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The Making of Medicine

When Is It Safe for Young Athletes to Play After COVID-19?

Peter Dean, MD, one of our pediatric cardiologists, has teamed up with two other experts to issue important guidance on when it's safe for children and teens to return to sports after recovering from COVID-19. (Dr. Dean is pictured above at left with Firezer Haregu, MD, a resident at UVA Health.)

As I'm sure you've seen in the news, COVID-19 can cause significant heart problems in adults. But what about kids and teens? That will be an important issue for many families this fall.

Dr. Dean and his co-authors say that children who have mild or asymptomatic cases should be able to return to the field two weeks after they have recovered. These young athletes likely won't need cardiac testing, though it's important to listen to your family physician. A primary concern is ensuring the children are no longer contagious, so that they don't spread the disease.

Children and teens who have more serious symptoms may need more in-depth evaluation. Youths who have prolonged fevers, for example, should be evaluated on a case-by-case basis, and their doctors should consider the type and intensity of sports they play, Dr. Dean advises. “Providers should not treat the 7-year-old recreational soccer player the same as the 18-year-old varsity basketball player,” he and his co-authors say in a new article outlining their recommendations.

In the rare case when a child or teen is hospitalized, has abnormal cardiac tests or suffers multisystem inflammatory syndrome, more cardiac testing is warranted, the doctors say. These kids may need to be kept out of sports for three to six months, and their doctors should clear them to return to play, the cardiologists advise.

High-school and college athletes who have moderate COVID-19 symptoms may warrant cardiac testing before returning to the field, but younger children likely will not, the doctors say.

To be on the safe side, the heart docs suggest that youth sports and high-school athletics programs make sure defibrillators, CPR and medical care are available going forward.

“Most pediatric patients should be fairly easily cleared to resume sports after a COVID-19 infection, but there will be rare cases where more extensive cardiac testing is required,” Dr. Dean said. “We also expect to learn more about the long-term cardiac implications of the virus in the next several months to years, so it is important to stay up-to-date with information.”

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