How Long COVID affects the careers of top athletes

Marie-Sophie Zeidler's training is intense and her focus is on the 2024 Olympic Gamesin Paris. However, the top German rower is still having to contend with an opponent who is difficult to assess.

The 24-year-old, younger sister of two-time world champion Oliver Zeidler, contracted COVID-19 for the second time just over a month ago. At the time her lung capacity was reduced to 60 percent. Today she has to cope with a loss of just over 25 percent. "It's extremely frightening to see how quickly the body can break down, even though you're actually fit," Zeidler tells DW.

For six months after her first infection in October 2020, she struggled with Long COVIDLong COVID symptoms such as rapid physical exhaustion, shortness of breath and other unpleasantries before she regained her former fitness. "Yes, medicine has now advanced and there are medications," says Zeidler, who is employed as a police officer.

The anti-COVID medicine has helped and now everything goes faster, she says. Therefore, the elite rower hopes to be able to find a way back to her old form more quickly and permanently. "But whether there's enough time to have a realistic chance at the Olympic Games remains to be seen," says Zeidler, who still has to qualify for the summer spectacle.

Treatment is challenging

"Even though we as a science community are getting to know this disease more and more - there is not one single way to combat Long COVID. We're talking about 200 different symptoms that have to be differentiated," Wilhelm Bloch, head of the Department of Molecular and Cellular Sports Medicine at the German Sport University Cologne, tells DW.

However, he and his colleagues are getting closer to better approaches andtreatment methods treatment methods. Bloch, however, leaves no doubt about how serious Long COVID is. According to the sports scientist, around six percent of those affected are no longer able to practice their sport at all: "There are individual cases in the post-COVID area, they are just dramatic."

Physical exhaustion is often observed in Long COVID patients - persistent fatigue, deep lack of strength and lack of drive, so that normal everyday life can hardly be managed. That's how Marie-Sophie Zeidler had experienced it, too. "You always have to focus on the patient's individual complaints in each case, that's very important," says Bloch. That's what often makes treatment so challenging and sometimes complicated.

From the easy to the difficult

At TSV Bayer 04 Leverkusen, rehab coach Hans-Peter Gierden works in specially-developed courses to help Long COVID patients gradually get back on their feet. "Many people can't concentrate, some have balance problems. And there's always fatigue involved," Gierden says. "The trick is not to overwhelm the participant and to get the exercises right."

Every hour of class is put together differently, he explains. "It may be that I combine balance exercises with strengthening exercises. Or sometimes there's a badminton lesson. All exercises are always done from light to heavy. And if it gets too much, you can go back to the previous exercise," Gierden says. After each exercise session, the 57-year-old uses the so-called "Borg scale" (named after the Swedish physiologist Gunnar Borg) to check how the individual course participants felt about the subjective strain.

"Since I've been taking part in it, I've been feeling much better," Hermann-Josef Eigen tells DW. In April 2021, a COVID-19 infection had hit the formerly active amateur athlete quite hard, and he was on the verge of being admitted to intensive care. "I could no longer breathe properly. Nothing worked for me," says the 61-year-old.

It took almost four months before he was even able to take a few steps again. When his health started to improve, he joined Hans-Peter Gierden's rehabilitation course. "The type of training made the shortness of breath fade into oblivion," Eigen says. He now practices the exercises at home, outside of classes, for at least an hour every day, he says. "I feel even better now than before I got sick."

Zeidler: 'Strange disease'

"In the months after the illness, athletes usually complain that they can't get up to full capacity. Especially in the first three months, it is easy to tell how affected athletes are by their elevated resting pulse," says sports scientist Bloch. "But it often takes a few months more before everything is back to the old performance level."

After carefully increasing her workload, rower Marie-Sophie Zeidler is currently symptom-free after most physical exertions. At a recent training camp, she was able to push herself towards her physical limits again.  Only after the last day of training did she quite unexpectedly fall into a physical hole. "Suddenly, nothing worked for me again," said Zeidler, who is about to compete in her first competition after the recent brush with Long COVID.

"That's the strange thing about this disease: you just can't predict the body's reaction. On a good day anything is possible, on a bad day nothing at all." For now she'll just have to accept being surprised.