Return to play after covid-19 disease

Physical activity is one of most important parts of a healthy life style. After covid-19 we have to consider alterations needed in prescribing exercise

The guidelines for returning to exercise should consider elite athletes as well as the general population in different categories.
We may also classify the patients to these categories:
1-those who were not affected by Covid-19 or were completely asymptomatic and were home- quarantined; this group will suffer from deconditioning. They have to begin milder physical activity and reduced duration compared to the previous active days before quarantine. The increase in volume and severity of exercises are based on the general condition and the patient’s tolerance. All major changes should be monitored by a medical profession expert.
2-Those who were affected by mild to moderate Covid-19 and were not hospitalized; this group will suffer from decreased cardio-respiratory fitness as well as deconditioning. They have to begin with semi-monitored activities. Oxygen saturation should be monitored during physical activity and supplementaloxygen may improve tolerance and safety.
3- Those who were affected by severe Covid-19 and were hospitalized; this group will suffer from severe generalized muscle wasting and decreased cardio-respiratory fitness. They have to begin with in-patient rehabilitation.
All participants have to pay attention to social/physical distancing and good hygienic measures, proper warm-up/ cool down, adequate hydration, and appropriate dietary regimen.
Many affected patients may need protein supplements to counteract severe muscle wasting; anti-oxidant and vitamin-mineral supplements may be helpful because of long term decreased intake during hospitalization (low appetite, intensive care measures, and gastrointestinal symptoms)
Psychological consultation to manage post-traumatic stress disorder, anxiety, depression, obsessive symptoms should not be neglected.

Dr. Laleh Hakemi- internist
Medical Committee of Iran Taekwondo Federation