Cardiovascular Risk Assessment after COVID-19 Infection before Resuming Sports Activities - Practical Flowchart and Meta-Analysis
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.Keywords
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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