Article Notes
See the more recent 2022 article, Return to exercise post-COVID-19 infection: A pragmatic approach in mid-2022, which also sets out a graduated return to exercise, though is perhaps even more pragmatic.
This editorial from authors working in elite sport, exercise medicine and sports cardiology, contextualises the best current advice on returning to exercise after COVID infection, specifically acknowledging the Omicron variant and its potential differences.
"...with over 6 million cases recorded in Australia & NZ in the first 4 months of 2022, and few reports of serious adverse outcomes with exercise, the approach to return to exercise has become more pragmatic."
The author's experience has been that most vaccinated elite athletes achieve pre-morbid fitness levels after COVID recovery by day 7-14. Recreational athletes are recommended to pursue a more conservative course, but nonetheless they suggest:
"...a quick return to moderate exercise with a more cautious return to higher intensity exercise."
For those with no or minimal symptoms, the authors describe a graduated approach of exercise return over 6 days (days 1-3, 50% intensity for 15-30 min, then days 4-6, 75% intensity for 30 min), culminating in return to normal activity on day 7 if the graduation is well tolerated.
Elite athletes with close medical and training supervision may be able to undertake an accelerated progression of training intensity.
The full-text article includes a useful decision flowchart.
The usual 'correlation is not causation' qualifier is very necessary here. Perhaps doubly-so because this is a meta-analysis using pooled data of over 1 million people.
It's completely possible that someone who chooses to receive an influenza vaccine is also someone who makes more cautious health decisions and is more risk-averse, reducing their COVID exposure risk. The vaccinated are also more likely to be from better health-serviced locations and probably from higher socio-economic groups.
Still, interesting association nonetheless.