Running with an Elevated Heart Rate After COVID

As a journalist and an athlete, I like answers. And with COVID-19, there aren’t a lot of clear ones. I found this to be true after I got COVID-19 in March of 2022. I experienced lung and heart problems after COVID, including an elevated heart rate.

It was hard to find information as to why my heart rate was spiking, if it was a cause for concern, and IF I should not run until it was regulated. I found that from athletes I personally know and fellow runners in my Instagram community, having an elevated heart rate after COVID was fairly common.

elevated-heart-rate-after-covid
It’s common to have an elevated heart rate after recovering from COVID.

But did that mean it was safe to run with a higher heart rate? I still had so many questions. So, I’ve dug into the research to share what I have learned about cardiac symptoms after COVID and long COVID to help guide you in your training and treatment. 

Note: I am NOT a doctor, though this information comes from doctors and researchers. Always follow your doctor’s guidance.

Related: How to Start Running After Having COVID

My Experience with Cardiac Symptoms After COVID

I want to begin with a quick overview of what happened to me with my COVID recovery. Obviously, every case with COVID is different, which is a huge reason why it is all so confusing. But maybe, my experience can help you find answers or recover quicker.

Related: How to Return to Running After COVID Reinfection

In April of 2021, I got my second COVID shot and experienced severe chest pain later that day. I ended up in the ER with pleurisy (inflammation of the lung lining). It took me 6 weeks to recover, including a 6-week break from running. Nothing like this has ever happened to me before.

In late March of 2022, I went for a 16-mile run and felt pretty bad. I continued to feel bad the next morning. My stats on all my wearable fitness tracker, WHOOP, were all off including my Heart Rate Variability which is an indicator that you may be getting sick.

I tried to do a shake-out run and my heart rate was very high. I returned home and took a COVID-19 test which tested positive.

Related: How Long Does It Take to Lose Running Fitness?

My Progression of COVID-19 Symptoms

I felt very sick for about 3 days including a deep cough, fatigue, and shortness of breath.  A week later, I felt better and attempted to run. After four days of light running, I regressed.

I experienced heart problems after COVID including heart palpitations, heart rate spikes, chest pain, shortness of breath, and what felt like an irregular heartbeat.

I went to a walk-in clinic and got my blood drawn, a chest X-ray, and an EKG which all came back normal.

A week later, I continued to feel ill. My WHOOP kept showing my vitals out of whack including heart rate spikes. For example, when I was putting peanut butter on a bagel, my heart rate was in the 140s.

Related: Garmin Stats Explained

My post-COVID-19 Diagnosis & Treatment

elevated-heart-rate-covid
Pin this information about elevated heart rate after COVID and COVID concerns for later.

I went to see a doctor. She diagnosed me with chest wall inflammation and sympathetic overdrive. She prescribed steroids, an inhaler, and rest.

I took a few days of complete rest and then began walking. About 10 days later, I did a 3-mile jog, alternated run days, repeated mileage, and progressed. (Read more on my return to run plan below).

My heart rate was unusually high on my runs. My resting heart rate dropped to 41 and then went up to 57 (46 is my norm). And I had brain fog and fatigue no matter how much I slept. In the third week, I felt markedly more energetic with less brain fog.

I am 5 weeks into my recovery, and I am happy to report that everything is normalizing minus some chest pain and an elevated heart rate.

Why I Wrote This Article

The time scales for recovery differ for everyone. Still, I believe my COVID-19 recovery journey and research may be helpful to you.

I think while the new variants of COVID-19 may produce a milder infection, it’s important for people (especially runners) to understand it is still more taxing on the body than a bad cold and it’s important to be conservative in your return to running.

As Dr. William Li, physician, scientist, president and medical director of the Angiogenesis Foundation, and author of Eat To Beat Disease: The New Science of How Your Body Can Heal Itself, told me:

“While COVID infection has become much milder for most people, the unpredictable nature of serious aftereffects is still something the medical community is very concerned about.”

In this article, I am going to discuss:

  • What research has found about elevated heart rates after COVID
  • When to be worried about your heart after COVID
  • Why your heart rate may be higher after having COVID, and
  • How to run if you have cardiac symptoms post-COVID, and more.

So, let’s go.

What the Research Finds About Cardiac Symptoms After COVID

A study, published in Nature, of more than 37,000 people recovering from COVID-19, found I was not alone in my lingering symptoms. 

Tracking the data from wearables like FitBit, the researchers revealed that:

  • After 9 days of first reporting symptoms, the participants’ resting heart rate dropped.
  • Then, the heart rates rose and remained elevated for months. The resting heart rate was elevated 5 beats, on average.
  • On average, participants had elevated heart rates for 79 days.
  • Sleep and physical activity returned to baseline more slowly.

Why does my heart beat faster after having COVID?

Researchers and doctors believe the prolonged heart rate elevation is a sign that Covid-19 disrupts the autonomic nervous system,

autonomic-nervous-system
The autonomic nervous system controls unconscious functions in the body. Graphic from BYJU’s.

which regulates basic physiological processes.

This explains why the heart races, palpitates and causes dizziness. This may also explain fatigue and brain fog.

“Lots of people who get Covid end up getting autonomic dysfunction and a kind of ongoing inflammation, and this may adversely affect their body’s ability to regulate their pulse,” explained one of the researchers, Dr. Jennifer Radin.

Is it normal to have a high heart rate after COVID-19?

Yes. Research shows it is normal to have a higher heart rate for more than two months after recovering from COVID-19.

In my personal experience and an unofficial Instagram poll of more than 100 runners, 85 percent had elevated heart rates. Most of these heart rates normalized in time

Related: When to Skip a Workout & How to Adjust Your Schedule

All of my tests came back normal, but I am still having chest pain and a rapid heart rate, what is going on?

You’re in good company. Many others and I have had tests like blood tests, an EKG, x-rays, and cardiac MRIs return to normal yet still experience an elevated heart rate, shortness of breath, and chest pain.

Doctors, including my own and those at UAB, attribute this to sympathetic overdrive along with chest wall inflammation which your body should heal in time.

However, if you are concerned about your condition, consider seeing a cardiologist to get more tests and wear a Holter monitor, which monitors your heart around the clock.

“This can document when your heart rate changes, even if you cannot feel it,” explains Dr. Li.

One possible explanation for someone who develops an abnormal rise in heart rate when standing could be a condition called Postural Orthostatic Tachycardia Syndrome (POTS).

POTS is caused by an abnormality in the autonomic nervous system, which regulates blood flow back to the heart. You likely do not have POTS if your heart rate decreases each time you run or walk.

When should I be concerned about my elevated heart rate or heart palpitations?

You should be concerned about your rise in heart rate or heart palpitations, which feel like your heart is pounding, fluttering, or beating irregularly, if:

  • Your heart rate does not gradually go down after exercise.
  • You have chest pain.
  • The occurrences are becoming more severe or more frequent, and/or
  • You have a known heart condition, injury, or weak heart muscle.
  • If you feel lightheaded, dizzy, or collapse during an episode of tachycardia, or elevated heart rate. 

“In this case, the body is unable to compensate so the brain may not be getting enough oxygen from blood flow. This is an automatic red flag, and a signal to seek help,” warns Dr. Li, who has appeared on GMA and CNN and in The Atlantic and Time Magazine.

This is not an exhaustive list, and I am not a doctor. If you are concerned, you should go see one.

Could I have heart damage from COVID-19?

elevated-heart-rate
Pin this information about elevated heart rate after COVID and COVID concerns for later.

There have been fears that COVID-19 could cause myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the sack around the heart), leading to direct damage of the heart muscle.

However, this is rare.

Admittedly, when my heart rate was at the height of its irregularity accompanied by chest pain, I searched Dr. Google and was close to self-diagnosing with myocarditis as the symptoms were very similar (minus intense swelling).

However, the cause of the change in heart rate or irregular heartbeat is likely a hormonal imbalance triggered by the virus that impacts the function of the autonomic nervous system.

Related: How to Start Running: A Beginner’s Guide

What is the autonomic nervous system and how does COVID-19 affect it?

The autonomic nervous system controls unconscious bodily functions such as blood pressure, heart rate, breathing rate, digestion, body temperature, and metabolism.

It is usually divided into two parts: the parasympathetic nervous system and the sympathetic nervous system.

  • The parasympathetic system is often called the “rest and digest system” and controls functions that happen at rest.

    autonomic-nervous-system
    The autonomic nervous system is divided into two parts: the parasympathetic and sympathetic nervous systems. Image from BYJU’s.
  • The sympathetic nervous system is often nicknamed the “fight or flight” system and controls involuntary activities in response to stress or a perceived threat.

If your body perceives a threat like the COVID-19 virus, the sympathetic nervous system may overact, causing your heart to rate and breath rate to quicken.

This is what is thought to have happened to me in what my doctor called a sympathetic nervous system overdrive.

How do you treat autonomic system dysfunction?

The treatment for an imbalance of the autonomic systems varies depending on the symptoms and severity.

The treatment or way to quiet the sympathetic nervous system is often to do calming activities such as:

  • gentle walks
  • rest
  • sleep
  • deep breathing
  • yoga, and

Doing something that stresses the body and elevates the heart rate such as running could worsen or elongate the COVID recovery process.

What is Long COVID?

The lingering after-effects of a COVID infection are called Long COVID and are not related to damage by the virus itself but by the body’s immune response to COVID-19.

The most common symptoms of long COVID include:

  • chest pain
  • heart palpitations
  • abnormally high heart rates
  • heart palpitations
  • shortness of breath,
  • and difficulty doing their normal exercise routines

Doctors theorize that long COVID and related symptoms are caused by a dysfunction of the autonomic nervous system (caused by a hormonal imbalance) thereby disrupting functions such as blood pressure, heart and breathing rates, body temperature, digestion, and metabolism.

Long COVID or long-haulers can last weeks or months and can be severe and life-altering, sadly.

Related: 9 Steps to Return to Running After a Break

Who is more at risk for long COVID and cardiac symptoms after having COVID?

Doctors say long COVID can affect anyone, even if your case is mild. It can also begin after you thought you had recovered.

There is also no evidence if anything such as exerting oneself too soon by running can contribute to long COVID.

Can I start running if I am still having cardiac systems after having COVID?

You can return to run if you still have cardiac systems after having COVID such as an elevated heart rate as long as your doctor clears you!

“If there is any lightheadedness, dizziness, or feeling of passing out — or any chest pain, shortness of breath, or palpitations, it’s time to seek out a doctor to at least make sure there is nothing serious that must be addressed. When it comes to your heart, it’s best to take no chances,” says Dr. Li.

If you do not have heart damage or a heart condition, in most cases cardiovascular exercise (for 30 minutes a day, 5 days a week) is beneficial for your COVID recovery. Get guidance from your doctor.

Related: How to Start Running After Having COVID

The key for your return to running after COVID is taking a gradual approach. For example, when you are feeling more like your normal self:

rpe-scale-for-running
Run by RPE or rate of perceived exertion when returning to running after COVID. Keep your RPE 3 or below.
  • Walk every other day for 4 days for 30 minutes. When that feels good, add a consecutive day. Then another.
  • After being able to walk for 5 days for 30-60 minutes with no issue, try an easy run of 1-2 miles.
  • If that feels good, begin running every other day. You can walk in between.
  • After doing a run two times of a specific distance, you can add 5 minutes or a mile to your run (depending on your fitness level and how you feel).
  • Continue to repeat mileage one time and alternate days.
  • When you can run for an hour with no issue, try a consecutive day run.
  • Be sure to keep your pace very easy—much easier than your usual easy pace.
  • Continue to have at least one total rest day.
  • When your mileage gets higher (like over 4 miles, don’t repeat mileage. Alternate between higher and lower mileage).

Related: Benefits of an Easy Running Pace

How I Returned to Running with Cardiac Symptoms After COVID:

I began a gradual return to running even though my heart rate was elevated more quickly and my resting heart rate was higher than normal. I also still had some minor chest discomfort on the right side of my chest which was diagnosed as muscular inflammation.

  • I walked for about 10 days and began with a 3-mile jog. I tried another 3-mile jog two days later.
  • When that felt okay, I progressed to 4 miles and so on.
  • When I got to 6 miles comfortably, I tried running for consecutive days.
  • Then, I progressed my mileage as normal, taking it day by day.
  • I learned that keeping my easy pace about 1 minute per mile easier than my norm was key to recovering well and preventing chest pain.

If you need guidance in your return to running after COVID, an injury, or pregnancy, check out my run coaching services. Also, be sure to check out my free training plans:

 

 

27 thoughts on “Running with an Elevated Heart Rate After COVID”

  1. Whitney, Thank you so much for writing this, everything you experience happened to me as well it was a good 3-6 month battle of up and down symptoms. I am on my way and determined to get back to my pre Covid self.

    Reply
  2. This was a great summary and consistent with what my circle of athlete-friends have said about their symptoms. Hoping to avoid the current (minor) surge as race season is approaching…

    Reply
  3. Thanks a lot for posting this. I have read many articles on the internet but found this to be most complete. This really eases me a lot! It’s 2:30am and I’m wide awake because my wife is experiencing most of the above symptoms. The doctors to whom we’ve shown remain clueless and surprisingly they don’t even know half of what you have covered in the post above.

    Best Regards
    Shivam

    Reply
  4. Thanks for this post! I’m avery healthy, avid 44 y/o exerciser that alternated between jogging, cycling and weight lifting. I got CoVid recently despite vax and booster. I did not get paxlovid. Initially it felt like a flu but then unfortunately I ended up with after-effects including facial numbness, heart fluttering, shortness of breath and elevated heart rate. Steroids got rid of the numbness and an inhaler has helped a lot with the shortness of breath. It’s been 4 weeks and just now is when I’m starting to feel a bit more normal although I still get tired easily and my heart rate is still at least 20-30 points over normal when exercising. Your post was exactly what I am dealing with, so thanks so much for the information! It helped my drs figure out what to do next. My question now is- will this happen to me again if I get covid again? How can I avoid these symptoms if I do get it again? I’m hoping my pcp can give me some advice on that.

    Reply
    • I am glad you are feeling better! From people I know & what I have heard, it’s less likely for it to happen again if you get COVID again within 6 months or so of your first contraction. But I definitely check with your doctor!

      Reply
  5. Thanks so much for writing this. I started my return to sport based on the guidance of my doctor who referred me to a recent journal article written by the Chief Medical Officer at the AIS. I progressed through to the stages where I should return to normal activity, but then I had a huge amount of stress from work and now my HR is elevated in a zone 2 ride and my garmin body battery doesn’t recover like it normally would.
    I was pretty worried about it, but it makes sense given the impact of covid on the autonomic nervous system.
    I should have known better than to return to work!
    Guess it’s going to be a slow recovery, but it is unlikely to be anything too serious.

    Reply
    • I am so sorry Elise! Part of my recovery involved ditching the Garmin AND the whoop. All the negative feedback was only adding to the stress. Almost overnight after several weeks it all regulated! I hope you can find some stillness and let your nervous system calm down too

      Reply
  6. Super article Whitney and awesome comments. My illness symptoms were mild – elevated temp of 99 to 100 for three days with a sore throat, some sniffles but almost no cough. Pulse Ox normal at 98 to 99%. That was followed by a week and a half of fatigue with a few sniffles and this feeling like my legs were cement – like I had never been a runner in my life. I am now three weeks out from when the illness symptoms subsided.

    In the last week, I decided to test things by power walking a couple miles a couple days in a row. Had a little tightness and very minor breathless feeling on finishing that went away completely in a minute or two SO was happy about that.

    I followed that up the next day with a slow 1.15 mile jog (11.5 minute mile pace) just to test things. I could tell my heart rate was way higher than normal when running and on completion (>130 a minute a minute after completion). Took me an hour to get down to my normal heart rate (42 to 46 resting). Also had palpitations immediately after for a couple minutes.

    My basic physical, EKG, blood work were fine per my doc. My resting heart rate is normal though (and 02 normal) – it’s the running that raises my heart rate rapidly and way over what it normally was. Getting a cardiologist assessment in a couple weeks. I actually feel pretty good except for the elevated heart rate during/after physical activities and perhaps having a small bit of fatigue after physical exertion.

    Of course, as a runner, we are wondering when the heck will heart rate adjust down to normal or will it ever? What happens to those strenuous trail runs with all the steep ups and downs or that leisurely long Sunday run? I guess only time will tell. Gotta think positive thoughts. Had to contribute to these comments and share for others in our (running) shoes since this article and the comments helped me!

    Reply
    • Thanks for reading & sharing your experience! I hope it all calms down soon. But yes positive thoughts & just knowing what was going on & that it was common, especially in runners, helped me heal. Best of luck to you!!

      Reply
  7. This was a super helpful article, thank you! Just got COVID for the first time a week ago and was lucky to have a super mild case. However, I’ve been dealing with the increased HR somewhat at rest and definitely with running and it’s been so frustrating! I even feel great when I run except for my heart rate. Running a marathon in 8.5 weeks in an attempt to BQ so I’m hoping this clears up – if not, might have to just eat the registration fee and look forward to next year. Thanks for the write up – glad to know I’m not alone in this!

    Reply
    • Oh man! I hope you rebound quickly!!! It’s so hard to lose that training. Is there a backup marathon later in the fall you could do? I know it’s outside the BQ window for next year but still could be a bQ!

      Reply
  8. This was SO helpful and right on point with what has happened with me and COVID. I ran my best marathon yet last year in Indy (2:55:52) and had a goal to shoot for 2:50 this fall, then 3 weeks ago my wife and I both got COVID for the first time and we got it BAD. Two and a half days of fever, body aches, chills, fatigue, nasty headaches, and then a sore throat and productive chest congestion. With my first marathon on 9/11, I wanted to get back to training quickly, but when I went out for my first “easy” run a week after COVID, my heart rate had jumped about 10-15 BMP from just two weeks earlier! I’m very fit and haven’t been that sick in probably 20 years. I could tell my breathing was a bit more labored, but not all that bad. I could hardly believe the heart rate numbers for the effort I was putting forth. Also, being this is my second year working with a coach on heart rate based training, I’m very in-tune with where I need to be and my trusty Garmin and chest monitor are fairly accurate.

    My coach said to rest for 3-4 days and then has had me walking more and putting in some “easy” shorter runs that are still feeling way too hard. I was hoping to have recovered more by now as I was so happy to get into the London Marathon this year via the WANDA Age Group Championships; now I am just hoping I can cover the distance so I can get my 5th Star.

    As someone who eats healthy and runs year round, this has been a huge disappointment for this marathon cycle. I’m glad to not be alone in having these issues and am hopeful that my heart rate continues to improve in the next couple weeks (so I at least can get some long runs in).

    I wasn’t planning on doing Boston again next year, but now, it seems that may be my next best opportunity to get back to my goal of 2:50.

    Thank you for compiling this information and data!

    Reply
    • You are not alone, Nick! Many have found that resting more early on (what they call radical rest) can shorten symptoms. Also, the HR does regulate in time even when running! For me, an inhaler & steroids helped!

      Reply
  9. So very helpful. IronMAN here (M48). RHR was 53, post mild Covid 3 weeks ago (fever, some drainage for 48 hours), RHR 79+. Running zones have moved by AT LEASE 1 zone in the wrong direction now. Zone 1 is now Zone 2, Z2 is now Z3, etc. Labored breathing (heavy chest) all the time even though I have .5 liters larger lung capacity than the avg male.

    Very few search results are covering this from a runners POV. Thanks for the info from you and everyone here.

    Reply
  10. You can add me to the list of people who are feeling very grateful to have found this article! I’m a run-walker (10 min run, 1 min walk) who has done quite a few half-marathons and have been contemplating my first marathon. I’m not new to heart rate issues – my RHR was often in the low 40s, but it would go up a lot during my runs (one of the reasons I walk). A cardiologist did a number of tests on me last year and found nothing abnormal about my heart, so it was just something I lived with. I got Covid at the beginning of June, despite being triple-vaxxed, etc. My symptoms weren’t too bad, and I got back into the swing of things after a week or so. But I noticed that my RHR had gone up by about 20BPM, and my exercise heart rate was also up even higher than usual (when it’s already pretty high). I was managing it – running slower, making my run intervals even shorter, etc – but then I got another cold/flu bug (not covid) that lasted a couple of weeks, and that seemed to set me back again. The last couple of days, I’ve run super slowly, taken a lot more walking breaks, walked on the hills, etc. but my average heart rate is still super high. I think I will go to the doctor to look into it, but this article does give me some assurance that this is not unusual for runners who have had covid. I already have inhalers due to asthma, but I may also look into deep breathing exercises to see if that can help. I hope that I can get back into the swing of things soon, b/c I have been quite discouraged by how much I’ve struggled during my runs, and I’ve been nervous about increasing my distance beyond 10k.

    Reply
    • Hi Alison,
      I am sorry to hear you are having trouble too. I think going to a doctor to get checked out is definitely a good call and can maybe give you some reassurance and potential management strategies. As I mentioned, time and then knowing everything will eventually regulate helped me a lot because I was freaking out at first! I hope you can run without worry soon! Whitney

      Reply
  11. Yea thanks you all, made me a little more calm now.
    Same experience as most people here.
    Fairly good runner from 10k up to marathon, M45, had minor Covid, and after that 10-15 beats elevated HR for weeks now.
    Also poor sleep?!.
    Have been training, But taking it easy.
    Has anyone gotten back to normal RHR and how long did it take?

    Reply
  12. Hi Whitney,
    Really appreciate you writing this article.
    I’m on week 5 from my initial Covid symptoms and still have an elevated heart rate both resting and while running (or more like jogging right now lol) I’m praying that i follow in your footsteps and the old ticker goes back to normal after 6 weeks!

    Reply

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