When is it safe for an athlete to return to play after recovering from COVID-19?

The American College of Cardiology Sports and Exercise Council issues testing recommendations before an athlete is cleared to play.
Updated: May. 14, 2020 at 1:17 PM EDT
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CHARLOTTE, N.C. (WBTV) - The American College of Cardiology Sports and Exercise Council issued recommendations on when it is safe for an athlete who has recovered from COVID-19 to return to play.

Atrium Health Sanger Heart & Vascular Institute’s Dr. Dermot Phelan sits on the American College of Cardiology Sports and Exercise Council. Dr. Phelan says the recommendations will guide professional sports organizations like the NBA and NFL. Since there is no other guidance around the world, the recommendations will likely trickle down to college sports, high school sports, and other organizations.

“Given the fact that this particular virus seems to have much more cardiac injury than any other virus that we deal with, we felt that the safest thing is that we assume that they {athletes who have recovered from COVID-19} have cardiac injury if they had symptoms, and do some testing first. Then, once the testing is negative, say okay you’re good to go,” Dr. Phelan explained.

In some cases of COVID-19, patients are developing heart complications such as myocarditis, or inflammation of the heart muscle. The ACC Sports and Exercise Council recommends any athlete who recovers from COVID-19 undergoes cardiac tests to detect myocarditis or heart injury before returning to exercise.

“if you exercise with myocarditis, that’s a very bad thing to do. Because exercise causes an increase in the viral replication, it increases the scar of the heart, and it makes you more prone to abnormal and dangerous rhythms,” Dr. Phelan said. “Outside of COVID-19, if an athlete comes to me with myocarditis, we take that very seriously. And we tell athletes you have to not exercise or between 3 and 6 months. And even after that period of rest, we do very serious testing before we allow them to return to play.”

The council recommends athletes undergo blood testing, electrocardiograms, and echocardiograms before being cleared to play.

Under current data, Dr. Phelan says 7 to 33 percent of patients who show symptoms or are hospitalized from COVID-19, present with heart injury once they recover. Data is limited on whether mild cases of COVID-19, in which a patient may be asymptomatic or not hospitalized, can have the same effects on the heart.

“This data will come out. We will understand how often athletes and any, the general public, suffer the injury with mild symptoms. And if it’s extremely rare or it doesn’t happen, then we’ll be able to reevaluate and scale back these recommendations,” Dr. Phelan said.

For more information on the recommendations issued click here: https://jamanetwork.com/journals/jamacardiology/fullarticle/2766124?guestAccessKey=6e2409c7-67d4-45ea-bc59-299c2d0a9db1&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=051320

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