I’ve been around slowtwich for quite sometime and don’t post often, but, this one hits close to home, so against my better judgement I’ll try to help (which always ends well on ST lol

I went through a pretty horrific Covid experience I don’t care to talk about (neurological mainly but a handful of other issues), but I’ve experienced some of what you are saying.

I’m a coach and athlete, so I’ll speak from those positions. I’ve lived it, but almost all my athletes have had it at some point, so I’ve lived that with them.

Not a doctor, take my advice for the price you pay for it. Just some dude that wants to help.

I’m not gonna debate on what it is because everyone is different. Nervous system, vagus nerve, brain fog, multi organ effect, acute respiratory, undiscovered issue it brought to surface, blah blah blah. It’s endless the possibilities. We have a better data point on Covid now, but even I still have very little answers after every test you can probably think of and that’s a pretty common theme. It’s frustrating for doctors not having answers and frustrating for athletes.

Anywho, my advice, is you shouldn’t be going hard, especially with that blood pressure swing. Wanna stay active? No problem, keep it chill, z1/2/3, but if you think you’re somehow doing any good by subjecting your systems to intense workouts while they struggle to normalize, I’d take a step back and look at a better route to healing. Your Blood pressure is obviously out of whack, that’s a recorded data point we can look at, but, there’s likely a whole other set of undiscovered issues contributing to it. Will they resolve on their own? Maybe, some of mine did. Will a doctor need to diagnose and figure it out? Maybe, some of mine needed it. Either way, subjecting your body right now while it struggles is essentially asking it to breathe while you hold it under water. Might make ya feel better mentally, but physically it’s probably not moving the needle in the right direction. This also has to be contributing negatively to your mental health wondering if you’ll die. I know it did for me. Your nervous system at minimum could do without interpreting death.

I’m not saying don’t train/be active. I think most athletes “need” it and I think the stimulus is productive when used in the right format to keep things moving internally, but, I’d make a better plan that’s significantly more conservative. Make a safe base phase, set yourself up to get the body under control, get your blood tests in order, consult a cardiologist if needed and when it comes back around for the season ahead you’ll have all that base waiting for you to build a sweet house on with the confidence things are going terribly wrong underneath.

I’ll finish with this now that I’ve been a Debby downer on ya. It will get better. You will be back. It will take time. What does that look like? No one knows. Keep knocking, you’ll find an answer eventually.

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"A wise man once told me......God doesn't call the equipped, he equips the called."

[not a Dr./expert, just like reading about COVID]

Pretty safe advice, I think. Of all the running theories about long COVID and other lingering COVID weirdness, the needle almost always points to "chill for longer than just the first day you feel recovered." Which is hard for us Type A athletes.

I was listening to one Dr. on NPR this past weekend who has a (as yet unproven) theory that a signficant cause of long COVID is COVID re-awakening dormant Epstein-Barr virus. And of course to minimize the odds of that, the prescription would be "chill for longer."

Thank you for the great post! What you are saying makes great sense. But it is hard to not go maximum at times. While I am taking it easy someone is always out there out training you!

I hope this covid sequelae doesn't last too long!

Life > race results.

I took it easy for about 3 months post my first round of COVID, and about a month after my second.

Take it slow.

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Editor-in-Chief, Slowtwitch.com | Twitter

A single reading of 145 / 85 (in the doctor's office, etc) for a person otherwise normal is not much of an indicator by itself. When you say "hovering" what do you mean?

The normal advice in that circumstance, is to get a home BP cuff, and take daily morning, resting, readings for a week or two. The American Heart Association has instructions on how to take a valid set of morning readings---the procedure matters. That is what I would do before assuming that you had COVID induced hypertension---it could just be a bad-day-at-the-office....or it could be something.

What did your doctor say in regards to working out / intensity?

Notwithstanding alternate advice regarding your suspected hypertension (or confirmation of its persistance), the guidelines for return to sport post-covid are here:

https://www.fsem.ac.uk/...aphic-grtp-covid-19/

I've been hypertensive for nearly a week now. I've taken my blood pressure at several times throughout the day at home and at work even by a RN. In the past I would check my blood pressure periodically and it was always low. No change in my diet and I am taking no drugs or even vitamins. It really is an aberration which came on almost exactly 30 days after Covid.

There is at least one study which says 12% of those who had Covid have hypertension 30 days (+/- 5 days) after.

My physician told me to "take it easy." Like most of us here, I'm not sure what that means...

In that case, "easy" certainly doesn't include any HARD, or even moderate efforts, as we athletes would define them. Without simply asking a clarifying question, I'd lean on Stage 2/3a of the GRTP protocol I linked. Somewhere between 70-80% maxHR, and 15-30 minutes of activity.

But honestly, in your case I'd email your doctor as simply ask for a HR/duration definition of "easy". I've done exactly that on many occasions.

Given that EBV has infected like 90%+ of humans on the planet, it is easy enough to link it to pretty much anything and everything.
Even Goop's website agrees with that - https://goop.com/...-of-chronic-illness/

Outside of this paper, has there been any other well reviewed research that links EBV to long covid? This paper is pretty dodgy on many levels, ie it is based on 30 self selected/reported "long haulers".

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Next races on the schedule: none at the moment

I don't know, and I forget the name of the researcher I was listening to.

But I'm picking on the quoted bit, because that's just the nature of long COVID. It's a collection of symptoms correlated to having had COVID just prior. There is no definitive "test." Yet. So every case is going to be "self-selected."

And it's absolutely in the "dodgy" stage of research, teasing out correlations to try to tease out what's likely to be mixture of "causes" rather than one super-satisfying single mechanism.

I just mentioned the Epstein-Barr research because it seems to make some intuitive sense. It's pretty well established that Epstein-Barr is a weird-ass virus. To use lay terms. But even the researcher looking at it fully admitted there are a few dozen long COVID avenues being researched, and most of them might be going down fruitless paths, including his. That's the nature of science.

And just because Epstein-Barr *can* be linked to lots of things doesn't mean it *isn't* linked to many of those things. Just because you find a correlation doesn't mean there isn't causation. For example there are recent studies indicating a link between EBV and MS. (here's one) Of interest to me, because my wife has MS. The methodolgy being used here is a bit more clever than the logic like, "100% have toes, and 100% of people with long COVID have toes, therefore toes cause long COVID." Which can be gathered by the details of the Nature article I linked to or even the dodgy one you did.

Sorry to hear about your wife's MS diagnosis.

The research referenced in that paper tested for a single antibody and from what I can tell 1 in 5 people have it (perfectly healthy people that is). And in my memory it's been linked to vertigo, chronic fatigue syndrome, menopause, fibromyalgia, etc etc etc. It's not too different from blaming oxygen because it is almost equally omnipresent.

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Next races on the schedule: none at the moment

To share my experience that may help just knowing someone else has experienced something similar. And, it would've helped me at this time I went through this. Hopefully it helps you...

I tested positive in mid-July '22. I had an Oly 3weeks later. I felt like *ss for a week, then felt "normal". By normal I mean I didn't have the chest cold, gnarly nose or anything that came to me with Covid. Actually, I've had "typical" non-Covid colds that have taken multiple weeks to feel normal. My bout with Covid was only a week long - or so I thought. I can't tell you what my BP was during, but my RHR was 40 before, ~48 during & back to 40bpm 7-8days after testing positive. All good right? NOPE.

My easy Zone 2 runs pre-Covid were 120-124HR with an LT of 160. Post Covid at the same pace, same route, my HR was 148-154. I thought I was going crazy. Then I thought I was f*cked for life. I tried running to 124HR and my pace doubled to the SUPER slow side. I took it real easy leading up to the Oly; Zone 2 HR work only. I went to the Oly because I felt "fine" and "there's no way I'm not better by now", and sucked. My wife said I was shaking in T1 & T2, which she hadn't seen before (I didn't even feel it during, but you could see it on video). My HR was never below 162 during that race and hung near 168 for the close to 2.5 hrs. Afterward I learned about myocarditis and chilled WAY down. All in it was a week to feel physically "normal". It was 8weeks from my positive test for my cardiovascular system to recover. Myocarditis... I think I dodged a bullet.

My take-aways (i.e., what I'll be reminding myself the next time I get it, if I get it again): It will be okay. You're not going crazy. You can feel fine physically but still be affected cardiovascularly. Train to HR - when your pre-Covid paces come back inline with your HR post Covid you're probably good to get back after it.

FWIW...

Thanks for sharing your experience! I really like to know what others are going through with this weird disease.

I was probably going too hard when I first had Covid and didn't ease off. I may be cooked for a while!

Chipping in with my story so far.

Had Covid-19 in July, a very mild case that essentially was just a cough and a fatigued feeling. Resumed normal training (at the time a running block of 4-5 runs per week) as soon as I felt the fatigue was gone.
Noticed slightly elevated HR, around 10-15 % higher than normal at slow paces. Decided to skip all z4+ sessions and only focus on z2 until HR was normal. After a couple of weeks with no change decided to get a medical check-up (over here basic post-covid tests include regular blood sample, ECG and testing for hyperthyroidism). No issues found and was adviced to treat it as overtraining i.e. staying active but acknowledging that doing to much will delay recovery.

Over 6 months have now passed since and am still not recovered, on the contrary my HR is now even higher than before. Advice was still the same in my latest check-up, to stay active and wait it out. In practice I have given up all training, as walking gives me an HR level of what 6 months ago was my z2 run.

These experiences are kind of depressing! My physician says my elevated blood pressure may be my new normal. At least for a while. I hope.

one of my cycling friends had this, was borderline hypertensive before Covid then went to 240/110..
tried several different medications, got it down to about 140/80 eventually. That took a month or two. He had to switch to walking for his exercise. It's getting slowly better, about four months now, but not yet back to normal.