Cardiac screening prior to return to play after SARS-CoV-2 infection: focus on the child and adolescent athlete: A Clinical Consensus Statement of the Task Force for Childhood Health of the European Association of Preventive Cardiology

Flavio D'Ascenzi; Silvia Castelletti; Paolo Emilio Adami; Elena Cavarretta; María Sanz-de la Garza; Viviana Maestrini; Alessandro Biffi; Paul Kantor; Guido Pieles; Evert Verhagen; Monica Tiberi; Henner Hanssen; Michael Papadakis; Josef Niebauer; Martin Halle

doi:10.1093/eurjpc/zwac180

Cardiac screening prior to return to play after SARS-CoV-2 infection: focus on the child and adolescent athlete: A Clinical Consensus Statement of the Task Force for Childhood Health of the European Association of Preventive Cardiology

Eur J Prev Cardiol. 2022 Nov 15;29(16):2120-2124. doi: 10.1093/eurjpc/zwac180.

Authors

Flavio D'Ascenzi¹, Silvia Castelletti², Paolo Emilio Adami³, Elena Cavarretta^{4

5}, María Sanz-de la Garza⁶, Viviana Maestrini⁷, Alessandro Biffi⁸, Paul Kantor⁹, Guido Pieles^{10

11}, Evert Verhagen¹², Monica Tiberi¹³, Henner Hanssen¹⁴, Michael Papadakis¹⁵, Josef Niebauer¹⁶, Martin Halle^{17

18}

Affiliations

¹ Department of Medical Biotechnologies, Division of Cardiology, University of Siena, V.le M. Bracci, 16 53100, Siena, Italy.
² IRCCS Istituto Auxologico Italiano, Cardiomyopathy Unit and Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy.
³ Health and Science Department, World Athletics, Monaco, Principality of Monaco.
⁴ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
⁵ Mediterranea Cardiocentro, Naples, Italy.
⁶ Cardiovascular Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
⁷ Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
⁸ Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy.
⁹ Division of Cardiology, Department of Pediatrics, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
¹⁰ Sports Medicine Department, Aspetar, Orthopaedic and Sports Medicine Hospital, Doh, Qatar.
¹¹ Institute of Sport Exercise and Health (ISEH), University College London, London, UK.
¹² Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹³ Sport Medicine, Department of Prevention, ASUR Marche Area Vasta 1, Pesaro, Italy.
¹⁴ Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland.
¹⁵ Cardiovascular Clinical Academic Group, St George's, University of London, London, UK.
¹⁶ University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, Austria.
¹⁷ Department of Prevention and Sports Medicine, Accredited Centre for Sports Cardiology/EAPC, School of Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 56, D-80992 Munich, Germany.
¹⁸ DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Potsdamer Str. 58, 10785 Berlin, Germany.

Abstract

Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psychological and physical effects of the current pandemic. Therefore, RTP protocols should be balanced to promote safe sports practice, particularly after an asymptomatic SARS-CoV-2 infection that represents the common manifestation in children. The present consensus document aims to summarize the current evidence on the cardiac sequelae of COVID-19 in children and young athletes, providing key messages for conducting the RTP protocol in paediatric athletes to promote a safe sports practice during the COVID-19 era.

Keywords: Adolescent; Athlete’s heart; COVID-19; Children; Return to play; Screening; Sports cardiology.

MeSH terms

Adolescent
Athletes
COVID-19*
Cardiology*
Child
Heart Diseases*
Humans
Return to Sport
SARS-CoV-2
Sports Medicine* / methods