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Covid Return To Run


I tested positive for COVID… so, when can I run?

There’s a short and long answer to that question. The short answer is: hold all exercises for two weeks following your positive test. While it’s only been a year since COVID was identified, like any other illness, exercising while sick is not advised. Additionally, your body needs some extra time to bounce back to 100% even after all your symptoms have disappeared. Even asymptomatic individuals should hold off on exercise as a positive test indicates a virus in your system. The CDC recommends isolating for 10 days following a positive test (as long as symptoms resolve) and 14 days following exposure.

The long answer is a little more complex and based on the severity of your symptoms. In addition to being a respiratory disease, COVID has been shown to affect the cardiovascular system. In some individuals, this has resulted in cardiac symptoms that don’t appear until well after your other symptoms have resolved and you’re trying to return to running or any type of exercise. The majority of asymptomatic patients and those with mild cases do not undergo any type of cardiac screening. This can put them at an unknown cardiac risk with the return to activity.

In August 2020 two marathon cardiologists, Dr. Aaron Baggish and Dr. Ben Levine, published a return to exercise flow chart urging runners to take a more cautious approach following a COVID diagnosis. They compare returning to training too quickly to the mythological story of Icarus, who is too ambitious with his new wings and flies too close to the sun. It’s worth noting that both of these doctors have pushed for stricter screening in the past for pre-race health assessments, including a cardiac assessment.

The link to the article with the chart is attached here: Link

Below is a brief summary of the recommendations:

If your test is:

  • Negative: Keep on keeping on. You have no restrictions to what you can in your training.

  • Positive but asymptomatic: Take the full two weeks off. Even though you don’t feel anything, there is an active virus in your system. Let your body use your energy to fight it off, and then ease back into activity under the guidance of a medical professional.

  • Positive with mild symptoms: Similar to above, take two weeks off and don’t try to run while you’re sick. Take an additional two weeks off after symptoms resolve before returning to run and consider seeing a cardiologist for an evaluation.

  • Positive and hospitalized with symptoms: Same as above precautions. If cardiac testing is not performed in the hospital, consider testing before returning to activity and self-monitor for the onset of any cardiac symptoms.

As with any return to activity, ease back into training. Don’t try and jump right back in where you left off!

While the above might seem overly cautious, especially to us runners that may have returned to running (or continued to run) after being sick in the past, remember we are still learning new things about COVID daily. When in doubt, ask your health care providers (that includes us) for guidance. Listen to your body. If something seems off, take a rest day and get it checked out.

Baggish, A. L., MD, & Levine, B. D., MD. (n.d.). Icarus and Sports After COVID 19 Too Close to the Sun? Circulation,(142), 615-617. doi:10.1161

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