When Is It Safe for an Athlete to Return to Play after COVID-19?

Athlete Running After COVID-19 illness.Though the COVID-19 coronavirus emerged in late 2019, there are still many questions regarding the recovery process for someone who’s become ill and the long-haul symptoms they may experience. Among these questions are about when athletes recovering from COVID-19 can return to play. Learn about the American College of Cardiology Sports and Exercise Council’s return-to-play recommendations from Myocarditis Foundation.

Recommendations for Athletes after COVID-19

The American College of Cardiology Sports and Exercise Council provides guidance to professional sports leagues, such as the National Football League (NFL) and National Basketball Association (NBA), and its recommendations are often followed by semi-professional, collegiate, high school, recreational, and other levels of sports. Its return-to-play recommendations for athletes recovering from a COVID-19 diagnosis are as follows:

For Athletes Previously Hospitalized or Severely Ill with COVID-19

Because these athletes are at much higher risk for cardiac injury related to COVID-19, they should also follow return-to-play recommendations for myocarditis. In these cases, athletes shouldn’t compete, train, or exercise for roughly three to six months. However, if a hospitalized athlete had normal cardiac biomarkers and imaging studies, a minimum of two weeks of rest after symptoms resolve is recommended, followed by a clinical cardiovascular evaluation and gradual return to play.

For Athletes Positive for COVID-19 with Mild to Moderate Symptoms

Athletes should abstain from physical activity for a minimum of two weeks from the onset of symptoms. Recovered athletes should undergo a clinical cardiovascular evaluation, utilizing some or all of the following tests to ensure no evidence of myocardial injury in the heart:

      • Cardiac biomarkers and imaging
      • Cardiac magnetic resonance imaging (MRI)
      • Exercise testing
      • Ambulatory rhythm monitoring

If there are no symptoms present and no evidence of cardiac injury, an athlete can return to play under the close guidance of their doctor. If testing reveals cardiac injury, athletes should follow return-to-play recommendations for myocarditis.

 For Athletes Negative for COVID-19 and Who Remain Asymptomatic

Under direction from their doctor, athletes can resume play without additional testing, but asymptomatic athletes testing positive for the COVID-19 antigen should isolate and cease exercise or training for at least two weeks from the date of the positive result.

The Importance of Following the Recommendations

There is still much to be learned about COVID-19 , its link to myocarditis, and its long-term impacts on athletes. That’s why it’s so crucial for athletes recovering from the coronavirus to take extreme caution upon their return to play and follow these recommendations from the American College of Cardiology Sports and Exercise Council.

“Given the fact that this particular virus seems to have much more cardiac injury than any other virus that we deal with, we felt that the safest thing is that we assume that they have cardiac injury if they had symptoms,” Dr. Dermot Phelan of the American College of Cardiology and Sports Exercise Council told WBTV. He goes on to explain that those with negative test results may return to play, though those showing signs of cardiac injury or myocarditis should have a significant period of rest for at least three to six months. “If you exercise with myocarditis, that’s a very bad thing to do. Because exercise causes an increase in the viral replication, it increases the scar of the heart, and it makes you more prone to abnormal and dangerous rhythms.”

For more information, contact Myocarditis Foundation today.
JAMA Covid and Athletes Article Headline.
Chart showing COVID Return-To- Play Algorithm for Adult Athletes Diagram