Return to play for athletes after covid-19

Planinc, N.; Zupet, P.; Kavaš, G.; Turel, M.; Zbačnik, R.; Jug, B.; Fras, Z.; Juvan, K. A.

Most athletes with COVID-19 are asymptomatic or mildly symptomatic, but there are now consistent reports that COVID-19 positive athletes may present with persistent and residual symptoms many weeks to months after initial infection. Most often the respiratory system is affected, but COVID-19 can also entail pathological consequences on other organ systems. Athletes are especially at risk for cardiovascular complications but attention must also be paid to other organ systems (neurological, gastrointestinal, musculoskeletal…) when treating an athlete. COVID-19 can cause myocardial damage among athletes that can be due to myocarditis, which is an important cause of sudden cardiac death among them. The following article describes an approach to return to play after COVID-19 for three different athlete groups: elite athletes, child athletes under 15 years old and highly active recreational athletes. We designed four groups according to the course of COVID-19: asymptomatic athletes, athletes with mild symptoms, moderate to severe or prolonged symptoms (≥ 14 days), and with severe disease that requires hospitalization. The content of the article is adjusted to current knowledge, COVID-19 restrictions, capacity and organization of the health system in Slovenia, and is subject to additional adjustments as new evidence becomes available. © 2021, Slovene Medical Society. All rights reserved.