Is running dangerous?

For the past several months, throughout Italy and much of the rest of the world, it has been possible to participate in long-distance running races in which even thousands or tens of thousands of athletes are present. It has come about after a year and a half of restrictions on mass sporting activity, and if all goes well and the necessary precautions are maintained (green passes, masks and quota starts) perhaps we will be able to run together without further stops. With the return to competition, however, there has unfortunately also been a return to incidents one would gladly do without, those in which a runner loses his or her life during or because of a race. There have been several cases in Italy this year, and they have been given considerable prominence in the media, as is plausible and right. I’ve wondered-and we’ve all wondered in the Runlovers editorial staff and many times on the Runlovers Club on Facebook – whether the death of a runner, of a person who runs, could be averted, whether there has perhaps been a relaxation among the mesh of medical controls or whether the pandemic situation has actively affected this very sad aspect of our leisure time.

It is a question that has also been asked by many researchers, especially to understanding how any worsening of physical condition can be predicted in individuals who have overcome the disease and resume physical activity. The studies conducted have identified some parameters related to the effects of CoViD-19 on the body and the production of certain factors that could influence sports performance. These are very complex studies and cannot yet be called complete, as much more data will be needed globally to have repeatable and reliable statistics. However, the results obtained regarding some aspects-including the number of deaths in the race-are clear and in complete agreement.

What the data say

Without going into details of what are the physiological parameters used, it has been seen that the organs affected by Sars-Cov-2 in trained subjects very quickly activate a response that stimulates the production of a whole series of substances related to the reconstitution of ante-virus conditions (antibodies in the first place, but also hormones or chemicals), thus trying to eliminate it and restore the organ to full function. This process is also activated in sedentary people, but to a much lesser extent. Several studies are under way to understand how the increase in these components may, from being an ally in fighting the virus, become a danger to the body, as some are also known to have negative effects in certain situations. Of them all, the most studied is the class of hormones called the ACE2, involved both in the first contact of the virus with our bodies and in the onset of respiratory and cardiac problems(that’s put very, very simply!), which had been identified as possibly responsible for the CoViD-19 myocarditis recorded in some patients who recovered from the infection. These studies, however, fail to answer the question: how come there were so many deaths in the race this year?

Although-I repeat-these are events one would gladly do without, the number of deaths has not statistically increased in these two years from previous years, and there is no evidence to correlate the deaths with the spread of Sars-Cov-2. This number has only concentrate at this late time of the year, because long-distance races were not allowed in the spring (or were postponed, and very few were held in 2020) and so their numbers were greater in the fall season than usual (just look at the six major, ran all within a six-week period).

In conclusion

An estimate made by analyzing data from several years of long-distance running concerning the population of American and European runners says that about one in one hundred and twenty thousand people encounter circulatory problems so severe that they lead to death during a run. In half of the cases, these deaths would also occur during other normal daily activities as a result of undiagnosed issues, and their number could be cut in half if a sports medicine examination that could detect the most common cardiac alterations were supported. In Italy, fortunately, the sports medical examination is compulsory if you want to practice competitive sports (and we recommend it even if you do not participate in races), and although it cannot exclude acute problems and due to undiagnosable aspects, it is definitely a good ally to run with more serenity and have the most fun, enjoying our favorite pastime to the fullest and trying to push that of death away from our thoughts, Celebrating life by running.


main image credit: mikesaran on

Bibliografia parziale
COVID-19 infection and death rates: the need to incorporate causal explanations for the data and avoid bias in testing, di Fenton et al., 2020 
Marathon-induced cardiac fatigue: A review over the last decade for the preservation of the athletes’ health, di Vitiello  et al., 2021
Life-threatening and major cardiac events during long-distance races: Updates from the prospective RACE PARIS registry with a systematic review and meta-analysis, di Gerardin et al., 2021
DNA aptamers masking angiotensin converting enzyme 2 as an innovative way to treat SARS-CoV-2 pandemic, di Villa et al., 2021
Running statistics from Yale University, di Galic, 2021
Mortality during marathons: a narrative review of the literature, di Dayer & Green, 2019
Exploring the Health-Promoting Potential of the “parkrun” Phenomenon: What Factors are Associated With Higher Levels of Participation?, di Cleland et al., 2019
Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise, di O'Keefe et al., 2012
Risk for sudden cardiac death associated with marathon running, di Maron et al., 1986


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