Some children with COVID-19 may need ECG before returning to sports: AAP

Also, any individual who has current or a history of positive cardiac symptoms, who has concerning findings on their examination, or who had moderate symptoms of COVID-19, including prolonged fever, should have an EKG performed and potentially be referred to a pediatric cardiologist for further assessment and clearance. 

Allindividuals with a history of a positive test result for SARS-CoV-2 should have a gradual return to physical activity. Before returning to play, children who experienced severe presentations of COVID-19 or who had multisystem inflammatory syndrome in children (MIS-C) "must be treated as though they have myocarditis and restricted from exercise and participation for a duration of 3 to 6 months," and their cardiac testing must have returned to normal before they can return to playing sports, according to the AAP guidance.

In updated guidance, the AAP said some children with COVID-19 may also need an ECG to be done before they return to playing sports, based on growing evidence that SARS-CoV-2 infection can severely damage the heart. The focus of their return to participation screening should be for cardiac symptoms, including but not limited to chest pain, shortness of breath, fatigue, palpitations, or syncope, the AAP guidelines mentioned.

The AAP also said that if a child athlete tests positive for COVID-19 while on a sports team, team officials and the health department should be notified to ensure contact testing and appropriate quarantining.