How long to wait – and when it’s dangerous

Many people still feel weak and lack energy long after getting the corona virus. Photo: iStockphoto / Youngoldman

Your questions – our answers

Julia Jannaschk

Some lie flat for weeks, others are just a small cold: Corona disease can manifest itself extremely differently in each person. In Germany, there are currently around 1.6 million Covid 19 patients cured – the number is constantly increasing. But how do people feel when they are healthy again?

Baden-Württemberg’s Environment Minister Thekla Walker is currently out of action for a few weeks due to an inflammation of the heart muscle called myocarditis. But the exact number of Long Covid cases is difficult to record, as not everyone affected goes to the doctor or to the rehabilitation clinic.

Possible long Covid symptoms

– Chest pain
– Cough
– Pain in the joints
– Recurrent fever
– Muscle pain
– fatigue
– Depression and anxiety

Recent studies show that even young, healthy people have health problems for a long time after an infection. In a data donation project by two researchers at Humboldt University Berlin and the Robert Koch Institute, over 190,000 active users have shared their fitness data via their tracker with a data app since April 2020.

The result: Even weeks after a corona disease, the test subjects were less active. The daily number of steps was more than a thousand steps lower, the average resting heart rate was higher for more than 120 days on average. “The heart must obviously compensate for the damage that the infection has done to the body“, says Dirk Brockmann from the newspaper” SZ “.” ​​Lang Covid should not be underestimated. “

Those who have been vaccinated get back in shape faster

“On average, vaccinated people show fewer changes in their vital signs and return more quickly to normal levels,” Brockmann says. The resting heart rate recovered after three to six weeks and not after eleven weeks as in unvaccinated persons. On average, vaccinated individuals were as active after four weeks as before they became infected, while it took six to eleven weeks for the unvaccinated.

The data from the app are not representative, as educated people and those with a strong belief in science tend to participate in such projects, and fitness trackers are more likely to be owned by younger people. However, the data from the Berlin app match results from a study in the UK. In it, 38 percent of respondents said they still suffered from at least one Covid 19 symptom twelve weeks after surviving the infection, and 15 percent even three.

We talked to dr. Lutz Graumann, Physician for Sports Medicine, Chirotherapy & Nutrition Medicine, what to consider if you want to start exercising again after a corona disease.

How long can I not play sports after the corona infection?

The most important thing when returning to the sport after a corona infection is patience. It can be very difficult, especially for sporty people, but it is extremely important, as the sports doctor explains. If you start too early, you could risk harming your health. Even with an asymptomatic course, it should be ten days of rest.

A heart rate measurement in the morning can provide additional information about how healthy you are again. If you want to know more about it, you can make a heart rate variation measurement, with which you can find out if and when the resting heart rate has dropped again.

Regardless of the severity of the disease, Graumann recommends waiting for “complete symptom relief” instead of just waiting for a negative test result.n. It is best to be symptom-free for seven days. “I should wait until the body itself has fought the virus and the immune system can do its job,” Graumann says. Only then do you need to think about sports again.

The expert states:

“Most of the time, if you do a PCR test at all, just wait until the test is negative again. If you start training again right away, there is a high risk that you will get too excited too soon. So the only thing I can do is warn you, stick to this protocol, and there’s less chance that something bad will happen. “

How do I get back to training after Corona?

Graumann has worked out exactly how to start training again in a protocol based on a study from England, following the guidelines of the research group Elliotts and others. This is a scientific group dedicated to theirs Return-to-play protocol focused on reintegration of athletes after Covid-19 diseases.

This sports protocol includes six levels and provides a step-by-step and accompanied guide to getting back to the sport. After a few days, you can increase your performance again.

Return to work & sports management is primarily aimed at people with mild and moderate disease progression. “But you still should not underestimate this infection. We keep seeing delayed cases, which means people can not return to the sport right away, and people who need a longer break,” Graumann says.

“One should not underestimate this infection.”

To start with, Graumann recommends starting with 15 minutes of jogging or cycling, “in an area where I can easily have a conversation”. This is best followed by an interval load, ie a short duration with a slightly faster movement. In the meantime, one should be aware of possible physical symptoms such as shortness of breath or palpitations.

What symptoms should I not train with?

If the symptoms recur on the way back to sports with light exertion, you should return to the starting level. Graumann also recommends that in this case you seek medical attention and have your blood taken and your heart checked with an ECG. “What we always see today is that the heart beats a little irregularly and makes a few extra beats. Something like that needs to be clarified,” the expert says.

A sudden drop in fitness after a good phase after a corona infection is also a clear sign that you have exaggerated yourself and strained yourself too quickly.

Grauman says:

“Many patients describe palpitations. They notice that the heart is doing strange things, increased fatigue or pain when going up stairs.”

“What we always see today is that the heart beats a little bit irregularly and makes a few extra beats.”

Another symptom in the early stages of sports is heavy legs or joint pain, even after light exertion. “If you are active in sports, you should usually be able to withstand this small load in the first two or three levels the next day. But for many, it means that they feel the load in the bones the next day.” says Graumann.

What is the risk of myocarditis with overexertion?

Graumann warns against getting started too quickly: “What a meltdown is, so what we want to avoid is that the pericardium becomes inflamed.” That is, the much-feared inflammation of the heart muscles, also called myocarditis.

“What a meltdown is, so what we want to avoid is inflammation of the pericardium.”

This is not so easy to recognize as there are no clear criteria for myocarditis. The only definitive means of determining myocarditis is a nuclear spin examination of the heart, the so-called cardiac MRI. However, a routine check for heart damage is not recommended. You should only have your heart examined if you have symptoms such as chest pain, shortness of breath, tachycardia, stumbling or short-term unconsciousness (syncope).

“Often the changes in the heart can only be detected with the help of an imaging cardiac examination. Specific criteria are therefore important for the diagnosis and treatment of myocarditis. Medical Thomas Voigtländer, CEO of the German Heart Foundation. But do not let it get that far.

Myocarditis can also occur after an mRna vaccination, as a recently published study from Scandinavia shows. Young men in particular are at risk. But according to the German Center for Cardiovascular Research, an infection is still more risky than a vaccination: According to this, the risk of myocarditis from Covid-19 is at least four times higher than with vaccination. It showed studies from the US, UK and Israel.

Generally important: If there is evidence of heart damage or myocarditis, strenuous physical exertion should be avoided for three to six months.. “This rest period is the best way to avoid damage to the heart muscle,” confirms cardiologist Prof. Voigtländer, medical director at the Agaplesion-Bethany Hospital in Frankfurt am Main, in a public statement.

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