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Review
. 2022 Nov;115(11):562-570.
doi: 10.1016/j.acvd.2022.06.005. Epub 2022 Sep 29.

Cardiac screening before returning to elite sport after SARS-CoV-2 infection

Christophe Hédon  1 , Frédéric Schnell  2 , Philippe Sosner  3 , Frédéric Chagué  4 , Iris Schuster  5 , Marc Julia  6 , Alexandre Duparc  7 , Jean-Michel Guy  8 , Nicolas Molinari  9 , Lionel Michaux  10 , Frédéric Cransac  11 , Stéphane Cade  11
Affiliations
Review

Cardiac screening before returning to elite sport after SARS-CoV-2 infection

Christophe Hédon et al. Arch Cardiovasc Dis. 2022 Nov.

Abstract

Background: SARS-CoV-2 infection can induce cardiac damage. Therefore, in the absence of clear data, a cardiac evaluation was recommended for athletes before returning to play after recent SARS-CoV-2 infection.

Aim: To assess the proportion of anomalies detected by this cardiac screening.

Methods: We reviewed the medical files of elite athletes referred for cardiac evaluation before returning to play after a non-hospitalized SARS-CoV-2 infection (based on a positive polymerase chain reaction or antigen test) from March 2020 to July 2021 in 12 French centres.

Results: A total of 554 elite athletes (professional or national level) were included (median age 22 years, 72.0% male). An electrocardiogram (ECG), echocardiogram and exercise test were performed in 551 (99.5%), 497 (89.7%) and 293 (52.9%) athletes, respectively. We found anomalies with a potential link with SARS-CoV-2 infection in four ECGs (0.7%), three echocardiograms (0.6%) and three exercise tests (1.0%). Cardiac magnetic resonance imaging was performed in 34 athletes (6.1%), mostly due to abnormal first-line examinations, and was abnormal in one (2.9%). The rates of those abnormalities were not higher among athletes with cardiac symptoms or more severe forms of non-hospitalized SARS-CoV-2 infection. Only one athlete had a possible SARS-CoV-2 myocarditis and sport was temporally contraindicated. None had a major cardiac event declared during the follow-up.

Conclusion: The proportion of cardiac involvement after non-hospitalized forms of SARS-CoV-2 infection in athletes are very low. Systematic cardiac screening before returning to play seems to be unnecessary.

Keywords: Athletes; Myocarditis; Return-to-play; SARS-CoV-2; Screening.

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Figures

Fig. 1
Fig. 1
Cardiac examinations performed and the proportions of anomalies found after recent SARS-CoV-2 infection. CMR: cardiac magnetic resonance; ECG: electrocardiogram; LVNC: left ventricular non-compaction; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2.
See this image and copyright information in PMC

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