Even those who were completely asymptomatic should increase activity gradually and only after screening, said Dr. Briskin and suggested five levels of gradual progression towards full activity. The AAP recommends a gradual return to game schedule published in the British Journal of Sports Medicine earlier this year.
Dr. Aaron Baggish, the director of the cardiovascular benefits program at the Massachusetts General Hospital Heart Center, said that as the pandemic began, when it became clear that many of those sick enough to be hospitalized with Covid had signs of injury in Im Hearts those who worked with athletes worried about what they might see in young people.
Early guidelines are very conservative and recommend extensive testing. More recently, however, with better information it has become clear that it is more important to focus on those who have been more seriously ill. Dr. Baggish was the lead author of an article, “Coronavirus Disease 2019 and the Athletic Heart,” published in JAMA Cardiology magazine in October, which provides guidelines for performing heart tests on adult athletes before they can play again. The article also argued that while there are still many unknowns about the possible effects of Covid-19 on the heart, the main consideration about organized sport should be to prevent the transmission and spread of viruses.
Dr. Briskin agreed that when little was known about the effects of Covid-19 infection, pediatricians’ initial approach was to “make sure we do everything we can to keep our athletes safe”. The Council has generally been very conservative. “We’re just starting to get to the point where we can get some data on the cardiac effects of Covid-19 on a younger population,” she said. “That will help us give more precise instructions on how to get back to the game.”
Dr. Peter Dean, a pediatric cardiologist who is a team cardiologist for athletes from the University of Virginia and is a member of the Executive Committee on Exercise and Exercise for the American College of Cardiology, said athletes started using Covid as early as June asking if they could play again . The adult recommendations at the time indicated fairly extensive cardiac tests for everyone, including EKGs, echocardiograms, and blood tests for troponins (proteins that increase when the heart muscle is injured).
“We really didn’t see any pediatric cases at the time,” said Dr. Dean, and it seemed that children were generally less affected by the infection. Covid-19 infection can definitely affect a child or teenager’s heart, said Dr. Dean, and some children, such as B. Children with inflammatory multisystem syndrome require extensive cardiac exams. Instead of testing all children, it makes sense to focus on those who have had moderate or severe illness, or have persistent symptoms.
“Myocarditis is a big deal, but it’s incredibly rare,” he said.
“I think we as a community are now less concerned about subclinical myocarditis than we were before,” said Dr. Dean. There may have been concerns that slightly ill children might suddenly have cardiac arrest at home or while exercising, but “we just didn’t see it”.