Pathology of the cardiovascular system in people returning to sports after COVID-19

Aim: to summarize the data published in our country and abroad on the diagnosis of cardiac complications after COVID‑19 and to compare it with our own experience of examining such athletes.

Materials and methods: open data sources such as eLibrary, Scopus, PubMed etc. were used as a scientific base to achieve the set goal, a meta-analysis of 42 domestic and foreign literature sources was carried out upon the results of post‑COVID changes in athletes. Besides that, the indicators of 11467 athletes, aged from 16 to 45 years, were studied who have been playing for the Moscow national team and who passed in‑depth medical examination on the basis of Sports Medicine Clinic in Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine.

Results: the prevalence of myocarditis in mild COVID‑19 in athletes does not exceed 1 %, arrhythmia does not exceed 9 %. Classical cardiovascular screening is sufficient for their detection in most cases. If hospitalization is necessary, the risks increase for myocarditis up to 7.2 %, for myocardial infarction up to 4,7 %, for other cardiac complications up to 3–14 % and require advanced diagnostics. For optimal resource management in the healthcare system, a working algorithm for examining athletes returning to trainings after a previous COVID‑19 is proposed.

Conclusion: in most cases a classical cardiovascular screening is enough for symptomatic individuals returning to sports trainings after the COVID‑19. However, additional examinations, including loading tests and MRT, are required to find out possible latent ongoing pathology as well to evaluate prospects for the athlete.

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