Elite athletes must find an adequate balance between training load (TL), competitions, recovery phases, and everyday demands to perform. Fatigue may be related to infections, and COVID-19 may have severe medical consequences for an athlete (eg, myocarditis); hence, the necessity for sports-medicine staff to follow the latest guidelines to manage infected athletes and their return to training while minimizing negative health and performance outcomes.1,2 A positive COVID-19 test in asymptomatic or mild symptomatic athletes mandates a 10-day rest period. Decision to return to sport follows different phases: return to participation (RTPa) and return to competition until return to performance (RTPe).3 Return to sport management after COVID-19 infection is still evolving and data are needed.4 Coaches and sports scientists use external and internal load monitoring to help athletes optimize performance. External TL may be monitored with volume and subjective feedbacks from athletes, while internal load may be monitored by heart rate variability (HRV). The HRV has been associated with stress, fatigue, overtraining, and infection. Recently, HRV was cited as a useful indicator for COVID-19 onset and early detection.5,6 Considering limited knowledge available on return to sport post COVID-19, this case report highlights synergistic TL and HRV monitoring values, in addition to medical follow-up, in a COVID-19 infected elite track and field sprinter who moved successfully through the different return to sport phases.
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