Athletes want to compete and give their best to their sport at every age. COVID has changed this in ways that no one was prepared to imagine. Now that we may be nearing a possible end to this pandemic, many people of all ages will be asking about a return to play (RTP) and getting back to everyday life. As we work to get to this level, some practitioners will be asked to sign RTP forms for school. All patients must divulge if they have had COVID, and, if confirmed, the severity of the illness will play a factor in clearing these patients.
A new consensus statement by the American College of Cardiology lists some key points to consider before sending a student back on the courts and fields for play. Some important takeaways from the statement include being cautious with patients who had active disease and possible complications, such as myocarditis, leading to arrhythmias. The recommendations include a comprehensive screening of symptoms and severity of illness and taking the patient history into account to direct the extent of a workup. At a minimum, electrocardiograms, high sensitivity troponins, and echocardiograms are probable tests for patients who have had COVID symptoms or complications. While these tests have limitations on diagnosing exact problems, they may be the initial steps in determining any physical damage. More specific testing, such as cardiac MRI, will play a larger role in looking for abnormalities. It is recommended that these sensitive tests are performed where an experienced clinician can read them.
It is too early to say what the long-term impact of COVID will be. However, getting back to normal is not like flipping a switch. Careful consideration to return to everyday life, including sports, must be taken. When the time comes, be sure to spend a little extra time evaluating your patients for RTP and consider these new guidelines.
For more information on the consensus statement, you can go to the JACC website.