Cardio‐pulmonary function among children with mild or asymptomatic COVID‐19 infection needing certification for return‐to‐play

Chicco, Daniela; Rispoli, Francesco; De Nardi, Laura; Romano, Sara; Mazzolai, Michele; Bobbo, Marco; Tavcar, Irena; Cattarini, Gilberto; Badina, Laura; Barbi, Egidio; Maschio, Massimo

AIM: To explore the cardio‐pulmonary function of children returning to play sports after mild or asymptomatic SARS‐CoV‐2 infection. METHODS: This is a consecutive case series conducted at the Institute for Maternal and Child Health, Trieste, Italy. Paediatric patients who accessed the Institute for cardiologic and pneumological evaluation before the return‐to‐play competitive sports were recruited, according to the Italian Sports Medical Federation recommendations. Echocardiogram, electrocardiogram, treadmill ECG test and pulmonary function tests were performed. RESULTS: One hundred and thirty‐two patients (aged 8–17 years old, mean age 12.8 ± 2.5) were recruited. Among these, 127 children were considered for the final analysis (49.6% females). Out of 127, 84 (66.1%) had a mild symptomatic form of SARS‐CoV‐2 infection, while 43 (33.9%) were asymptomatic. The main referred symptoms were fever (n = 37, 44%), asthenia (n = 14, 16.7%), rhinitis (n = 16, 19%), ageusia (n = 19, 22.6%), anosmia (n = 24, 28.6%), sore throat (n = 3, 3.6%), cough (n = 9, 10.7%), arthralgia‐myalgia (n = 11, 13.1%), headache (n = 23, 27.4%) and gastrointestinal symptoms (n = 7, 8.3%). No child presented evidence of cardio‐pulmonary function impairment after an average time of 77.3 days (SD 35) from SARS‐CoV‐2 swab positivity and a median of 68 days (IQ1 52, IQ3 92.5). CONCLUSION: This preliminary study suggests that, in the absence of specific symptoms, the diagnostic yield of cardio‐pulmonary tests before returning to play sports may be very low.