This call-to-action document indicates that preparticipation cardiovascular screening (PPCS) is recommended by all major professional organizations overseeing the clinical care of competitive athletes. Of note, data indicates that cardiac imaging findings consistent with inflammatory heart disease following COVID-19 infection are more common than most forms of heart disease associated with sudden death during exercise. Using this research, new recommendations are being offered related to routine preparticipation cardiovascular screening for young competitive athletes – which has the capacity to detect both COVID-19 cardiovascular complications and pathology unrelated to infection – should be altered to account for recent scientific advances.

“This pronouncement emerges from the hard work of thought leaders representing both ACSM and AMSSM who convened to discuss how lessons learned throughout the COVID-19 pandemic could be used to refine our approach to preparticipation cardiovascular disease screening,” said Aaron Baggish MD, FACC, FACSM director of the Cardiovascular Performance Program at Mass General Hospital. “This approach includes an emphasis on looking for complications from recent infections that may place competitive athletes at risk during sport participation.”

Key recommendations based on this new research are as follows:  

• PPCS should include a history of recent infections illnesses, including COVID-19 infection.
• For athletes who have returned to exercise, it is critical to confirm that they feel well and to exclude the presence of cardiovascular symptoms.
• PPCS provides an opportunity to determine an athlete’s vaccination status and to educate about and facilitate vaccination administration.
• PPCS should include athlete education about the importance of reporting new onset cardiovascular symptoms during exercise following infection, but not limited to, COVID-19.
• A comprehensive preparticipation physical provides the valuable opportunity to screen for anxiety, depression and suicidal tendencies possibly caused and/or exacerbated by the COVID-19 pandemic.

“This call-to-action helps provide important guidance in an area where advice has been changing and conflicting during the course of the pandemic, and this information should be helpful as we head into the fall sports season,” said AMSSM Past President Kimberly Harmon, MD, FAMSSM, who served as a co-author on the document.

To learn more about this joint paper and its recommendations, read the full call to action statement. ACSM call to action statements combine research evidence and expert opinion to bring attention to a current scientific or clinical need and highlight a series of actions that can be taken.