What It’s Like to Run After Recovering From Covid-19

I live in New York City and am married to an Emergency Physician, so it may not come as a surprise when I say that I contracted Covid-19 three weeks ago. While I did not get tested, my wife, who had the exact same symptoms, did get swabbed at work and was positive, so it is almost certain that I had the 'rona as well.

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There have been many accounts of what it feels like generally, so I thought I would talk about how I dealt with contracting the disease, recovery, and dealing with the remnants afterwards as it pertains to my running.

Before Covid-19

I am not a pro runner, but I am not an amateur either. I am a sub-3 hour marathoner (2:58:04 NYC '19), with 10 under my belt so far. This year, I was signed up for four marathons (Mt. Charleston, Chicago, NYC, Philadelphia) and have tried to maintain marathon shape throughout the entire year. In the weeks before contracting the virus, I was running between 50 and 65 miles per week, with an average of 56. I would run 5-6 times a week in the mornings, with daily runs no shorter than 8 miles, and a longer run on the weekends.

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My marathon goal pace this year was a 2:55:00, meaning I set my base marathon pace for training at 6:40/mi, and my calculated paces ranges were:

• Tempo: 6:19/mi - 6:27/mi
• Marathon Pace: 6:35/mi - 6:45/mi
• Easy 7:36/mi - 8:43/mi

I use the excellent Daniels' Running Tables spreadsheet for those interested. Twice a week on Wednesday and Friday mornings, I would do speed workouts with the New York Harriers, generally working 10-12 miles with 3 mile warm up/cool down and tempo, hills, and/or intervals in the middle.

On long runs, I could go 23 miles without a problem, and without soreness the next day. I would run long runs generally with a 7:20/mi - 7:30/mi pace, and try to get some 6:40/mi miles in the middle or near the end of the run. All of my prep work had been paying off, and I was feeling nearly ready to run the Mt. Charleston marathon in early April, when the Covid-19 virus first starting hitting New York City, and everything changed.

Covid-19 in NYC

On March 1st, the first confirmed Covid-19 case was reported in NYC. Starting on that day, I self-quarantined and changed my routines. I was the first from my company to work from home. I maintained social distancing with my ER Doctor spouse, even within our home. I stopped going to the Harriers workouts, but I did not stop running. It was actually one of the only things that still made me feel "normal" throughout the month of March.

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I was able to maintain my routine and weekly distances, all while weaving and bobbing through Central Park, trying to stay six feet away from other runners and pedestrians. As gyms started to close around New York City, more and more runners emerged in the park as their treadmills were no longer available. Throughout the month of March, I felt great, maintaining good pacing and speed control.

The Mt. Charleston marathon was canceled on March 19th, but I was still sticking with my marathon training plan. I wanted to run a marathon solo on the day of the canceled event, so kept my distance run increases steady up to my peak week, and was planning on tapering down up to early April, though wasn't very successful in tapering off my weekly mileage. I felt great, and was running well, when all of a sudden, I got a fever…

Getting the Disease

In the middle of the night on April 1st, I woke up hot and drenched in sweat. Using an over the counter oral thermometer, I had measured a 99.9° temperature and knew I was in trouble. The following morning, I ended up with a 102.5° temp, and general body pain. My spouse gave me a once-over and declared me (most likely) Covid-19 positive. She herself wasn't symptomatic at all, but was most likely the source due to the exposure in the hospital.

I won't go into the details of what it was like being sick, but I will fast forward to the evening of the 2nd, where my fever, and all other symptoms, just vanished. It was like nothing ever happened. I locked myself in the house for 72 hours after my symptoms went away, closely monitoring my temperature, blood oxygen levels, and other vitals, and felt great. My wife declared the viral-shedding portion of the infection most-likely "over", and we both were grateful that my symptoms were not that bad.

I didn't run on April 2nd, 3rd, 4th, or 5th, but after getting my doctor's approval and checking the CDC guidelines, I decided to get back out there on the 6th, taking it short and easy. I ran 4.3 miles at an easy run pace and noticed something was a little off… It was a little bit tough to breath while running.

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Author's Note:

There is a lot of misinformation out there and a lot of opinions on the web, mine included. While some people may be mad at my decision to run, I did so by following my doctor's guidelines, and the CDC guidelines as they existed at the time. Those guidelines currently state:

Persons with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:

• At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications
• Improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
• At least 7 days have passed since symptoms first appeared.

To be honest, I can't remember if the third point was established yet on April 6th, but I took 5 days off, and passed the other two criteria for resuming activity with protection.

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Throughout the time spent at home not running, I never had a cough, never felt short of breath, never felt any lung issues at all, but when running, I felt as if I was not able to get 100% of the oxygen I needed to maintain the activity. I told my wife about how I felt, and she ultrasounded my lungs to take a look at what was going on inside of them.

For anybody in the medical field that may be reading this, according to my wife:

This scan shows multiple B-lines in the inferior posterior aspect of the lung suggesting interstitial edema that is consistent with COVID lung findings, which are also very commonly found in other viral pneumonias

In layman's terms, my lungs were full of moisture, remnants of the disease, making it tougher for my body to absorb and covert the oxygen it needs for strenuous activity such as running.

I felt great though. My legs were well rested, I didn't feel sick at all, I was ready to go. So I decided to try and power through it, hoping that by running, I would be able to burn it off. Coming back out the next day, I decided to let my body control my pacing, for my normal distance of 8.5 miles. I ended up running a 7:19 pace, but it was not easy. I kept feeling "phlegmy", and was coughing up a little during my run. Not wanting to spew any fluids into public, I swallowed anything that I might have coughed up, and also covered my mouth with my mask or sleeve whenever coughing.

I went back out the next day, and the next, each with hopes of burning out the remnants of fluid in my lungs, but it didn't get any easier. My Strava pace and run notes from those 4 days:

• April 6 - 4.3mi - 7:41/mi: I got sick, recovered, waited 72hrs post fever, first run back, taking it easy just in case
• April 7 - 8.5mi - 7:19/mi: Still taking it easy
• April 8 - 8.3mi - 7:26/mi: Still taking it easy on my lungs.
• April 9 - 8.5mi - 7:22/mi: Still having a hard time breathing. Even though I’ve recovered, I’m worried I might have permanent damage

Another New York Harrier reached out to me after one of these early runs and gave me some context as to what I could expect over the next few weeks:

Hey man, I’m on the Harriers. Saw your run description so wanted to message you that I had Corona and how it affected my running. Started feeling crappy March 17 and couldn’t run for three days, but my chest didn’t hurt. Began running again March 20th for two days and then felt sick again but this time with chest/breathing issues. Couldn’t run again for another three days. I prob came back way too soon but the first time I felt normal on a run, chest and body wise, was April 5th so it’ll come back soon.

I originally doubted the estimated time line of how long it would take to get better, but they were 100% right.

I had been trying to run the same route each day to get a sense of how each part has been getting easier or harder day-to-day. My go-to route is a one mile warm up to Central Park, a single counter-clockwise loop, and a mile back home. This route has a few stress points on it, notably Cat Hill (mile 3), the Harlem Hill (miles 4-5), and the Three Sisters (miles 5-6). I found myself short of breath on the tops of each of these hills, much more than I normally would be. I have been having to stop to catch my breath before moving on, something I never did before at all.

Using a decently accurate Garmin chest strap, I noticed that my average heartbeats per minute was elevated about 10 beats higher than normal, at all parts of the run. I normally run at a steady 141 bpm on flats, but was regularly hitting 150 or higher on the same portions. My heart was working harder to get oxygen to my muscles, which was is short supply because my lungs were not absorbing at 100% due to the residual moisture in them.

I decided to take the next several days off to see if it would help. Resuming after four long rest days on April 14th, I still felt like my lungs were full of fluid. It may have been slightly easier, but it was still tough. My pace was starting to get back down to normal though, but I was still working hard to get my oxygen.

• April 14 - 8.5mi - 7:00/mi: Running with this mask suuuuucks
• April 15 - 5.2mi - 7:14/mi: Legs and mind are ready to run, lungs are still making it tough. So frustrating!

At this point I was pretty scared. I thought that I might never feel normal again while running. It was frustrating that everything about me felt healthy and ready. My legs were fresh, I had no cough, my mind was ready to run, my heart was fine mostly, but my lungs were just not cooperating with me. I got a little depressed and decided to take one more day off, then another few runs to test.

• April 17 - 8.5mi - 6:51/mi: Not getting any easier. Tough to keep this pace with my lungs the way they are... trying to power through to burn it out
• April 18 - 8.5mi - 6:56/mi: Maybe getting better? Still doesn’t feel normal, but seems to be getting easier to keep pace
• April 19 - 10.8mi - 7:31/mi: Tougher on my lungs than any other day the past week. What a bummer. Had high hopes of doing a long run today

After a depressing Sunday run, I decided to take another rest day and went back out on Tuesday with my standard 8.5 mile run around Central Park:

• April 21 - 8.5mi - 6:43/mi: Sunday was horrible. Yesterday was a rest day. Today felt like normal again. Strange times.... Maybe I am finally getting over this virus

Am I getting better? I think so, but I still don't feel normal at all. My pacing got back down to sub-7 this week, but it feels like I am having to work much harder at it to keep that up. Of course, running with the mask isn't making it any easier, but my mask is pretty flimsy and shouldn't get in the way too much. It is really only there to prevent bits of spittle from leaving my mouth as I run.

It has been 22 days since I was first symptomatic, but I am still feeling the long-lasting effects of this virus. On the more challenging parts of my runs (read: up hills), I feel as though I am breathing in deeply only to have the needed oxygen blocked by some sort of mucus moisture barrier. Is it bad? I don't know… It certainly doesn't feel 100% normal yet, but I am able to keep pace, and aside from the anomaly this last Sunday, I seem to be improving each day.

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As a disclaimer in conclusion, this is a completely anecdotal account of running while recovering from Covid-19. It should not be used as medical guidance, running guidance, or anything else other than to give you an idea of what might happen, should you catch the virus and try to keep running while recovering. It gets better, though it takes several weeks!

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