轻度新型冠状病毒肺炎感染后高水平运动员恢复训练：一项多中心前瞻性研究（ASCCOVID-19）
Resuming Training in High-Level Athletes After Mild COVID-19 Infection: A Multicenter Prospective Study (ASCCOVID-19).
作者信息
Chevalier Laurent, Cochet Hubert, Mahida Saagar, S Sylvain Blanchard, Benard Antoine, Cariou Tanguy, Sridi-Cheniti Soumaya, Benhenda Samy, Doutreleau Stéphane, Cade Stéphane, Guerard Sylvain, Guy Jean-Michel, Trimoulet Pascale, Picard Stéphane, Dusfour Bernard, Pouzet Aurelie, Roseng Stéphanie, Franchi Marco, Jaïs Pierre, Pellegrin Isabelle
机构信息
Clinique du Sport Bordeaux-Mérignac, 2 rue Georges Negrevergne, 33700, Merignac, France.
IHU Liryc, CHU Bordeaux, Univ. Bordeaux, Bordeaux, France.
出版信息
Sports Med Open. 2022 Jun 25;8(1):83. doi: 10.1186/s40798-022-00469-0.
BACKGROUND
There is a paucity of data on cardiovascular sequelae of asymptomatic/mildly symptomatic SARS-Cov-2 infections (COVID).
OBJECTIVES
The aim of this prospective study was to characterize the cardiovascular sequelae of asymptomatic/mildly symptomatic COVID-19 among high/elite-level athletes.
METHODS
950 athletes (779 professional French National Rugby League (F-NRL) players; 171 student athletes) were included. SARS-Cov-2 testing was performed at inclusion, and F-NRL athletes were intensely followed-up for incident COVID-19. Athletes underwent ECG and biomarker profiling (D-Dimer, troponin, C-reactive protein). COVID(+) athletes underwent additional exercise testing, echocardiography and cardiac magnetic resonance imaging (CMR).
RESULTS
285/950 athletes (30.0%) had mild/asymptomatic COVID-19 [79 (8.3%) at inclusion (COVID(+)); 206 (28.3%) during follow-up (COVID(+))]. 2.6% COVID(+) athletes had abnormal ECGs, while 0.4% had an abnormal echocardiogram. During stress testing (following 7-day rest), COVID(+) athletes had a functional capacity of 12.8 ± 2.7 METS with only stress-induced premature ventricular ectopy in 10 (4.3%). Prevalence of CMR scar was comparable between COVID(+) athletes and controls [COVID(+) vs. COVID(-); 1/102 (1.0%) vs 1/28 (3.6%)]. During 289 ± 56 days follow-up, one athlete had ventricular tachycardia, with no obvious link with a SARS-CoV-2 infection. The proportion with troponin I and CRP values above the upper-limit threshold was comparable between pre- and post-infection (5.9% vs 5.9%, and 5.6% vs 8.7%, respectively). The proportion with D-Dimer values above the upper-limit threshold increased when comparing pre- and post-infection (7.9% vs 17.3%, P = 0.01).
CONCLUSION
The absence of cardiac sequelae in pauci/asymptomatic COVID(+) athletes is reassuring and argues against the need for systematic cardiac assessment prior to resumption of training (clinicaltrials.gov; NCT04936503).
背景
关于无症状/轻度症状的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染（新冠病毒感染）的心血管后遗症的数据较少。
目的
这项前瞻性研究的目的是描述高水平/精英级运动员中无症状/轻度症状新冠病毒感染的心血管后遗症。
方法
纳入950名运动员（779名法国国家职业橄榄球联盟（F-NRL）运动员；171名学生运动员）。在纳入时进行SARS-CoV-2检测，对F-NRL运动员进行密切随访以观察新冠病毒感染情况。运动员接受心电图和生物标志物分析（D-二聚体、肌钙蛋白、C反应蛋白）。新冠病毒检测呈阳性（COVID(+)）的运动员接受额外的运动测试、超声心动图和心脏磁共振成像（CMR）。
结果
950名运动员中有285名（30.0%）患有轻度/无症状新冠病毒感染[纳入时79名（8.3%）（COVID(+)）；随访期间206名（28.3%）（COVID(+)）]。2.6%的COVID(+)运动员心电图异常，而0.4%的运动员超声心动图异常。在压力测试期间（休息7天后），COVID(+)运动员的功能能力为12.8±2.7代谢当量，只有10名（4.3%）出现压力诱发的室性早搏。COVID(+)运动员和对照组的CMR疤痕患病率相当[COVID(+)与COVID(-)；1/102（1.0%）与1/28（3.6%）]。在289±56天的随访期间，一名运动员出现室性心动过速，与SARS-CoV-2感染无明显关联。感染前和感染后肌钙蛋白I和CRP值高于上限阈值的比例相当（分别为5.9%对5.9%，5.6%对8.7%）。比较感染前和感染后，D-二聚体值高于上限阈值的比例增加（7.9%对17.3%，P=0.01）。
结论
轻度/无症状COVID(+)运动员无心脏后遗症令人安心，这表明在恢复训练前无需进行系统性心脏评估（clinicaltrials.gov；NCT04936503）。
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