Pediatrician visit recommended after COVID-19 diagnosis, before return to sports

With fall athletics underway and the threat of COVID-19 still lingering, medical professionals are encouraging parents and schools to stay on top of guidelines around COVID-19 and kids playing sports. Cincinnati Children’s Hospital follows the return to sports counseling from the American Academy of Pediatrics. It recommends that any child who contracts COVID-19 see a pediatrician before returning to sports practices or games. Chris Peltier is a community pediatrician and director of General and Community Pediatrics at Cincinnati Children’s. He is also the president-elect of the Ohio Chapter of the American Academy of Pediatrics. “All those kids who have covid and play sports need to be seen in their primary care physician’s office before they can be released to exercise,” Peltier said. “Like a concussion, children with COVID infection should be evaluated before returning to exercise.” Peltier said children should be examined to make sure they have not had rare but serious heart problems.” he said. The AAP’s recommendations say a child with an asymptomatic or mild case of COVID infection should see their primary care physician for a physical exam.Children and teens with moderate symptoms, for example, fever, muscle aches, chills, or lethargy, should see a pediatric cardiologist to be evaluated and for an EKG.Children with a severe case leading to an ICU stay, intubation, or MIS-C diagnosis are also recommended to see a pediatric cardiologist.The AAP recommends also imposed a three- to six-month restriction of movement.Peltier said the overwhelming number of children studied after COVID-19 was cleared to exercise.Still, the precaution is important measure to protect children who suffer from rare side effects. “Very mild myocarditis can cause chest pain, shortness of breath, some exercise intolerance. But uncontrolled and in the worst case scenario it can result in sudden death, which is what we see in an athlete who unfortunately just collapses on the field or on the field and not is able to revive,” Peltier said. Each school district follows different guidelines when it comes to getting student athletes back on the field. Many work closely with local health departments. Such is the case for Mason City Schools and Christina Hare, one of the three track trainers. “The overall role of the athletic trainer is to keep athletes safe,” she said. “Everyone is different. COVID doesn’t look the same on any athlete.” Last year, Mason used a similar protocol for every athlete who came back from COVID-19. “The return to the game was a step-by-step gradual increase in activity, so similar to our concussion protocol. Each day there was just an increase in intensity and duration of exercise,” Hare said. This year they rely on guidance from the individual doctor who determines at what rate an athlete returns. Enabling athletes to voice their opinions is also part of Hare’s role. “Be honest and please look at the bigger picture,” she said. “This is a season of your life. We don’t want to make the last season.”

With fall athletics underway and the threat of COVID-19 still lingering, medical professionals are encouraging parents and schools to stay on top of guidelines around COVID-19 and kids playing sports.

Cincinnati Children’s Hospital follows the return to sports counseling from the American Academy of Pediatrics. It recommends that any child who contracts COVID-19 see a pediatrician before returning to sports practices or games.

Chris Peltier is a pediatrician and director of General and Community Pediatrics at Cincinnati Children’s. He is also the president-elect of the Ohio Chapter of the American Academy of Pediatrics.

“All those kids who have covid and play sports need to be seen in their primary care physician’s office before they can be released to exercise,” Peltier said. “Like a concussion, children with COVID infection should be evaluated before returning to exercise.”

Peltier said children should be examined to make sure they have not had heart problems that are rare but serious.

“The reasons these guidelines came about was the small risk of developing myocarditis or inflammation around the heart after COVID infection,” he said.

The AAP’s recommendations say that a child with an asymptomatic or mild case of COVID infection should see their primary care provider for a physical exam.

Children and teens who have moderate symptoms, such as fever, muscle aches, chills, or lethargy for more than four days, should see a pediatric cardiologist to be evaluated and for an EKG.

Children with a severe case leading to an ICU stay, intubation, or MIS-C diagnosis are also recommended to see a pediatric cardiologist. The AAP also recommends an exercise restriction of three to six months.

Peltier said the overwhelming number of children have been studied after COVID-19 has been cleared to exercise. Still, the precaution is important to protect children who suffer from rare side effects.

“Very mild myocarditis can cause chest pain, shortness of breath, some exercise intolerance. But uncontrollably and in the worst cases it can result in sudden death, which is what we see in an athlete who unfortunately just collapses on the field or court and can not be revived,” Peltier said.

Each school district follows different guidelines when it comes to getting student athletes back on the field. Many work closely with local health departments. Such is the case for Mason City Schools and Christina Hare, one of the three track trainers.

“The overall role of the athletic trainer is to keep athletes safe,” she said. “Everyone is different. COVID doesn’t look the same on any athlete.”

All athletes are required to bring a doctor’s note so they can practice before starting team activities. Last year, Mason used a similar protocol for every athlete who came back from COVID-19.

“The return to the game was a step-by-step gradual increase in activity, so similar to our concussion protocol. Each day there was just an increase in the intensity and duration of the workout,” Hare said.

This year they rely on the guidance of the individual doctor who determines at what rate an athlete returns.

Enabling athletes to voice their opinions is also part of Hare’s role.

“Be honest and please look at the bigger picture,” she said. “This is a season of your life. We don’t want to make the last season.”

Comments are closed.