Dealing with Covid during Marathon Training

There is never a good time to get covid (period!). After evading covid for 2.5 years, my time was due. Even though we’re 2.5 years into this pandemic, there is little known about return to sport guidelines for athletes post-covid since every case is variable. Fortunately, Omicron is mostly mild these days and the percentage of hospitalization is much lower, nonetheless, there is still fear and stress involved regarding long covid. I don’t write this post to provide any medical advice, you should always consult your primary care doctor first. I only share this post for others going through the same experience.

I got covid in September 2021 after an exposure from a patient in clinic. With Berlin Marathon coming up, I considered myself extracareful and always wore a mask in clinic. The only thing I can think of is covid got through my mask, but who knows. I was actually just coming off a posterior tibial tendon injury in August and voluntarily opted to take a full week of rest to heal and give myself the best shot at Berlin. Cross training during a marathon build up is stressful because regardless of how much time you spend on the bike and weight room, you still don’t feel like you’re doing enough. I spent hours in the gym during this week off from running. My return to run was going somewhat well and after my first workout back, I developed a scratch in my throat that felt similar to post nasal drip. I prayed to god I wasn’t getting sick, which is the last thing I needed to deal with. I desperately needed those last 4 weeks of training to put in enough miles to confidently do Berlin. My travel arrangements had already been made and it was too late to cancel. That night, I tested negative on home test.

The next day, I waited for my symptoms to progress. I’ve heard horror stories of body aches, night sweats, awful bed ridden days so I always thought if I had covid, that is how it would present itself. I still had a mild sore throat on Friday and tested negative. Ran 8 miles and it felt fine, not totally great, but ok.

Saturday morning before my long run, I decided to covid test since I was running with my cardiologist friend Arvind. I almost threw away my covid test before I could see it…. That faint line under the “T”. I took another test and that faint line became more visible. Holy shit, I had just tested positive for covid 4 weeks before Berlin Marathon. For the rest of the day, it felt like I had been kicked when I was already down and I scrambled to find as much information as possible. Covid would require more time off and by the time I would recover, it would be 2.5 weeks before Berlin.

(Photo is my covid test on day 3 of having a mild sore throat.)

The first thing my friend Dr. Arvind Nishtala and I did was classify the severity of my covid case. There are updated CDC guidelines now differentiating between severity and return to sport. Fortunately, my covid case was more mild than a typical cold. My symptoms were: sore throat days 1-3, mild congestion & phlegm days 4-5, lethargy & fatigue day 6-8). I did have a cough throughout that lasted for about 3-4 weeks total. My average sleep during covid was 10 hours/night. While my initial covid test was faint early on, the T line did get darker and indicated more viral load by day 5.

I ran the first 2 days I was symptomatic, but only because I tested negative and didn’t know it was covid. I continued to walk for exercise to get some fresh air. I never felt bed ridden. I tried to run on day 5, 30 minutes (very easy 9:15 pace) and my heart rate was almost 150. Normally, my heart rate is in the low 130’s at that pace so I knew it was out of the norm. I called my coach Mario and we both decided I would scratch out of Berlin Marathon and focus my efforts into getting healthy for CIM at the end of the year. It was a hard pill to swallow. I’ve waited for Berlin Marathon for a year since I time qualified. Perhaps if it was just covid, I would still do it. Coming off a post tib injury made it complicated. Even then, I was scared at how taxing running a marathon (even an easy one for me) would be on my immune and cardiovascular system. It was logical to skip it.

That being said, my return to run started about 9 days of complete rest. I took an extra 2 days since I wasn’t racing Berlin anymore. I gradually returned to running once I tested negative. Coach Mario had me doing 3 miles the first day, and adding a mile each day after that for about 5 days. The following week, we started doing very light workouts again but still keeping volume low. My heart rate was still elevated by 5-10 bpm, which could be normal due to not running for 9 days. All in all, it took me about 4 weeks to feel normal during running. I fortunately never experienced shortness of breath or chest pain, but I did have difficulty with running anything faster than threshold pace. It took about 6 weeks total for me to feel 100% normal with running and hitting paces I normally would.

My best advice for someone dealing with covid is be patient the first 7 days. We often get blindsided when we have a race coming up and it’s hard to think logically, but listen to your body to avoid getting long covid. When in doubt, go see your doctor! I didn’t make my training decisions alone (thanks to my coach and sports cardiologist) and neither should you. I am immensely grateful for the vaccine and boosters available to us that getting covid is the norm these days and the rate of hospitalization is very low.

I also really enjoyed this podcast and found it super informative for runners with covid: Rambling Runner Ep. #459 - Monica Verduzco-Gutierrez, MD: Returning to Running Post-Covid/Long Covid