Myocarditis and COVID-19…A Game Plan for the Resumption of Sport and Exercise after Coronavirus Disease (COVID-19) Infection

Myocarditis, a rare disease, can affect us all. The high risk age population is from puberty through early 30s, and it is the 3rd leading cause of Sudden Cardiac Death in Children and Young Adults. 
Approximately 20% of patients hospitalized with COVID-19 have evidence of cardiac damage. Although most cardiac damage is related to infection in the lungs, some cardiac damage is related to myocarditis, particularly in young persons. Most people with myocarditis will recover with supportive care. 
In the latest guidelines from JAMA Cardiology, 5/13/2020, risk stratification may occur after 3 to 6 months of exercise restrictions and is based on extensive testing including echocardiography, stress testing, and rhythm monitoring. Return to competitive sports and exertional activities after myocarditis, is predicated on normalization of ventricular function, absence of biomarker evidence of inflammation, and absence of inducible arrhythmias.