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In March 2020, Gez Medinger came down with COVID-19. The London-based filmmaker was 41 years old, busy with work, sports, and training for the London Marathon. “Exercise and activity were a huge part of my life,” he recalls. “I was near the end of my marathon training, and I was the fastest and fittest I’d ever been.”

Medinger’s bout of COVID was mild. “At the time, we were told there were basically two possible outcomes. If you’re old and have preexisting conditions, you might end up in the hospital and it might go very badly. If you’re young, you’ll get over it in a week and you’ll be fine.”

Feeling that he was in the latter category, Medinger returned to marathon training in the second week of his infection. “I started going on some gentle runs every day — because I didn’t want to lose fitness,” he says. “Looking back, I wish I hadn’t.”

After each run, he felt exhausted. But he kept powering through.

One morning, about five weeks after his initial infection, he woke up with a distinctly gristly feeling in his throat and chest. Medinger remembered having the same feel­ing 20 years earlier when he had mononucleosis, the illness caused by Epstein-Barr virus (EBV).

“It took me a year to get over mono. I thought, Am I looking down the barrel of another year like that now?

Medinger struggled with intense fatigue, headaches, heart palpitations, and brain fog. Then he heard about others experiencing the same. So he decided to devote his YouTube channel to exploring the science of postviral fatigue and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which shares many symptoms with long COVID.

His videos soon attracted hundreds of thousands of views, many of them from fellow long-haulers — people who had also found themselves unable to return to their pre-COVID baseline.


Medinger has found some pro­vocative commonalities among his extensive community of long-haulers. “It’s a subject that’s quite sensitive to address for those with a history of ME/CFS, but we’re seeing a surprisingly high proportion of people who previously exhibited type A personalities,” he says. “And when you dig a bit more, they frequently have some history of significant prior physical or emotional trauma.”

He’s also noted that a disproportionate number of athletes and highly fit people have been affected. In an informal poll of 1,200 long-haulers, Medinger found that two-thirds had engaged in vigorous exercise at least three times a week before their ­COVID-19 infection.

“The patients I’ve disproportionately seen in the long-COVID program are those who spend a lot of time on cardio-based activities — marathon runners, people who are really into biking. Less frequently, I see patients who do more weightlifting or yoga types of exercise.”

This mirrors UCLA Health Long COVID Program director Nisha Viswanathan, MD’s experience. “Interestingly, the patients I’ve disproportionately seen in the long-COVID program are those who spend a lot of time on cardio-based activities — marathon runners, people who are really into biking. Less frequently, I see patients who do more weightlifting or yoga types of exercise.”

These anecdotes do not qualify as scientific data. But if they point toward an underlying vulnerability among highly fit, active, and driven types, what might be the cause?

“The thing that gives this theory merit is that there are downsides to being a type A personality and being an overexerciser in terms of immune function,” says Joel Evans, MD, director of the Center for Functional Medicine in Stamford, Conn. Whether physical or psychological, “stress decreases the efficiency of the immune system and could conceivably increase the likelihood of developing long COVID.”

Whether physical or psychological, “stress decreases the efficiency of the immune system and could conceivably increase the likelihood of developing long COVID.”

High levels of activity can also stress the autonomic nervous system (ANS), adds Medinger. The ANS controls bodily functions that aren’t consciously directed, such as breathing, heart rate, and digestion.

“When those autonomic systems are running in a high state of stress, it’s relatively easy for them to be tipped over into this dysregulated state,” he explains. Indeed, many long-COVID sufferers experience dysautonomic symptoms: a racing heart, shortness of breath, headaches, dizziness, and extreme fatigue.

This may also explain why prior trauma could increase one’s vulnerability to the illness. Medinger explored this in video interviews with clinical psychologist Sally Riggs, DClinPsy. Riggs also suffered from long COVID, but she found relief through an approach that included addressing past emotional trauma.

“If you’ve got prior trauma, especially in childhood, you find yourself existing in a constant state of sympathetic overdrive, because that has become familiar,” says Medinger. “Going into rest-and-digest mode actually feels uncomfortable, so you do stuff to keep yourself in fight-or-flight mode — hence the type A personality. You may think you’re living a healthy lifestyle, but your whole body is on a knife’s edge.

“Then this pandemic virus comes along and knocks you over the edge.”

This was excerpted from “How Long COVID Affects Your Ability to Exercise” which was published in the December 2022 issue of Experience Life.

Mo
Mo Perry

Mo Perry is an Experience Life contributing editor.

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