Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
Sports Medicine Unit, USL Toscana Centro, Italy.
Int J Cardiol. 2021 Aug 1;336:130-136. doi: 10.1016/j.ijcard.2021.05.042. Epub 2021 May 31.
The COVID-19 pandemic has shocked the sports world because of the suspension of competitions and the spread of SARS-CoV-2 among athletes. After SARS-CoV-2 infection, cardio-pulmonary complications can occur and, before the resumption of sports competitions, a screening has been recommended. However, few data are available and discrepancies exist in the screening modalities. We conducted this prospective study to investigate the incidence of cardiovascular consequences following SARS-CoV-2 infection in young adult competitive athletes and the appropriate screening strategies for a safe return-to-play.
Ninety competitive athletes (24 ± 10 years) after asymptomatic or mildly symptomatic SARS-CoV-2 infection were screened by physical examination, blood testing, spirometry, 12‑lead resting ECG, 24-h ambulatory ECG monitoring, echocardiogram, and cardiopulmonary exercise testing (CPET).
Sixty-four athletes (71.1%) were male, and most (76.7%) were mildly symptomatic. After SARS-CoV-2 infection, spirometry and resting ECG were normal in all athletes. Ambulatory ECG monitoring demonstrated <50/24 h supraventricular and ventricular premature beats in 53.3% and 52.2% of athletes, respectively, in the absence of malignant arrhythmias. CPET did not demonstrate cardiopulmonary limitations. Echocardiography showed pericardial effusion in 3 athletes (all females) with symptomatic SARS-CoV-2 infection (3.3%; 4.4% in the symptomatic group) with a definitive diagnosis of myopericarditis in 1 athlete (1.1%) and pericarditis in 2 athletes (2.2%).
Cardiac consequences of SARS-CoV-2 infection were found in 3.3% of competitive athletes. An appropriate screening primarily based on the detection of uncommon arrhythmias and cardiac symptoms should be recommended in competitive athletes after SARS-CoV-2 infection to detect a cardiac involvement and guarantee a safe return-to-play.
由于比赛暂停和 SARS-CoV-2 在运动员中的传播，COVID-19 大流行震惊了体育界。SARS-CoV-2 感染后可发生心肺并发症，在恢复体育比赛前建议进行筛查。然而，可用的数据很少，筛查方式也存在差异。我们进行了这项前瞻性研究，以调查 SARS-CoV-2 感染后年轻成年竞技运动员心血管后果的发生率，以及安全重返比赛的适当筛查策略。
90 名无症状或轻度症状 SARS-CoV-2 感染后竞技运动员进行了体格检查、血液检查、肺量测定、12 导联静息心电图、24 小时动态心电图监测、超声心动图和心肺运动测试（CPET）筛查。
64 名运动员（71.1%）为男性，大多数（76.7%）为轻度症状。SARS-CoV-2 感染后，所有运动员的肺量测定和静息心电图均正常。动态心电图监测显示，53.3%和 52.2%的运动员分别有<50/24 h 室上性和室性早搏，但无恶性心律失常。CPET 未显示心肺受限。超声心动图显示 3 名（均为女性）有症状 SARS-CoV-2 感染（3.3%；症状组 4.4%）的运动员有心包积液，1 名运动员（1.1%）有心肌心包炎，2 名运动员（2.2%）有心包炎。
在 3.3%的竞技运动员中发现 SARS-CoV-2 感染的心脏后果。SARS-CoV-2 感染后，竞技运动员应主要基于检测罕见心律失常和心脏症状进行适当筛查，以检测心脏受累情况并保证安全重返比赛。
