Returning to physical activity after COVID-19
Returning to physical activity after covid-19
David Salman, Dane Vishnubala, Peter Le Feuvre, Thomas Beaney, Jonathan Korgaonkar, Azeem Majeed, Alison H McGregor
Salman D, Vishnubala D, Le Feuvre P, Beaney T, Korgaonkar J, Majeed A et al. Returning to physical activity after covid-19 BMJ 2021; 372 :m4721 doi:10.1136/bmj.m4721
Background and Scope
A frequent question for primary care clinicians, particularly in the early period of the pandemic, was how to return to exercise following Covid-19 infection. This was more so as people acknowledged the role of obesity and non-communicable disease in exacerbating severity of Covid-19 illness. However, at the time of writing, most guidance was focussed on returning athletes to training and competition. This article set out to bring together some of the key principles from previous work and apply them in a pragmatic way to help support physically active individuals in the general population.
The article discusses some of the key concerns regarding physical activity (PA) following Covid-19 infection such as myocarditis, thromboembolism and psychiatric sequelae. It covers a risk-stratification approach, advocating only returning to PA once the person has been symptom-free for at least 7 days, and tailoring guidance to their pre-morbid state. It also discusses the potential for post-covid illness, and that those with ongoing symptoms regardless of system will need more individualised management. Those whose illness required hospitalisation, or with symptoms suggesting cardiac involvement, are likely to need support from post-covid rehabilitation services. Finally, the article offers a suggestion for a phased return to PA, and advocates self-monitoring at all stages for returning symptoms, excessive fatigue and inability to recover. These might indicate the need for further assessment and support.