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It's the topic that's been on everyone's mind for close to a year now; COVID. While everyone has heard of it, what should you do if you catch it? And how should you go about restarting your training if you've been unwell? Well, first, it probably goes without saying that if you're experiencing symptoms, it's vital that you don't train through them or try to "sweat it out". 

COVID is an airborne virus and will enter the body through the eyes, nose or mouth and moves down your respiratory tract. Symptoms can include a loss of taste and smell, fever, coughing, shortness of breath, fatigue, physical aches and chills, headache, sore throat, feeling congested, having a runny nose, nausea, and sometimes diarrhoea. 

COVID can inflame the lungs, making it hard to breathe. This could cause pneumonia for some vulnerable people. Still, for the majority of people, symptoms end with a persistent cough and a fever. The impact on the lungs will mean returning to exercise after recovering from COVID should be treated with caution.

Now, that's what we hear from everywhere, but until someone close to us or even ourselves end up on the wrong end of it, we may not comprehend these symptoms' gravity. I think I am ready to share my story. I have no intention to scare you, but it will highlight the importance of being super on top of your body and recognising when something is not right.

I started feeling tired and lethargic, and achy on Saturday 11th April last year. By Tuesday 14th, I developed a cough and a temperature. The whole family self-isolated, and I spent most of the week asleep in bed. 

We already had a SATS machine at home, so I was monitoring my oxygen levels. By Friday 17th, my temperature was up to 39, and my SATS were 94. I was advised to go to A&E, got a chest X-ray, was diagnosed with pneumonia in my right lung and given antibiotics, and got sent home thinking that they would sort me out.

I started taking the antibiotics but didn't feel any better at all. On Sunday 19th, after 2 days of antibiotics, my temperature was 39.5, and my SATS were 92. I went back to A&E and got put on oxygen. I had some blood tests and another X-ray that showed that pneumonia had spread to my left lung. I was put on IV antibiotics and was admitted to the hospital. I stayed on oxygen until Monday 20th. My oxygen levels remained stable without any assistance, and I was discharged on Tuesday 21st.

I came home expecting to feel loads better and bounce straight back, but my cough was still terrible, and I was breathless at doing the smallest of tasks. On Thursday 23rd, my temperature was 40, and my SATS had dropped to 85. I rang the doctors again, and they asked me to go in and be assessed. They put me straight on oxygen and rang an ambulance.

I got to the hospital, had more blood tests, another chest X-ray, a CT scan and an ECG. Even though I was on oxygen, it wasn't bringing my oxygen levels up, so they kept having to increase the dosage. After I had been admitted that night, the doctor and the consultant came in and discussed with me that because I was on the highest dose of oxygen and my levels were still going down, if that continued overnight, they would have to put me into intensive care and on a ventilator the next day.

Thankfully, my oxygen levels remained the same overnight, and although they weren't getting any better, they weren't getting any worse. On Sunday 26th, they started to reduce the levels of oxygen that I was on gradually. I was on IV antibiotics this whole time, and because of that, my liver function began to deteriorate. I got taken off all antibiotics and was on and off oxygen until I got discharged on Tuesday 28th.

I had been booked in for a blood test and another liver function test on Monday 4th May at the doctors. My oxygen levels had slowly been dropping since being at home, and I began to get another temperature. I got a call on Tuesday 5th May from the doctor saying that although my liver function still wasn't great, it improved. The bad news was that the infection markers in my blood had shot back up and that I was to go back into the hospital. I had another ECG, another chest X-ray and a full liver screen. Pneumonia had started to clear, and although my SATS weren't excellent, they were 94. I got sent home.  

When I got home, I was still fragile and breathless, and my skin was slightly yellow because of my liver function. I had lost 9kg since first starting to feel unwell less than 2 weeks earlier. My recovery was prolonged. I was exhausted most of the time and got breathless very quickly.

The infection markers in my blood tests gradually came down, and I had a scan on my liver, and it showed signs of improvement. It was probably 4-6 weeks before I even attempted to do any form of training. Even then, I was fragile and unable to do much at all. I slowly and gradually increased what I was doing and finally got somewhere close to my previous strength levels 6 months later.

After having COVID, your priority must be fully recovering first. Consider a very gradual return to exercise, even if you didn't feel like your experience of COVID was particularly serious. If you've had COVID, wait for at least 7 days after your last symptoms have vanished and return to exercise with no more than 50% of your regular work capacity. Doctors are recommending a prolonged build-up.

The long term effect of pulmonary functions is too soon to predict from COVID itself. Still, our understanding of SARS from 2003 suggests that there could be ongoing breathing problems and capacity for exercise. 

There are additional risks when considering psychological problems. Following a COVID infection, there's a risk of PTSD, anxiety and depression. All of which will be made worse if exercise is ignored.

If at any point, your symptoms return, you experience shortness of breath, or any chest pain, palpitations or start to run a fever, seek medical advice immediately. And if you had breathing difficulties or chest pains when you still had COVID symptoms, you are advised to speak with your cardiologist before returning to exercise because of the increased risk of myocardial inflammation.

Slowly building your activity level over time will be the best approach, starting with a considerably reduced training volume. The NHS's advice is to do little and often, giving yourself plenty of chance to recover between activities. They suggest starting with reducing the time you spend sitting by standing up once an hour and marching on the spot. 

When you're feeling a little better, aim for a daily walk with someone from your household until you feel comfortable and confident to walk alone. This can give your day structure and provide you with something to look forward to. Take all the rest time you want; this is part of getting back to your full strength.  

Select a time of day when you're awake and not too tired for your walk. If you've eaten a meal, wait an hour or so and bring a drink with you. Start with a goal of 5 minutes and build up slowly to extend the duration by a minute or two each time. Once you can walk for 10 minutes, consider introducing a second daily walk. Keep them both short. Once you can walk for 30 minutes without needing to stop and rest, you can think about increasing your speed.

If it's rainy, you may choose to exercise indoors. An indoor bike can be an excellent investment while you're recovering and getting back to your previous level of fitness. The goal is aerobic fitness, so you shouldn't be so out of breath that you can't speak in full sentences. If you feel a little warm while moving or even a bit tired and achy after, it's to be expected while you're recovering. Keeping a record of your walks can be encouraging as you see yourself making progress each week.

Once your aerobic capacity is sufficient, try adding some strength exercises gradually. It doesn't have to last too long in the first week, and you can even start with one set each day until you feel the energy to do more. If you think you may not be able to decide the right effort, don't hesitate to contact an expert and get help with your recovery to training.

Although progress with exercise should be slow, it's important not to get frustrated at your progress. With all recovery, treat it as diligently as you would treat your regular training to shorten the time it takes to get back to full health. 

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