Abstract
Background: The risk of sports-related sudden cardiac arrest after COVID-19 infection can be a serious problem. There is an urgent need for evidence-based criteria to ensure patient safety before resuming exercise. Objective: To estimate the pooled prevalence of acute myocardial injury caused by COVID-19 and to provide an easy-to-use cardiovascular risk assessment toolkit prior to resuming sports activities after COVID-19 infection. Methods: We searched the Medline and Cochrane databases for articles on the prevalence of acute myocardial injury associated [...]
Highlights
The recent severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) outbreak has created an unprecedented global challenge and triggered the implementation of interventions to promote social distancing, including cancellation of sports events.Importantly, coronavirus disease (COVID-19) affects relatively young people, with 77.8% of diagnoses in the age range of 30-69 years.[1]
The overall pooled prevalence of acute myocardial injury considering all hospitalized patients was 21.7%, and increased with increasing disease severity
Estimation of disease severity is the first step to determine the treatment approach and ensure patient safety. It is not known if COVID-19-related myocarditis is associated with sudden cardiac death, the prevalence of myocardial injury may be the best approximation for risk stratification based on available data
Summary
The recent severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) outbreak has created an unprecedented global challenge and triggered the implementation of interventions to promote social distancing, including cancellation of sports events.Importantly, coronavirus disease (COVID-19) affects relatively young people, with 77.8% of diagnoses in the age range of 30-69 years.[1]. The risk of sports-related sudden cardiac arrest after COVID-19 infection can be a serious problem. Objective: To estimate the pooled prevalence of acute myocardial injury caused by COVID-19 and to provide an easy-to-use cardiovascular risk assessment toolkit prior to resuming sports activities after COVID-19 infection. The pooled prevalence of acute myocardial injury was calculated for hospitalized patients treated in different settings (non-intensive care unit [ICU], ICU, overall hospitalization, and non-survivors). We propose a practical flowchart to assess the cardiovascular risk of individuals who recovered from COVID-19 before resuming sports activities. The overall pooled prevalence of acute myocardial injury in hospitalized patients was 21.7% (95% CI 17.3-26.5%). We provide an approach to assess cardiovascular risk based on the prevalence of acute myocardial injury in each setting. We created a toolkit to assist with clinical decision-making prior to resuming sports activities after COVID-19 infection.
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