Myocarditis fears over COVID-19

[amum/Cathy]

Is anyone else worrying about their dancing dcs not allowing for recovery time if they get COVI-19? I haven’t really looked into the incidence of myocarditis yet but I came across this article this morning. https://www.wired.com/story/if-youve-just-had-covid-exercise-might-not-be-good-for-you/ talking about myocarditis in athletes. Are any of the vocational schools/colleges monitoring or warning their students? After a summer of zoom classes with ds home where I could keep an eye on him, he’s now back to Trinity Laban where I have to trust he’ll be sensible. 

 

[alison]

"If a person rests while they are ill and during recovery, most of the time the inflammation recedes and the heart muscle heals on its own. But strenuous activity while the heart is weakened can cause swelling in the legs, dizziness, shortness of breath, and—in serious cases—irregular heartbeat, cardiac arrest, and sudden death."

 

I cannot stress enough the importance of taking things easy and listening to your body while recovering from COVID-19.  We seem to have lost sight of the concept of convalescence after serious illness - a friend had pneumonia about a decade ago, and was off work convalescing for months afterwards - and expect to be as right as rain after a few weeks, and that's not always the case.  Not only is there a possible risk of myocarditis (although I have no idea how common it is), but there is also quite a serious risk (it may be as high as 1 in 5, if I'm recalling the stats correctly) of developing a post-viral syndrome which at the very least appears to have a lot in common with, and may actually be, myalgic encephalomyelitis (M.E.)/chronic fatigue syndrome (which, believe me, you do not want to develop), and which frequently seems to be triggered or worsened by people trying to return to exercise too fast (Google on Paul Garner, British Medical Journal and Covid "long haul"/"long tail", for example).  Even with a "mild" dose of Covid (and some of those "mild" cases seem to turn out to be some of the worst, longer-term), it would be sensible to return to exercise gently and cautiously (and "exercise" might just be a walk round the block at first, not going out for a short jog - and "pushing through" the fatigue could be disastrous) and rowing back on it if you get any adverse after-effects, even a day or two later.

 

NOT intended as medical advice as such - and I'm sure not what Cathy wants to hear - but this is a summary of what I've picked up from cases of patients who have been thus affected.  Of course, they do say that young people generally seem to recover better/get less ill with Covid, but there are exceptions.

[Anon2]

I think it’s worth remembering that dancers and athletes must learn to listen to their bodies following any illness and not bow to any pressure from teachers to return to training if they don’t feel 100%
 

One of the reports I’ve read regarding myocarditis (from Bart’s research) comments that although they had tested x number of covid +ve patients for myocarditis they have never done a similar study with influenza patients so don’t know how it compares. Any infection can cause myocarditis and the symptoms can vary from tiredness to stage 4 heart failure. 
 

Whilst my Dd was at vocational school I used to pay for her to have the flu jab. Although it was no guarantee she wouldn’t get flu I would hope she’d be lucky and therefore avoid any complications. 

[amum/Cathy]

This is an easier article to read about the study of athletes on a US student sport scheme who had MRIs of their heart done. https://edition.cnn.com/2020/09/14/health/covid-heart-inflammation-athletes-study/index.html

 

 

[amum/Cathy]

2 hours ago, alison said:

"If a person rests while they are ill and during recovery, most of the time the inflammation recedes and the heart muscle heals on its own. But strenuous activity while the heart is weakened can cause swelling in the legs, dizziness, shortness of breath, and—in serious cases—irregular heartbeat, cardiac arrest, and sudden death."

 

I cannot stress enough the importance of taking things easy and listening to your body while recovering from COVID-19.  We seem to have lost sight of the concept of convalescence after serious illness - a friend had pneumonia about a decade ago, and was off work convalescing for months afterwards - and expect to be as right as rain after a few weeks, and that's not always the case.  Not only is there a possible risk of myocarditis (although I have no idea how common it is), but there is also quite a serious risk (it may be as high as 1 in 5, if I'm recalling the stats correctly) of developing a post-viral syndrome which at the very least appears to have a lot in common with, and may actually be, myalgic encephalomyelitis (M.E.)/chronic fatigue syndrome (which, believe me, you do not want to develop), and which frequently seems to be triggered or worsened by people trying to return to exercise too fast (Google on Paul Garner, British Medical Journal and Covid "long haul"/"long tail", for example).  Even with a "mild" dose of Covid (and some of those "mild" cases seem to turn out to be some of the worst, longer-term), it would be sensible to return to exercise gently and cautiously (and "exercise" might just be a walk round the block at first, not going out for a short jog - and "pushing through" the fatigue could be disastrous) and rowing back on it if you get any adverse after-effects, even a day or two later.

 

NOT intended as medical advice as such - and I'm sure not what Cathy wants to hear - but this is a summary of what I've picked up from cases of patients who have been thus affected.  Of course, they do say that young people generally seem to recover better/get less ill with Covid, but there are exceptions.

Alison I agree completely with everything you have said here. Thanks for posting. I worked in General Practice with CFS sufferers for about 10 years - often seeing them through from first presentation until recovery. That warning to "rest when you are ill and allow recovery time" is one I gave often to patients attending with acute viral illnesses. Often those who go on to suffer CFS are those working flat out physically and mentally, who are too impatient or driven to slow down and follow that advice. I'm scared for our dc dancers. I wish I knew the colleges/schools were watching out for it and insisting students were aware of the issue. 

[amum/Cathy]

1 hour ago, Jane said:

I think it’s worth remembering that dancers and athletes must learn to listen to their bodies following any illness and not bow to any pressure from teachers to return to training if they don’t feel 100%
 

One of the reports I’ve read regarding myocarditis (from Bart’s research) comments that although they had tested x number of covid +ve patients for myocarditis they have never done a similar study with influenza patients so don’t know how it compares. Any infection can cause myocarditis and the symptoms can vary from tiredness to stage 4 heart failure. 
 

Whilst my Dd was at vocational school I used to pay for her to have the flu jab. Although it was no guarantee she wouldn’t get flu I would hope she’d be lucky and therefore avoid any complications. 

Completely agree about the flu jab. I've always paid for my dcs too. That's interesting about not knowing how prevalent myocarditis is for influenza. In fact we have no idea for chronic fatigue syndrome patients either I suspect. Cardiac investigations weren't on the protocol for diagnosing CFS when I worked with CFS patients.  Probably only those with POTS ( Postural orthostatic tachycardia syndrome) got those investigations, and then it was some years down the line.

[Anon2]

https://www.sciencemag.org/news/2020/09/evidence-builds-covid-19-can-damage-heart-doctors-are-racing-understand-it  
 

It was this article I read. The Bart’s team do a lot of research into cardiac muscle damage at the best of times so hopefully will get funding/support to carry on their work into covid damage 

[alison]

1 hour ago, amum/Cathy said:

I worked in General Practice with CFS sufferers for about 10 years - often seeing them through from first presentation until recovery.

 

Lucky them, if they recovered.  Many don't, hence my concern  

[amum/Cathy]

7 hours ago, Jane said:

https://www.sciencemag.org/news/2020/09/evidence-builds-covid-19-can-damage-heart-doctors-are-racing-understand-it  
 

It was this article I read. The Bart’s team do a lot of research into cardiac muscle damage at the best of times so hopefully will get funding/support to carry on their work into covid damage 

Thanks for the article Jane.

 

6 hours ago, alison said:

 

Lucky them, if they recovered.  Many don't, hence my concern  

Alison the ones who recovered relatively quickly were the ones who were picked up straight away, as soon their post viral fatigue period was ended and they still had symptoms they were referred to the Immunologist and started working with a key worker. Those who were shunted around from doctor to doctor without anyone properly taking responsibility for getting them investigated and diagnosed did less well. The longer they had the symptoms before getting the help they needed the longer it took to see improvement, basically. 

[alison]

Sounds only too familiar.  (What's an immunologist? )

[amum/Cathy]

On 16/09/2020 at 23:34, alison said:

Sounds only too familiar.  (What's an immunologist? )

Alison it's a consultant physician specialising in immunological diseases and disorders. They are generally looking to rule out autoimmune disease (eg thyroid or lupus) when patients are referred with a potential diagnosis of CFS/ME, but also infections (such as Lyme disease if there's a possibility of tick exposure). The GPs should be doing an autoimmune screen blood test anyway but the immunologist may consider rarer ones.