Deepak Chahar, who tested positive for Covid-19, said on his social media handles on September 1 he felt fit and hoped to be in action ‘very soon’. (Source: File)

The IPL has mandated a ‘cardio-stress test’ to all players who have tested positive for Covid-19 after they recover. However, since the long-term effects of this virus on athletes is still largely unknown, health professionals and trainers warn about rushing back into playing competitively.

Two Chennai Super Kings players tested positive in IPL, raising questions about how soon players who have tested positive should be pressed into action. On September 1, Deepak Chahar, one of the infected players, posted on his social media handles that he was hoping to return soon. “…I am better now and trying my best to keep myself fit. Hopefully, you will see me in action very soon,” he wrote.

Sources in the Board of Control for India told The Indian Express: “The Cardio-stress test is to ensure that players have recovered fully and the virus hasn’t harmed any parts of the body. As there have been reports that the virus does damage the lungs after leaving the body.”

Infectious-disease experts and health professionals do not have enough data to make conclusions about how Covid-19 might affect an athlete’s hearts and lungs. But some of the preliminary findings have alarmed them. In some cases of asymptomatic patients who have tested positive, evidence of myocardial injury, an inflammation of the heart and usually defined by an elevated troponin level have been found.

READ | BCCI set to spend around Rs 10 crore for 20,000 plus tests

Ramji Srinivasan, high-performance coach and strength and conditioning trainer of India’s 2011 World Cup team, warns against rushing the players back into action.

“This is a life-and-death issue. Just a stress test to test the pulmonary levels may not be enough. This isn’t a fitness issue, it isn’t like an injury; that’s the first thing we need to understand. As a trainer, I don’t want blood on my hands by rushing through. The IPL would be played in hot weather conditions and it’s a high-pressure tournament where the stakes are high. The kind of stress a fast bowler, say, puts on his body is insane and we don’t know how a body post-Covid (asymptomatic or serious) reacts to such severe intensity. We need a proper medical team to take care of the recovery process. Worldwide, studies are emerging about the post-Covid scenario for athletes, which warns us that it can even get fatal,” Ramji told this newspaper.

“Based on what the doctors are saying and studies emerging, I would say at least two weeks of rest after they recover, after they test negative. Let the body stabilise, and then careful monitoring should be done along with a battery of medical tests from ECG to a blood test to confirm as much as possible that the recovery is proceeding well,” Ramji says. “The truth is that we don’t have enough information as of now and there is a thin line between will power that all athletes feel they have in abundance and foolishness. It’s better to be safe than sorry.”

Rajasthan Royals squad after arriving in UAE maintaining all health protocols. (Source: File)

Sports cardiologist Dr Tim Beaver of Kansas Medical centre in the US warned about the severity that’s facing the sports world.

“I think we’re dealing with a population of young people that are healthy and the majority of them are going to be safe. The problem is that with the propensity of this virus to affect the heart more and emerging data showing asymptomatic people having evidence of inflammation. That concern about baseline rate of sudden death with myocarditis being around 8%, that could be higher because you have a population that’s going to be active. So, that inflammatory phase or even the post-inflammatory phase when you develop a little scar could put you at higher risk,” Beaver said in an online seminar of the University of Kansas Health System.

Dr SK Chhabra, the pulmonary medicine head at Delhi’s Primus Hospital, says one of the fallouts of Covid-19 is there is a scar on the lungs. “The condition is called lung fibrosis. If the scar is large, then it will reduce the lung capacity,” Dr Chhabra told this newspaper.

According to Dr Beaver, the difficulty with Covid-19 is that one can’t rely on athletes showing the usual symptoms associated with heart problems. “With other viruses in the past, you would be able to identify an athlete or anyone with myocarditis or pericarditis, which is the inflammation of a sack around the heart by them having come in with symptoms. They would have chest pain, shortness of breath, other things, and then they would start to get active studies and then get referred on to a cardiologist from the sports medicine physicians. That’s the tough thing with Covid, is that we’re finding it in asymptomatic people and we’re not sure what to do with that. There’s a lot of unknowns and that’s why when we’re being asked if we know if it’s safe, we don’t know because we don’t have a lot of information.”

Ramji reckons it’s best to play safe and monitor the recovery period carefully with the help of medical professionals. “With the kind of money, fame, and potential benefit to their careers that IPL provides, it’s understandable that players might want to get back to action quickly but it’s the responsibility of the authorities to ease them back. Don’t risk and regret later.”

READ | CSK to start training after all, except 13, test negative again

How to monitor players’ health post-Covid

The players need to be carefully monitored for at least two weeks after recovering and the workload should be slowly increased under professional supervision. Chest x-rays are needed to see if it shows any scar, a CT scan of the chest may be required and a lung-function test should be done. Dr SK Chhabra, the pulmonary medicine head at Delhi’s Primus hospital, says the tests should be followed with weight management to cover up nutritional deficiencies and that this should happen for five-six months after recovery. “Even if it shows 100% recovery, the monitoring should continue. After that, there should be a pulmonary rehab.”

IPL teams to play 3 practice matches

IPL teams will be playing three practice games among themselves. It is learnt the teams wanted these warm-up games to be played with other sides but the request wasn’t approved by the IPL. With most of the players coming without any competitive games, it was decided to allow teams to play three warm-up matches among themselves.

(With inputs from Sriram Veera)

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