Return to Play for Athletes After Coronavirus Disease 2019 Infection—Making High-Stakes Recommendations as Data Evolve

Udelson, James E.; Curtis, Michael A.; Rowin, Ethan J.

doi:10.1001/jamacardio.2020.5896

Cited by 15 publications

(12 citation statements)

References 10 publications

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“…12 Coronavirus disease and the athletic heart 7,8 is now a known concern and is subject to screening protocols 6 and return to sports play guidelines. 14 At the upper levels of competition where diagnostic testing (electrocardiogram, echocardiogram, and cardiac magnetic resonance imaging) are usually readily available, detection of those at risk with acute cardiac inflammation is likely. 11 At the high school and other junior levels of competition, these resources are likely not available and are hopefully not needed for the young and healthy.…”

Section: Sports In 2021mentioning

confidence: 99%

Sports in 2021

Wojtys¹

2021

Sports Health: A Multidisciplinary Approach

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Section: Sports In 2021mentioning

confidence: 99%

Sports in 2021

Wojtys¹

2021

Sports Health: A Multidisciplinary Approach

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“…For example, during return to play protocols for concussion, athletes are monitored for cognitive, physical, and emotional symptoms that are hallmarks of an athlete who may not be fully recovered from their injury. In this same fashion, it is suggested that athletes returning to activity after COVID-19 diagnosis be monitored for cardiac and respiratory symptoms that may be indicative of the need for further evaluation 2,12 (SOR: C; CEB: 5). Expert opinion is clear that athletes returning to sport following any severity of COVID-19 infection should undergo a gradual return to play protocol with medical supervision 3,4,6,12,[14][15][16] (SOR: C; CEB: 5).…”

Section: Return To Play Considerationsmentioning

confidence: 99%

“…However, in the words of Tufts Medical Center cardiologist James E. Udelson, "expert opinion is far better than no opinion." 2 Scope of the Disease COVID-19, an acute viral infection, is known to affect both the respiratory and cardiovascular systems of infected patients. Cardiovascular issues, including myocarditis, is a concern for athletes returning to play after any acute viral syndrome 3 (Strength of Recommendation [SOR] Taxonomy: C; Centre for Evidence-Based Medicine [CEBM] rating: 1).…”

Section: Introductionmentioning

confidence: 99%

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Return-to-Play Recommendations After COVID-19 Diagnosis in High School Athletes

Calpino¹,

Morrissette

2021

Journal of Athletic Training

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COVID-19 has drastically changed everyday life across the world and has dramatically impacted how athletics operate. Since the return of high school sports, high school athletic trainers are now responsible for ensuring the safe return of athletes previously diagnosed with COVID-19 to sports. Due to the relatively recent identification of this novel virus, very little is understood about the long-term effects of COVID-19 infection on the cardiac and respiratory systems. Due to the rapid return of athletics, there is unfortunately limited research available regarding how athletes respond to COVID-19 and how it may affect their ability to return to play. Therefore, it is recommended that high school athletes previously diagnosed with COVID-19 undergo a comprehensive medical evaluation with their physician and complete a graduated medically supervised return to play protocol.

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“…[6] Multiple other groups have published expert recommendations, but there have been few studies to date validating any of these approaches. [7][8][9][10][11][12][13][14][15] We present a cohort study of 55 collegiate student-athletes with a history of asymptomatic or mildly symptomatic [5] SARS-CoV-2 infection and their subsequent cardiac work-up. The goal of the present study was to determine if current published recommendations were appropriate for detecting post-infection cardiac sequelae.…”

Section: Introductionmentioning

confidence: 99%

Findings from Cardiovascular Evaluation of NCAA Division I Collegiate Student-Athletes after Asymptomatic or Mildly Symptomatic SARS-CoV-2 Infection

Hwang

Kussman

Christle

et al. 2021

Preprint

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ObjectivesThe risk of myocardial damage after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been controversial. There is an urgent need for data to support the appropriate level of cardiovascular screening for safe return-to-play. The purpose of this study is to report the incidence of abnormal cardiovascular findings in National Collegiate Athletic Association (NCAA) Division I student-athletes with a history of SARS-CoV-2 infection.MethodsThis is a case series of student-athletes at a single NCAA Division I institution who tested positive for SARS-CoV-2 by polymerase chain reaction (PCR) or antibody testing (IgG) from 4/15/2020 to 10/31/2020. From 452 athletes who were screened, 5,124 PCR and 452 antibody tests were completed. Student-athletes were followed through 12/31/2020 (median 104 days, range 64-182 days). Cardiac work-up included clinical evaluation, troponin level, electrocardiogram (ECG), and echocardiogram. Additional work-up was ordered as clinically indicated.Results55 student-athletes tested positive for SARS-CoV-2. Of these, 38 (69%) had symptoms of Coronavirus Disease (COVID-19), 14 (26%) had a positive IgG test, and 41 (74%) had a positive PCR test. Eight abnormal cardiovascular screening evaluations necessitated further testing including cardiac magnetic resonance imaging (cMRI). Two athletes received new cardiac diagnoses, one probable early cardiomyopathy and one pericarditis, while the remaining six had normal cardiac MRIs.ConclusionThese data support recent publications which recommend the de-escalation of cardiovascular testing for athletes who have recovered from asymptomatic or mildly symptomatic SARS-CoV-2 infection. Continued follow-up of these athletes for sequelae of SARS-CoV-2 is critical.

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Return to Play for Athletes After Coronavirus Disease 2019 Infection—Making High-Stakes Recommendations as Data Evolve

Cited by 15 publications

References 10 publications

Sports in 2021

Sports in 2021

Return-to-Play Recommendations After COVID-19 Diagnosis in High School Athletes

Findings from Cardiovascular Evaluation of NCAA Division I Collegiate Student-Athletes after Asymptomatic or Mildly Symptomatic SARS-CoV-2 Infection

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