Cardiac screening before returning to elite sport after SARS-CoV-2 infection

BackgroundSARS-CoV-2 infection can induce cardiac damage. Therefore, in the absence of clear data, a cardiac evaluation was recommended for athletes before returning to play after recent SARS-CoV-2 infection.AimTo assess the proportion of anomalies detected by this cardiac screening.MethodsWe reviewed the medical files of elite athletes referred for cardiac evaluation before returning to play after a non-hospitalized SARS-CoV-2 infection (based on a positive polymerase chain reaction or antigen test) from March 2020 to July 2021 in 12 French centres.ResultsA total of 554 elite athletes (professional or national level) were included (median age 22 years, 72.0% male). An electrocardiogram (ECG), echocardiogram and exercise test were performed in 551 (99.5%), 497 (89.7%) and 293 (52.9%) athletes, respectively. We found anomalies with a potential link with SARS-CoV-2 infection in four ECGs (0.7%), three echocardiograms (0.6%) and three exercise tests (1.0%). Cardiac magnetic resonance imaging was performed in 34 athletes (6.1%), mostly due to abnormal first-line examinations, and was abnormal in one (2.9%). The rates of those abnormalities were not higher among athletes with cardiac symptoms or more severe forms of non-hospitalized SARS-CoV-2 infection. Only one athlete had a possible SARS-CoV-2 myocarditis and sport was temporally contraindicated. None had a major cardiac event declared during the follow-up.ConclusionThe proportion of cardiac involvement after non-hospitalized forms of SARS-CoV-2 infection in athletes are very low. Systematic cardiac screening before returning to play seems to be unnecessary.     

Return to Play After Injuries: A Survey on the Helpfulness of Various Forms of Assistance in the Shared Decision-Making Process in Semiprofessional Athletes in Germany

Objective

To assess how different decision-guiding factors, such as health- and performance-related stakeholders, as well as evidence-based guidelines, support the process-oriented final positive return-to-play (RTP) decision of head coaches responsible for semiprofessional sport teams.

POSTERIOR STERNOCLAVICULAR JOINT DISLOCATION IN A DIVISION I FOOTBALL PLAYER: A CASE REPORT

Posterior dislocation of the sterno‐clavicular (SC) joint is a rare injury in athletes. It normally occurs in high collision sports such as American football or rugby. Acute posterior dislocations of the SC joint can be life‐threatening as the posteriorly displaced clavicle can cause damage to vital vascular and respiratory structures such as the aortic arch, the carotid and subclavian arteries, and the trachea. The potential severity of a posterior SC joint dislocation provides multiple challenges for clinicians involved in the emergency care and treatment of this condition. Integration of clinical examination observations, rapid critical thinking, and appropriate diagnostic imaging are often required to provide the best management and outcome for the injured athlete. The criterion for return‐to‐play and participation in collision sports after suffering a posterior dislocation of the SC joint are unclear due to the rarity of this injury. The purpose of this case report is to describe the management, from the initial on‐field evaluation through the return‐to‐sport, of a collegiate Division I football player following a traumatic sports‐related posterior SC joint dislocation. The rehabilitation process and the progression to return to participation are also presented and briefly discussed.

Level of Evidence

4‐Single case report     

磁共振扩散张量成像诊断曲棍球运动员髌软骨早期损伤

目的 探讨应用磁共振扩散张量成像(DTI)诊断曲棍球运动员髌软骨早期损伤的可行性。方法 对40名非运动员(正常组)和17例专业曲棍球运动员(运动组)的双膝关节行质子密度加权成像(PDWI)和DTI扫描,生成DTI伪彩图,于连续两个髌软骨最大层面上选择5个ROI(内侧、偏内侧、中间、偏外侧、外侧),测量各ROI的各向异性分数(FA)和平均弥散系数(MD),并进行比较。结果 与正常组比较,运动组右侧髌软骨各部位的FA值减小,MD值增加,差异均有统计学意义(P均<0.001);左侧髌软骨上层偏外侧、外侧及下层偏外侧MD值增加,差异有统计学意义(P均<0.005)。运动组左、右髌软骨各部位的FA和MD值差异有统计学意义(P均<0.05)。运动组右侧髌软骨的上层内侧与外侧MD值的差异有统计学意义(F=7.02, P=0.012)。结论 FA值和MD值能够体现髌软骨水分子弥散能力的变化,量化髌软骨早期损伤的生化改变。DTI技术可以对曲棍球运动员髌软骨不同程度早期损伤的诊断提供影像学依据。     

Haematological and iron-related parameters of male endurance and strength trained athletes

Summary To obtain more information on the effects of long-lasting endurance and strength training on the constituents of the blood, several haematological and iron-related parameters were measured at rest in 39 male athletes from the Polish team who participated in the Olympics in Seoul in 1988. The athletes were divided into two groups: endurance-trained subjects (group E, cyclists, canoeists and rowers; n=22) and strength-trained subjects (group S, wrestlers and judo; n=17). The control group was composed of untrained male subjects (n=48). Blood samples were taken from an antecubital vein with the subject at rest for determinations of haemoglobin concentration ([Hb]), packed cell volume (PCV), erythrocyte (RBC) and reticulocyte count, plasma free haemoglobin concentration, haptoglobin concentration, serum iron, transferrin concentration and ferritin concentrations ([Ferr]); red blood cells were used for estimation of glutamato-oxalate transaminase (GOT) activity and free erythrocyte protoporphyrin concentration ([FEP]). The mean [Hb], PVC, RBC measured in the E athletes were significantly lower than in the control group but were comparable to those obtained in the S athletes. There were no significantly differences in the haematological indices [mean corpuscular volume (MCV), mean copuscular haemoglobin and mean corpuscular haemoglobin concentration] between the groups of athletes and the control group. A significant increase in reticulocytosis and GOT activity was observed in the endurance-trained athletes. No impairment of erythropoiesis was observed as indicated by several sensitive markers of haemoglobin formation (FEP, MCV and inspection of blood smears) in the athletes. The athletes from group E had mean serum [Ferr] below 50 g·l^–1 which was significantly lower than [Ferr] in the serum of subjects from the control group and the strength-trained athletes. The results of the present investigation showed that some haematological parameters and the iron status of the endurance athletes differed from the untrained subjects as well as the strength-trained athletes.