Minor physiological changes observed in diastolic indices and body composition without adverse remodeling.
Guideline-Based Recommendations
Diagnosis
Use echocardiography including strain imaging (LV/RV GLS) to assess myocardial function post-COVID-19 in athletes.
Perform cardiopulmonary exercise testing (CPET) to evaluate exercise capacity and ventilatory parameters.
Management
Support return to sport in asymptomatic athletes after mild COVID-19 based on stable cardiac and exercise performance findings.
Monitor athletes longitudinally with clinical and functional assessments to detect any late cardiac changes.
Monitoring & Follow-up
Repeat echocardiographic and CPET evaluations at baseline (~3 months post-infection) and 12 months to assess stability.
Track body composition and diastolic function indices as part of comprehensive follow-up.
Risks
Clinically significant myocardial involvement (e.g., myocarditis) is rare (~1%-3%) in athletes with mild COVID-19.
No evidence of adverse cardiac remodeling or impaired cardiopulmonary function at 12 months in this population.
Patient & Prescribing Data
Adult elite and recreational athletes with mild SARS-CoV-2 infection
Return to sport is safe in asymptomatic athletes with preserved myocardial and cardiopulmonary function at 12 months; baseline fitness is a key predictor of long-term exercise capacity.
Clinical Best Practices
Incorporate advanced echocardiographic strain imaging for sensitive detection of subclinical myocardial changes post-COVID-19.
Use CPET to objectively measure cardiopulmonary performance and guide return-to-play decisions.
Consider baseline aerobic fitness as a prognostic factor for long-term recovery in athletes.
Maintain regular follow-up assessments to ensure stable cardiac function and exercise capacity.
by Jana Schellenberg, Lynn Matits, Johannes Kersten, Daniel A. Bizjak, Florian Horn, Johannes Hell, Sebastian Viktor Waldemar Schulz, Eric Schwarz, Johannes Kirsten
Invited narrative review supports early, interprofessional rehabilitation across the ICU recovery continuum while emphasizing heterogeneous evidence and inconsistent implementation worldwide.
So get this: sodium may track with memory decline (in men), steroids might not be “immunosuppressive” in the ICU, and second pregnancies reshape the brain differently than first. Same theme: biology is less binary than we teach it.
