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Cardiovascular Risk Assessment after COVID-19 Infection before Resuming Sports Activities - Practical Flowchart and Meta-Analysis
Puga, Luís; Dinis, Paulo; Teixeira, Rogério; Ribeiro, Joana Maria; Dores, Hélder; Gonçalves, Lino.
  • Puga, Luís; Centro Hospitalar e Universitário de Coimbra EPE. Coimbra. PT
  • Dinis, Paulo; Centro de Saúde Militar de Coimbra. Coimbra. PT
  • Teixeira, Rogério; Hospital Geral. Coimbra. PT
  • Ribeiro, Joana Maria; Centro Hospitalar e Universitário de Coimbra EPE. Coimbra. PT
  • Dores, Hélder; Hospital da Luz. Lisboa. PT
  • Gonçalves, Lino; Centro Hospitalar e Universitário de Coimbra EPE. Coimbra. PT
Int. j. cardiovasc. sci. (Impr.) ; 35(1): 14-24, Jan.-Feb. 2022. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-2318339
Responsible library: BR1.1
ABSTRACT
Abstract

Background:

The risk of sports-related sudden cardiac arrest after COVID-19 infection can be a serious problem. There is an urgent need for evidence-based criteria to ensure patient safety before resuming exercise.

Objective:

To estimate the pooled prevalence of acute myocardial injury caused by COVID-19 and to provide an easy-to-use cardiovascular risk assessment toolkit prior to resuming sports activities after COVID-19 infection.

Methods:

We searched the Medline and Cochrane databases for articles on the prevalence of acute myocardial injury associated with COVID-19 infection. The pooled prevalence of acute myocardial injury was calculated for hospitalized patients treated in different settings (non-intensive care unit [ICU], ICU, overall hospitalization, and non-survivors). Statistical significance was accepted for p values <0.05. We propose a practical flowchart to assess the cardiovascular risk of individuals who recovered from COVID-19 before resuming sports activities.

Results:

A total of 20 studies (6,573 patients) were included. The overall pooled prevalence of acute myocardial injury in hospitalized patients was 21.7% (95% CI 17.3-26.5%). The non-ICU setting had the lowest prevalence (9.5%, 95% CI 1.5-23.4%), followed by the ICU setting (44.9%, 95% CI 27.7-62.8%), and the cohort of non-survivors (57.7% with 95% CI 38.5-75.7%). We provide an approach to assess cardiovascular risk based on the prevalence of acute myocardial injury in each setting.

Conclusions:

Acute myocardial injury is frequent and associated with more severe disease and hospital admissions. Cardiac involvement could be a potential trigger for exercise-induced clinical complications after COVID-19 infection. We created a toolkit to assist with clinical decision-making prior to resuming sports activities after COVID-19 infection.
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Full text: Available Collection: International databases Database: WHO COVID / LILACS (Americas) Main subject: Sports / Heart Disease Risk Factors / COVID-19 / Myocarditis Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews Topics: Long Covid Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2022 Document Type: Article Institution/Affiliation country: Centro Hospitalar e Universitário de Coimbra EPE/PT / Centro de Saúde Militar de Coimbra/PT / Hospital Geral/PT / Hospital da Luz/PT

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Full text: Available Collection: International databases Database: WHO COVID / LILACS (Americas) Main subject: Sports / Heart Disease Risk Factors / COVID-19 / Myocarditis Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews Topics: Long Covid Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2022 Document Type: Article Institution/Affiliation country: Centro Hospitalar e Universitário de Coimbra EPE/PT / Centro de Saúde Militar de Coimbra/PT / Hospital Geral/PT / Hospital da Luz/PT