Why the study?
Cardiovascular magnetic resonance has been employed and interpreted nonuniformly in COVID-19, raising uncertainty regarding its clinical relevance for athletic return to play.
How should cardiovascular magnetic resonance imaging be utilized in the return to play assessment of athletes with prior COVID-19 infection?
How should cardiovascular magnetic resonance imaging be utilized in the return to play assessment of athletes with prior COVID-19 infection?
Provides expert consensus on the appropriate use of cardiovascular magnetic resonance imaging for evaluating athletes recovering from COVID-19 prior to returning to play.
Guides CMR use in post-COVID athlete return-to-play decisions; extends expert consensus to this population.
The global pandemic of COVID-19 caused by infection with SARS-CoV-2 is now entering its fourth year with little evidence of abatement. As of December 2022, the World Health Organization Coronavirus (COVID-19) Dashboard reported 643 million cumulative confirmed cases of COVID-19 worldwide and 98 million in the United States alone as the country with the highest number of cases. Although pneumonia with lung injury has been the manifestation of COVID-19 principally responsible for morbidity and mortality, myocardial inflammation and systolic dysfunction though uncommon are well-recognized features that also associate with adverse prognosis. Given the broad swath of the population infected with COVID-19, the large number of affected professional, collegiate, and amateur athletes raises concern regarding the safe resumption of athletic activity (return to play) following resolution of infection. A variety of different testing combinations that leverage ECG, echocardiography, circulating cardiac biomarkers, and cardiovascular magnetic resonance imaging have been proposed and implemented to mitigate risk. Cardiovascular magnetic resonance in particular affords high sensitivity for myocarditis but has been employed and interpreted nonuniformly in the context of COVID-19 thereby raising uncertainty as to the generalizability and clinical relevance of findings with respect to return to play. This consensus document synthesizes available evidence to contextualize the appropriate utilization of cardiovascular magnetic resonance in the return to play assessment of athletes with prior COVID-19 infection to facilitate informed, evidence-based decisions, while identifying knowledge gaps that merit further investigation.
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Ruberg et al. (2022) conducted a review in COVID-19 infection in athletes. Cardiovascular magnetic resonance imaging was evaluated. Cardiovascular magnetic resonance imaging utilization for return to play assessment in athletes with prior COVID-19 is guided by this expert consensus document.
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