Cardiac screening before returning to elite sport after SARS-CoV-2 infection - 02/12/22
, Frédéric Schnell b, Philippe Sosner c, l, m, n, Frédéric Chagué d, Iris Schuster e, Marc Julia f, Alexandre Duparc g, Jean-Michel Guy h, Nicolas Molinari i, Lionel Michaux j, Frédéric Cransac k, Stéphane Cade k
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Highlights |
• | Systematic cardiac evaluation has been proposed in athletes after SARS-CoV-2. |
• | Electrocardiogram and echocardiography are most commonly performed. |
• | Cardiac anomalies after SARS-CoV-2 infection are very rare in athletes. |
• | Hence, cardiac screening may not to be necessary in the absence of cardiac symptoms. |
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.
Le texte complet de cet article est disponible en PDF.Keywords : SARS-CoV-2, Screening, Athletes, Return-to-play, Myocarditis
Abbreviations : CI, CMR, ECG, LGE, LVEF, LVNC, RT-PCR, SARS-CoV-2
Plan
Vol 115 - N° 11
P. 562-570 - novembre 2022 Retour au numéro
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