News
October 25, 2025
ASK THE DOCTORS: Exercise intolerance one of the symptoms of long COVID
Dear Doctors: I’ve been an endurance athlete my whole adult life. After having COVID-19, I’ve gone from running marathons at an 8-minute mile pace to needing walking breaks whenever I run. Are there studies about long COVID and endurance? How...
Endurance athletes experiencing a sudden drop in performance after recovering from COVID-19 might be suffering from a common symptom of long COVID: exercise intolerance. In a recent "Ask the Doctors" column, medical professionals addressed concerns from a lifelong marathon runner who found themselves struggling to maintain their usual pace and needing walking breaks after contracting the virus. This highlights a growing understanding of the lingering effects of COVID-19, even in individuals previously considered to be in peak physical condition.
The athlete's experience, transitioning from running marathons at an impressive 8-minute mile pace to struggling with even moderate runs, is a stark example of the debilitating impact long COVID can have on endurance. Exercise intolerance, in this context, refers to the body's inability to perform physical activity at the level it could before the infection. This can manifest as extreme fatigue, shortness of breath, muscle weakness, and an overall feeling of being unwell even after minimal exertion.
While the exact mechanisms behind exercise intolerance in long COVID are still being investigated, doctors believe several factors may contribute. These include damage to the heart and lungs, dysfunction of the autonomic nervous system (which controls functions like heart rate and breathing), and persistent inflammation throughout the body. Studies are ongoing to better understand how these factors interact and contribute to the condition.
The physicians responding to the athlete's query emphasized the importance of listening to your body and avoiding pushing yourself too hard. Gradual return to exercise is crucial, with careful monitoring of symptoms. They also stressed the need for further research into the long-term effects of COVID-19 on athletic performance and the development of effective rehabilitation strategies for those experiencing exercise intolerance. Consulting with a doctor specializing in sports medicine or long COVID is highly recommended to develop a personalized plan for recovery and safe return to activity. The athlete's experience serves as a reminder that even seemingly mild cases of COVID-19 can have significant and lasting consequences, particularly for those who rely on physical activity for their well-being.
The athlete's experience, transitioning from running marathons at an impressive 8-minute mile pace to struggling with even moderate runs, is a stark example of the debilitating impact long COVID can have on endurance. Exercise intolerance, in this context, refers to the body's inability to perform physical activity at the level it could before the infection. This can manifest as extreme fatigue, shortness of breath, muscle weakness, and an overall feeling of being unwell even after minimal exertion.
While the exact mechanisms behind exercise intolerance in long COVID are still being investigated, doctors believe several factors may contribute. These include damage to the heart and lungs, dysfunction of the autonomic nervous system (which controls functions like heart rate and breathing), and persistent inflammation throughout the body. Studies are ongoing to better understand how these factors interact and contribute to the condition.
The physicians responding to the athlete's query emphasized the importance of listening to your body and avoiding pushing yourself too hard. Gradual return to exercise is crucial, with careful monitoring of symptoms. They also stressed the need for further research into the long-term effects of COVID-19 on athletic performance and the development of effective rehabilitation strategies for those experiencing exercise intolerance. Consulting with a doctor specializing in sports medicine or long COVID is highly recommended to develop a personalized plan for recovery and safe return to activity. The athlete's experience serves as a reminder that even seemingly mild cases of COVID-19 can have significant and lasting consequences, particularly for those who rely on physical activity for their well-being.
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