Systematic cardiac screening may not be required amongst junior competitive athletes  

1. In junior athletes recovering from SARS-CoV-2 infection, cardiac complications were uncommon (3.2%) and not associated with malignant ventricular arrhythmias.

2. In junior athletes who were asymptomatic or had mild symptoms after SARS-CoV-2 infection, cardiac screening was unnecessary.

Evidence Rating Level: 2 (Good)

Cardiac manifestations after SARS-CoV-2 infection, though rare, have been shown to occur especially in adolescents and young adults. Viral replication can be accelerated during exercise and as a result there are currently no clear guidelines on the best approach to return to play (RTP). Therefore, the objective of this study was to investigate the prevalence of cardiovascular complications following SARS-CoV-2 infection in junior competitive athletes and the effectiveness of a cardiac screening protocol for a safe RTP.

This prospective multicenter study included 571 non-professional junior competitive athletes (7-18 years) with previous asymptomatic or mildly symptomatic SARS-CoV-2 infection. Athletes were excluded if they had a severe infection or were evaluated >45 days after the negativisation of their nasopharyngeal swab. Mann-Whitney test and the unpaired t-test were used to assess between-group significance (asymptomatic vs. symptomatic and younger vs. older athletes). All athletes underwent a clinical profile screen, twelve-lead resting ECG and echocardiography.

Results demonstrated pericardial involvement was found in 3.2% of athletes with no complex/life threatening arrhythmias or myocardial inflammation. Furthermore, it was deemed that cardiac screening for RTP using the above measures was unnecessary. However, the present study was limited by the absence of a baseline echocardiogram which limited the attribution of cardiac findings to SARS-CoV2-infection. Nonetheless, the present study addressed an important gap in the literature such that cardiac testing should likely be reserved for athletes who display cardiac symptoms, ECG abnormalities, or uncommon arrhythmias.

Click to read the study in British Journal of Sports Medicine

Image: PD

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