[Covid-19, myocarditis and return to play: it's time to be conservative]

Recenti Prog Med. 2021 Mar;112(3):191-194. doi: 10.1701/3565.35457.
[Article in Italian]

Abstract

Observational studies of cardiac magnetic resonance imaging in people with recent covid-19, including young asymptomatic athletes, have documented variable amounts of myocardial findings deemed suggestive of myocarditis. Despite a critical appraisal of the current literature points toward an insufficient evidence base about the existence of a peculiar association between covid-19 and myocarditis, the concern for unrecognized myocarditis and its potential consequences has led several sports medicine organizations to recommend a variety of cardiac tests to enable return to play in athletes with previous covid-19. We argue that some of these recommendations may lead to unnecessary tests or treatments, especially for asymptomatic SARS-CoV-2 positive people and for those with previous mild disease, and that sports participation may even be discouraged. As a response to current uncertainty, we advocate both for randomized studies that analyse the outcomes of different diagnostic strategies and for a prolonged follow-up of these people.

Publication types

  • Comment

MeSH terms

  • Athletes
  • COVID-19*
  • Humans
  • Medicine*
  • Myocarditis* / diagnosis
  • Myocarditis* / therapy
  • Physicians*
  • Return to Sport
  • SARS-CoV-2