Realmuto played designated hitter and batted fourth in a 5-1 win over the Toronto Blue Jays in Dunedin, Florida. He went 0-for-4 and drew a bases-loaded walk that made it 1-all in the seventh. Realmuto also grounded out with the bases loaded to end the third and struck out with two on to finish the fifth.
Realmuto felt ill and had a fever Wednesday night and was placed on the IL in accordance with MLB protocols. He didn't accompany the team on its flight to Florida but was cleared by MLB to return and traveled on his own.
The Blue Jays played their third and final homestand at their spring training ballpark because of COVID-19 protocols in Canada. Toronto will be shifting games to Buffalo, New York, next month.
Realmuto left Tuesday's game against the Washington Nationals after taking a foul ball off his left knee and sat out Wednesday night due to bruising and soreness.
Realmuto is hitting .302 with four homers and 17 RBIs. The two-time All-Star is in the first season of a five-year, $115.5 million deal.
A player goes on the COVID-19 IL by testing positive himself or for contract-tracing purposes after possibly being exposed to someone who tested positive.
The Associated Press contributed to this report.