Review of Cardiopulmonary Considerations for High School Student-Athletes During the COVID-19 Pandemic— Drezner 2020
This is a brief audio review. In the article Cardiopulmonary Considerations for High School Student-Athletes During the COVID-19 Pandemic: NFHS-AMSSM Guidance Statement published, 2020 by Drezner and Colleagues, The outcomes and key points are as noted: Student athletes in high school with a history of prior COVID-19 infection warrant evaluation by medical providers prior to sports participation. Ongoing symptoms related to COVID-19 need to be explored with respect to cardiopulmonary symptomatology such as exertion, palpitations, excess fatigue, or decreased exercise tolerance. Medical consultation before return to sports participation is recommended for patients with a previous confirmed diagnosis regardless of history of symptoms ( for example, a patient may have been asymptomatic) and regardless of severity. For student-athletes who have had mild to moderate illness and may also have been managed at home, these patients should see a medical provider to ascertain persisting symptoms and changes in health.
For these patients, if there were persistent symptoms or changes in health, further consultation with a specialist should be considered, namely cardiology for patients with persistent cardiopulmonary symptoms post infection. If there was a suspicion of myocarditis then an electrocardiogram should be obtained and cardiology consultation should also be ordered with an attention to obtaining expert help in interpreting electrocardiographic data in young athletes. For student athletes and cases who were affected with severe illness, these patients with a history of severe illnesses should be deemed as high risk for developing cardiopulmonary complications such as arrhythmias, myocarditis, heart failure, sudden cardiac arrest, and pulmonary embolism.
A comprehensive cardiac evaluation is recommended in consultation with cardiologist and such evaluation may or should include the following tests: electrocardiogram, cardiac biomarkers like high sensitivity troponins, echocardiogram, cardiac magnetic resonance imaging Holter monitor, or stress test. Follow up pulmonary evaluation and testing may also be indicated, including chest radiograph, spirometry, functional bronchospasm testing, pulse oximetry during exercise, and chest computed tomography, or additional pulmonary consultation. If the student athlete has ongoing symptoms associated with COVID-19 they should undergo comprehensive evaluation to ensure cardiopulmonary conditions may be screened for as these present risks for arrhythmias, respiratory compromise, sudden cardiac arrest, or sudden death. Other cases may present with myocarditis. Pulmonary conditions that are serious may also worsen or develop like asthma and pulmonary embolism. If myocarditis or other cardiopulmonary conditions are diagnosed these may be managed by current guidelines. Return to sports or exercise should not be undertaken prior to medical consultation by physician. These recommendations are sourced from a Guidelines document issued by the American Medical Society for Sport Medicine in reference to Patients who are student athletes with previous infection from COVID-19 with or without symptoms who may or may not have cardiopulmonary involvement.
Drezner JA, Heinz WM, Asif IM, Batten CG, Fields KB, Raukar NP, Valentine VD, Walter KD, Baggish AL. Cardiopulmonary Considerations for High School Student-Athletes During the COVID-19 Pandemic: Update to the NFHS-AMSSM Guidance Statement. Sports Health. 2022 Feb 21:19417381221077138. doi: 10.1177/19417381221077138. Epub ahead of print. PMID: 35188000; PMCID: PMC8863923.
