• Silvia Castelletti, Salvatore Gervasi, Enrico Ballardini, Maurizio Casasco, Elena Cavarretta, Furio Colivicchi, Maurizio Contursi, Francesco Cuccaro, Flavio D'Ascenzi, Giovanni Gazale, Lucio Mos, Stefano Nistri, Vincenzo Palmieri, Giampiero Patrizi, Marco Scorcu, Andrea Spampinato, Monica Tiberi, Giovanni B Zito, Alessandro Zorzi, Paolo Zeppilli, Luigi Sciarra, and Italian Society of Sports Cardiology (SICSport, Società Italiana di Cardiologia), the Associazione Nazionale Cardiologi Extraospedalieri (ANCE), the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), the Associazioni Regionali Cardiologi Ambula.
• Cardiology Department, IRCCS Istituto Auxologico Italiano, Milan, Italy.
• Panminerva Med. 2024 Mar 1; 66 (1): 637463-74.

AbstractThe Coronavirus-19 disease (COVID-19) related pandemic have deeply impacted human health, economy, psychology and sociality. Possible serious cardiac involvement in the infection has been described, raising doubts about complete healing after the disease in many clinical settings. Moreover, there is the suspicion that the vaccines, especially those based on mRNA technology, can induce myopericarditis. Myocarditis or pericarditis related scars can represent the substrate for life-threatening arrhythmias, triggered by physical activity. A crucial point is how to evaluate an athlete after a COVID-19 infection ensuring a safe return to play without increasing the number of unnecessary disqualifications from sports competitions. The lack of conclusive scientific data significantly increases the difficulty to propose recommendations and guidelines on this topic. At the same time, the psychological and physical negative consequences of unnecessary sports restriction must be taken into account. The present document aims to provide an updated brief review of the current knowledge about the COVID-19 cardiac involvement and how to recognize it and to offer a roadmap for the management of the athletes after a COVID-19 infections, including subsequent impact on exercise recommendations. Our document exclusively refers to cardiovascular implications of the disease, but pulmonary consequences are also considered.

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