men for the age ranges reported. The latter is not the profile of a very fit endurance athlete, though that is not a claim the authors of the paper made.

I think all you are going to get in asking these questions is anecdote. The “studies” I’ve seen have been small, self-selecting and of terrible design.

Average Joe generally doesn’t understand about resting HR, exercise response etc. They may feel “fine” after a week or so, and back to their baseline. However there may be physiological changes going still in the background that they don’t notice or care about.

Your keen amateur athlete will have a very different baseline. And generally more in tune with the changes in the body with exercise.

I can only share my experience (which is again no more than anecdote). I had COVID over New Year. Was ill for around 6 days, and no chest symptoms. Pretty certain it was Omicron. I was positive on LFD for 14 days. My resting HR was very erratic day to day though. I felt “fine” and started back some mild exercise. I would ride at Zone 2 power, with Zone 2 RPE but a HR consistent with a threshold workout. Completely stopped as my average resting HR was around 15% higher than pre-COVID. I also had some symptoms of headache, blurred vision and inexplicable fatigue. It was difficult convincing my GP that a resting HR of 46 was tachycardic for me, but my ECG was also “abnormal”.

Completely stopped any exercise as they needed to rule out myocarditis/pericarditis/cardiomyopathy. Cardiologist was unfazed by the “abnormal” ECG as the changes we consistent with those seen in athletes and with no chest pain nothing to worry about.

It’s only now that I’m able to do any intensity again, but I’m still down on power across the board.

My wife on the other hand is sedentary, and was fine after 10 days. Back to normal activities. But who knows if there have been any other changes as she doesn’t keep an eye on things like resting HR etc.

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Over the past 6 years I’ve taken several one month breaks, and always had elevated HR for 2-3 weeks after returning to the bike. So I thought it was normal when the same happened to me in October, after having C19 in early September. By the first week of December, 2 months after restarting, I was training at pre-C19 power:HR levels.

The first 6 weeks I trained by zone2 HR, and watched power levels climb quickly. Actually used walking and some light spinning in zone1 HR at first. Never tested ftp because my HR zones have been reliable since establishing them in 2016.

Pretty much mirrored what happened in 2019 after 2 months low activity level recovering from a thumb injury and then a month of travel.

But yeah, in terms of everyday activity I was back to normal the end of September. And then October and November appeared to work like previous returns after a long break.

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What was the abnormality in your ECG if you don’t mind?

Most endurance athletes have low resting HR. The base level for resting HR is 60 when you get an ECG. I’ve had “abnormal” ones for years because I dip ever so slightly below the 60hr during my exams.

That poster said their resting HR was 46. Their ECG will be abnormal because of that.

In other black swan news Tadej Pogacar had Covid. Hopefully he can recover fully.

There was an article last year around this time about maybe 10 triathletes who had Covid. I remember a number of them had resumed most training, a couple were back training 100% with no effects but they all were (cautiously) optimistic.

Wonder how they’re doing?

My baseline resting HR is around 40. A resting HR of 46 was abnormal for me, about a 15% increase. The abnormality in my ECG was that I had tall R waves. GP wondered if this was a sign of left ventricular hypertrophy, but cardiologist was happy given the exercise history, lack of other non-voltage ECG criteria and no other cardiac symptoms. This pattern doesn’t require any further investigation in athletes.

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I am assuming this would be so you can know if exercising means you recover better or worse? The problem is both groups are self-selecting.

The only study that could possibly lead to an answer would be one in which you randomly select from the population, have one group endurance train for 5 years and another group not exercise for 5 years. Then you would need give them the same strain of Covid and and see how both groups recover.

That would only really give you an answer for those people in those groups and that strain of covid. Obviously this experiment is very problematic. In other words, really any study of this topic would be highly suspect.

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Not quite. Scientific theory doesn’t fall so easily. Anomalies exist everywhere. The black swan isn’t a conceptual framework to describe observed phenomena, it’s a Venn diagram of two mutually exclusive facts.

I got an Apple Watch a couple of months ago and I waste way too much time looking at the health metrics. I recently had a booster shot during my rest week and I had a pretty sizeable bump in resting HR ~+15 bpm, especially about 12-36 hours post-shot when my immune system was in “all hands on deck” mode.

My resting HR is still a bit high, ~+3-4 bpm, compared to per-booster, but I did my ramp test a week after the booster (+12 ftp) and I am back into training so I wouldn’t read anything into that.

I know it is impossible to generalize from the booster effects to actually having COVID, but I do wonder if there is any correlation between the severity of the two responses. I sure can sympathize with all the people who have gotten whacked by this virus.

I’ll try and post the graphs of the change in my resting HR, but even three months after having COVID it’s still not back to normal.