Covid-19 and sport: take care of your heart!

the essential
Sports cardiologists warn of the risk of myocarditis occurring after a Covid-19 infection. Their message: no sport for 7 days to put the heart to rest after inflammation and even vaccination.

Sports cardiologists took advantage of the 32and European Days of the French Society of Cardiology, two weeks ago in Paris, to alert. More than other infections, Covid-19 increases the risk of triggering myocarditis, an inflammation of the heart muscle which can be extremely serious.

Their recommendation is simple: in the event of Covid, we stop intense physical activity for 7 days. But it is not easy to hear on the side of athletes, clubs or even all those who have long believed that in the event of a cold, it was better to take a good sweat…

« Do not exercise when you have a fever, body aches or joint pain, is one of the ten golden rules (1) to avoid cardiovascular accidents as well as myocarditis », recalls Dr Alexandre Duparc, cardiologist at the University Hospital Center (CHU) of Toulouse, rhythmologist, member of the board of directors of the Club des cardiologues du sport.

Inflammation of the heart muscle

“Myocarditis is a transient inflammation of the heart muscle that most commonly affects young males. It is most often linked to a benign viral infection and can therefore be discovered late, after this event (by MRI imaging). Myocarditis can alter cardiac mechanics (the heart performs its pumping role less well) and promote arrhythmias that can lead to loss of consciousness or cardiac arrest. Stopping physical activity reduces the risk of these complications occurring and promotes recovery,” adds the cardiologist. Either a stop of the sport (no shortness of breath) between three and six months, the time that the heart muscle heals. The gradual recovery is done after a cardiological assessment.

The Covid-19 has raised the alert. “We find myocarditis in around one case of Covid in ten thousand, that’s a lot. It also appears that myocarditis due to Covid-19 is more serious than that induced by other viruses, with more frequent complications. Dr Alexandre Duparc cites the example of a 22-year-old rugby player who triggered myocarditis after his Covid. “After three months, the inflammation of the heart muscle was still present. He therefore had to stop for three more months. Among young people about to land professional contracts, the situation can be problematic.

Recommendations after a positive Covid test but also after vaccination

Cardiologists have established the following recommendations: after a positive test for Covid-19, even without symptoms, moderate to intense sports activity must be excluded for at least 1 week; in case of palpitations, chest pain, shortness of breath, it is imperative to seek medical advice before resuming sporting activity.

They have also extended their recommendations to the period following vaccination. Even if the number of myocarditis occurring after vaccination is lower (about one case per 100,000) and the severity less. They also require specific cardiological management. To prevent the occurrence of this myocarditis, “we recommend stopping intensive sport seven days after vaccination, and 7 days after the disappearance of symptoms if there are any. This is perhaps the message that has the most difficulty getting across in sports clubs, ”adds Dr Alexandre Duparc.

(1) The ten recommendations enacted by the Club of Sports Cardiologists in 2006 have been validated by the National Academy of Medicine, and widely distributed to sports federations.

Dr. Alexandre Duparc declares that he has no conflict of interest with pharmaceutical companies.

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