Here’s Why Exercising Is Tougher After Covid

Topline

Many people say they find it difficult to work out after a bout of Covid-19 and these setbacks go beyond the usual struggles that follow physical illness, according to a study published Wednesday in JAMA Network Open, further illuminating the diverse array of symptoms suffered by those with long Covid that can last for months after infection.

Key Facts

Difficulty exercising can be added to the list of symptoms that emerge or linger in the months after infection, according to an analysis of nine studies comparing exercise performance between long Covid sufferers and those who recovered from the virus.

While the studies showed evidence of deconditioning following Covid infection—the bodily changes that come after a period of inactivity and are expected after illness—the researchers said the phenomenon could not account for all of their findings.

The researchers noted irregular breathing patterns and a reduced capacity to increase heart rate during physical activity as other factors that could contribute to the exercise difficulties faced by people with long Covid.

Muscles being less able to extract and use oxygen from the blood is also a contributing factor to the exercise difficulties faced by people with long Covid, the researchers said, citing studies showing people with long Covid to have lower peak levels of oxygen when exercising in a laboratory.

Dr. Matthew Durstenfeld, a professor of medicine at the University of California, San Francisco and one of the study’s authors, said the drop roughly translated to a woman aged 40 with long Covid having the expected exercise capacity of a 50-year old woman without the condition.

Durstenfeld said another way of viewing it would be having to switch from doubles tennis to stretching exercises or playing golf with a cart, or, instead of swimming laps, switching to low-impact aerobics, though the findings are averaged and he stressed each person will experience different drops in exercise capacity.

What We Don’t Know

The researchers said it was not possible to estimate how severe the drop in exercise tolerance is for those with long Covid or how common it is to experience the issue, though they said the study found a “modest but consistent” trend. While there have been multiple studies covering a large number of patients exploring the matter, the researchers said the quality of evidence is poor owing to the small sample sizes of most studies, which leave results open to bias.

Key Background

Though we are now years into the Covid-19 pandemic, our understanding of long Covid remains poor. It appears to be relatively common—the WHO estimates between 10% and 20% of Covid survivors—though there is no precise way of diagnosing the condition. Experts are not certain of the syndrome’s underlying causes—leading theories include immune system problems, lingering virus in the body after infection and blood clotting issues—or how long it lasts for and there are no proven treatments. Long Covid does not strike equally, with women and those hospitalized with the virus more likely to develop the condition. Experts and public health officials, including WHO chief Tedros Adhanom Ghebreyesus, warn of the “devastating” impact long Covid is having on millions of people around the world, as well as imposing a heavy economic burden that could delay our recovery from the pandemic.

Further Reading

Women And Hospitalized Patients More Prone To Long Covid, Study Finds (Forbes)

The astounding impact and reach of long Covid, in numbers and charts (Guardian)

‘I Had Never Felt Worse’: Long Covid Sufferers Are Struggling With Exercise (NYT)

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