Is extensive cardio-pulmonary screening useful in athletes with previous asymptomatic or mild SARS-CoV-2 infection?

Objective During the COVID-19 pandemic, it is\r\nessential to understand if and how to screen SARSCoV-2-positive athletes to safely resume training and\r\ncompetitions. The aim of this study is to understand\r\nwhich investigations are useful in a screening\r\nprotocol aimed at protecting health but also avoiding\r\ninappropriate examinations.\r\nMethods We conducted a cohort study of a\r\nprofessional soccer team that is based on an extensive\r\nscreening protocol for resuming training during the\r\nCOVID-19 pandemic. It included personal history,\r\nantigen swabs, blood tests, spirometry, resting/stress-test\r\nECG with oxygen saturation monitoring, echocardiogram,\r\nHolter and chest CT. We also compared the findings with\r\nprior data from the same subjects before infection and\r\nwith data from SARS-CoV-2-negative players.\r\nResults None of the players had positive swab and/\r\nor anti-SARS-CoV-2 IgM class antibodies. Out of 30\r\nplayers, 18 (60%) had IgG class antibodies. None had\r\nsuffered severe SARS-CoV-2-related disease, 12 (66.7%)\r\nhad complained of mild COVID-19-related symptoms\r\nand 6 (33.3%) were asymptomatic. None of the players\r\nwe examined revealed significant cardiovascular\r\nabnormalities after clinical recovery. A mild reduction in\r\nspirometry parameters versus pre-COVID-19 values was\r\nobserved in all athletes, but it was statistically significant\r\n(p<0.05) only in SARS-CoV-2-positive athletes. One\r\nSARS-CoV-2-positive player showed increased troponin\r\nI level, but extensive investigation did not show signs of\r\nmyocardial damage.\r\nConclusion In this small cohort of athletes with\r\nprevious asymptomatic/mild SARS-CoV-2 infection, a\r\ncomprehensive screening protocol including blood tests,\r\nspirometry, resting ECG, stress-test ECG with oxygen\r\nsaturation monitoring and echocardiogram did not\r\nidentify relevant anomalies. While larger studies are\r\nneeded, extensive cardiorespiratory and haematological\r\nscreening in athletes with asymptomatic/mild SARSCoV-2 infection appears unnecessary