You finally get over a bout of Covid. Your symptoms all seem to be gone for good. Then, you head out for your first run, only to find yourself desperately struggling to catch your breath.

There’s a lot we still don’t know about Covid. One thing we are beginning to see, however, is that there seems to be a connection between recovering from Covid and experiencing breathlessness while running.

Even a mild case of Covid has left some runners with breathing difficulties

Omicron didn’t hit me hard at all,” says Sarah, a 28-year-old PhD student in London. “I felt fine aside from a headache on the first day.” When her isolation period ended, Sarah was eager to head out for her usual jog. However, she was surprised to find that what had once been an easy jog had become impossible. 

“I set out for my usual 5k around the park but could barely manage a fraction of that,” she recalls. “My lungs completely seized up, and I had to stop and spend a few minutes recovering. I felt abnormally breathless.”

Covid is still being studied by the medical community, and we’re still learning about why the virus can cause breathlessness in some people. When it comes to running, there are a few hypotheses about why some people are more affected by Covid than others.

“Changes in how oxygen is exchanged in the lungs of some patients post-Covid has been shown to be altered in some studies,” says Dr Helen Wall, GP and lead of the Covid vaccine program in Bolton. Some people, she explains, begin to exaggerate their breathing involuntarily, which can lead to hyperventilation. “This makes getting decent amounts of oxygen to tissues may be more tricky.”

After a few weeks, Sarah finally managed to build up the lung capacity to complete her usual 5k. However, she remains perplexed by her odd reaction to the virus. “It was a strange experience as I hadn’t noticed anything wrong with my lungs while I had Covid,” she says.

For runners with Long Covid, breathlessness can be a long-term issue

Other runners have had even more serious, long-term reactions.

Lois, a 39-year-old blogger and businesswoman from Brentwood, had a similarly frustrating experience – but her breathlessness still hasn’t completely gone away.

Female runner out of breath
Sarah had a mild case of omicron but was left unable to complete her usual run

“Running is a fantastic activity for fitness and therapy, but after contracting Covid for the second time, I found I would get very tired and out of breath just doing the smallest of runs,” she said.

Eventually, Lois realised she was dealing with a case of long Covid

“In the end, I had to quit my running to concentrate on building my lung capacity with breathing exercises and doing some short yoga sessions instead.”

For Laura, a 29-year-old living in London, Covid-related breathing problems have also forced her to quit running.

“I’m usually quite a healthy, active person but since having Covid I have noticed I am out of breath just from walking up the stairs or from just walking and talking at the same time,” she says. “I do feel I am getting better slowly but it has shocked me how bad I have been. I thought it would all be OK once I got a negative test rather than being an ongoing thing.”

Laura gets so breathless with small movements that returning to running has been impossible. “I haven’t managed to try to go for a run yet. Even walking brings on a coughing fit,” she explains.

What does the science say about long Covid and breathlessness while running?

With long Covid, Hall explains, the body is essentially tricked into thinking it has worked harder than it has, leading to premature fatigue. “Long Covid patients may carry a SARS-CoV-2 S1 protein in cells that makes the body think it has worked out more than it has,” she says. “This leads to a reduced ability to exercise like you could before and increased fatigue.” However, she notes, the studies are unclear so far. As she put it, “Some other studies have found exercise can reduce long Covid symptoms, so it’s all very uncertain right now.”

Tired woman running with covid
We still don’t know enough about Long Covid or how it can affect runners ability to breath

Sarah, Laura and Lois were three healthy and active women who didn’t think Covid affected them much at all — until they tried to run. Covid resulted in notable breathlessness with each woman seemed to experiencing a different level of severity in her symptoms. Why?

“Essentially, we are now seeing that there are tangible physical changes in the bodies of some who have had Covid – mild or otherwise – particularly in how their lungs and circulatory systems work,” replies Hall. In other words, the body seems to react to the virus in its own unique way — but experiencing physical changes in lung capacity seems to be possible for anyone, even the healthiest, most active runners.

We still don’t know enough about the effects of long Covid

Ultimately, Hall believes that more research is needed. Right now, all we really know is that long Covid has the potential to be unlike any other long-term post-viral illness. “Studies are starting to demonstrate some possible Covid-specific physical changes can affect people’s ability to exercise or in some more severe cases even do day-to-day things like go shopping,” she says. 

We still don’t know why some people experience long Covid symptoms and others do not. We also can’t predict which organs will be affected by long Covid — for some, it may be the lungs; for others, the heart. For runners, this uncertainty, unpredictability and seeming lack of support is nothing short of terrifying.

However, there is good news on the horizon for avid runners who are concerned about the physical, seemingly chronic changes to their lung capacity post-Covid. In January, Nottingham University launched a global study into the impact of Covid on runners. The study will offer research-based advice on the best methods to train and recover pre-Covid lung capacity and fitness levels.

But for now, all that really is clear is that Covid isn’t always just a cold and we still don’t know how our bodies will react to the virus — especially on our morning runs.

While there may not be a cure or even an explanation for breathless in runners post-Covid, if you’re experiencing similar symptoms, know that you’re not alone. So listen to your body and try not to push yourself until you feel better. If you’re worried about ongoing breathless while running, be sure to check in with a GP.

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