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Injury Prevention Symposium, Day 1, Session 1 Recap: Risk Management and Return to Sport during COVID-19 April 28, 2021



COLORADO SPRINGS, Colo. – The 5th Annual Injury Prevention Symposium, a partnership between Steadman Philippon Research Institute (SPRI) and the U.S. Olympic & Paralympic Committee (USOPC), opened its two-day virtual proceedings on Wednesday. Following a scientific keynote presentation, a trio of speakers addressed the topic of risk management and return to sport for athletes returning during COVID-19.


Jonathan Finnoff, DO, Chief Medical Officer, U.S. Olympic & Paralympic Committee, began the session as he discussed the USOPC’s screening, management and mitigation strategies over the past year-plus since COVID-19 came to North America.


Finnoff outlined what actions the USOPC took from the outbreak of COVID-19 in March of 2020 through all of its steps in reopening its training centers for American athletes in the next several months.


“COVID-19 hit the world hard and fast and the response we had to have was dynamic, multi-faceted and often related to rapidly changing public health mandates,” said Finnoff.


One of the major concerns that came out of the spread of COVID-19 was the discovery of its effect on heart issues with young athletes, particularly the occurrence of myocarditis (inflammation of the heart muscle that can affect your heart's electrical system, reducing your heart's ability to pump and causing rapid or abnormal heart rhythms).


“There was a dramatic increase in cardiac complications of hospitalized patients with COVID-19 compared to those patients with non-COVID viral infections,” noted Finnoff. “We had to collect data and determine the exact correlation between COVID-19 and myocarditis.”


Aaron Baggish, MD, Associate Professor of Medicine, Harvard Medical School and Director of the Cardiovascular Performance Program at Massachusetts General Hospital, relayed data on COVID-19 patients—specifically young athletes—that dealt with cardiac complications.


“What is interesting is that we knew much about COVID-19 before it ever came to North America,” said Baggish.


Documents and publications from China from March and earlier in 2020 showed where the disease often originated, how it spread among small clusters of people and family members and what the primary causes and symptoms were.


“Another interesting thing we learned quite early about COVID-19 is that this is not just a disease of the lungs but also a disease of the heart,” said Baggish.


After outlining the phases of response by physicians and clinicians in North America to the breakout of COVID-19 last spring, Baggish noted that the biggest unanswered question—“What’s next?”—led to the major concerns with cardiac complications and disease.


“Myocarditis was here long before COVID-19 surfaced a year ago and will be an issue long after COVID-19 is no longer a daily topic of discussion,” said Baggish. “Our data shows, though, that less than 0.5 percent of 3,000 athletes that returned from diagnoses of COVID-19 had true myocarditis.”


The cardiac complications, though, and how they are related to COVID-19, are problems that certainly have not—and will not—just go away.


“Long haul COVID-19 is here to stay,” said Baggish, “but persistent follow-up and monitoring can go a long way toward maintaining the health and safety of young athletes returning to play.”


Stephanie Pearce, MD, a pediatric orthopaedic surgeon and sports medicine fellow at The Steadman Clinic, concluded the session with a presentation on her community’s approach to the return to sport for youth athletes.


Pearce reported that data from studies of youth sports organizations in the Vail, Colo., area showed that contract tracing, coupled with adherence to strict guidelines in activity and training procedures, helped to prevent any major outbreaks over the past year.


“Minimal evidence exists on complications in youth athletes following COVID-19 infection,” said Pearce. “Obviously, more research is needed as this virus is clearly an everchanging situation.


“Our local teams and organizations will continue to follow the strict policy that a graduated return to play is the best way to safely return our young athletes to their sport and to help ensure their health and safety,” said Pearce.

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