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Sports Medicine

Return to Play for Athletes After Coronavirus Disease 2019 Infection—Making High-Stakes Recommendations as Data Evolve

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Cardiology

Published Online: October 26, 2020

Editorial

Article Information and Disclosures

James E. Udelson, MD¹;

Michael A. Curtis, MEd, CSCS^2,3;

Ethan J. Rowin, MD¹

Author Affiliations

¹The CardioVascular Center, Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
²Exercise and Sports Injury Laboratory, Department of Kinesiology, University of Virginia, Charlottesville
³Men’s Basketball Program, Department of Athletics, University of Virginia, Charlottesville

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As the coronavirus disease 2019 (COVID-19) pandemic began to evolve, case reports suggested that a clinical syndrome consistent with inflammatory myocarditis could occur as the underlying mechanism for the oft-seen elevations in biomarkers of myocardial injury and stress.¹ However, as data have progressed, a picture has emerged from autopsy studies of myocardial involvement with viral infection and a cytokine response, but less often inflammatory cell infiltrate consistent with myocarditis.² In July, a high-profile report³ emerged from Germany showing that more than 2 months after COVID-19 diagnosis, in a group of patients who had clinically recovered after a broad spectrum of disease severity (ranging from asymptomatic to severe illness with intubation), cardiac magnetic resonance (CMR) imaging and biomarker findings in the recovery phase were consistent with active ongoing myocardial involvement and inflammation in 60% of patients.

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Article Information

Corresponding Author: James E. Udelson, MD, The CardioVascular Center, Division of Cardiology, Tufts Medical Center, 800 Washington St, PO Box 70, Boston, MA 02111 (judelson@tuftsmedicalcenter.org).

Published Online: October 26, 2020. doi:10.1001/jamacardio.2020.5896

Conflict of Interest Disclosures: None reported.

References

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Biesbroek PS , Hirsch A , Zweerink A , et al. Additional diagnostic value of CMR to the European Society of Cardiology (ESC) position statement criteria in a large clinical population of patients with suspected myocarditis. Eur Heart J Cardiovasc Imaging. 2018;19(12):1397-1407. doi:10.1093/ehjci/jex308 PubMed Google Scholar Crossref

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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.