{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T02:16:46Z","timestamp":1782958606013,"version":"3.54.5"},"reference-count":21,"publisher":"BMJ","issue":"16","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020506","name":"American Medical Society for Sports Medicine","doi-asserted-by":"crossref","award":["Collaborative Research Network"],"award-info":[{"award-number":["Collaborative Research Network"]}],"id":[{"id":"10.13039\/100020506","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2021,10,20]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the prevalence and clinical implications of persistent or exertional cardiopulmonary symptoms in young competitive athletes following SARS-CoV-2 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This observational cohort study from the Outcomes Registry for Cardiac Conditions in Athletes included 3597 US collegiate athletes after SARS-CoV-2 infection. Clinical characteristics, advanced diagnostic testing and SARS-CoV-2-associated sequelae were compared between athletes with persistent symptoms &gt;3 weeks, exertional symptoms on return to exercise and those without persistent or exertional symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 3597 athletes (mean age 20 years (SD, 1 year), 34% female), data on persistent and exertional symptoms were reported in 3529 and 3393 athletes, respectively. Persistent symptoms &gt;3 weeks were present in 44\/3529 (1.2%) athletes with 2\/3529 (0.06%) reporting symptoms &gt;12 weeks. Exertional cardiopulmonary symptoms were present in 137\/3393 (4.0%) athletes. Clinical evaluation and diagnostic testing led to the diagnosis of SARS-CoV-2-associated sequelae in 12\/137 (8.8%) athletes with exertional symptoms (five cardiac involvement, two pneumonia, two inappropriate sinus tachycardia, two postural orthostatic tachycardia syndrome and one pleural effusion). No SARS-CoV-2-associated sequelae were identified in athletes with isolated persistent symptoms. Of athletes with chest pain on return to exercise who underwent cardiac MRI (CMR), 5\/24 (20.8%) had probable or definite cardiac involvement. In contrast, no athlete with exertional symptoms without chest pain who underwent CMR (0\/20) was diagnosed with probable or definite SARS-CoV-2 cardiac involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Collegiate athletes with SARS-CoV-2 infection have a low prevalence of persistent or exertional symptoms on return to exercise. Exertional cardiopulmonary symptoms, specifically chest pain, warrant a comprehensive evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2021-104644","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T17:20:34Z","timestamp":1635787234000},"page":"913-918","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Prevalence and clinical implications of persistent or exertional cardiopulmonary symptoms following SARS-CoV-2 infection in 3597 collegiate athletes: a study from the Outcomes Registry for Cardiac Conditions in Athletes (ORCCA)"],"prefix":"10.1136","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6603-2262","authenticated-orcid":false,"given":"Bradley J","family":"Petek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Moulson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron L","family":"Baggish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-7406","authenticated-orcid":false,"given":"Stephanie A","family":"Kliethermes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manesh R","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy W","family":"Churchill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3670-6609","authenticated-orcid":false,"given":"Kimberly G","family":"Harmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3519-9120","authenticated-orcid":false,"given":"Jonathan A","family":"Drezner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"2024051414592763000_56.16.913.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01292-y"},{"key":"2024051414592763000_56.16.913.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01283-z"},{"key":"2024051414592763000_56.16.913.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.054824"},{"key":"2024051414592763000_56.16.913.4","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1001\/jamacardio.2021.0565","article-title":"Prevalence of inflammatory heart disease among professional athletes with prior COVID-19 infection who received systematic Return-to-Play cardiac screening","volume":"6","author":"Martinez","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2024051414592763000_56.16.913.5","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1001\/jamacardio.2021.2065","article-title":"Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 infection: results from the big ten COVID-19 cardiac registry","volume":"6","author":"Daniels","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2024051414592763000_56.16.913.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.5612"},{"key":"2024051414592763000_56.16.913.7","doi-asserted-by":"publisher","DOI":"10.7326\/M20-5926"},{"key":"2024051414592763000_56.16.913.8","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216377"},{"key":"2024051414592763000_56.16.913.9","doi-asserted-by":"crossref","first-page":"ofaa509","DOI":"10.1093\/ofid\/ofaa509","article-title":"Postacute COVID-19: an overview and approach to classification","volume":"7","author":"Amenta","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2024051414592763000_56.16.913.10","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1001\/jama.2020.19719","article-title":"Long-Term health consequences of COVID-19","volume":"324","author":"del Rio","year":"2020","journal-title":"JAMA"},{"key":"2024051414592763000_56.16.913.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.02.009"},{"key":"2024051414592763000_56.16.913.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097331"},{"key":"2024051414592763000_56.16.913.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.072"},{"key":"2024051414592763000_56.16.913.14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.052573"},{"key":"2024051414592763000_56.16.913.15","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1001\/jamacardio.2020.5890","article-title":"Coronavirus disease 2019 and the athletic heart: emerging perspectives on pathology, risks, and return to play","volume":"6","author":"Kim","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2024051414592763000_56.16.913.16","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1161\/CIRCULATIONAHA.121.054957","article-title":"Cardiac involvement in athletes recovering from COVID-19: a reason for hope","volume":"144","author":"Sarma","year":"2021","journal-title":"Circulation"},{"key":"2024051414592763000_56.16.913.17","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102516"},{"key":"2024051414592763000_56.16.913.18","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102710"},{"key":"2024051414592763000_56.16.913.19","unstructured":"American Medical Society for Sports Medicine and the American College of Cardiology . Cardiac considerations for College Student-Athletes during the COVID-19 pandemic. Available: https:\/\/www.amssm.org\/Content\/pdf-files\/COVID19\/NCAA_COVID-18-AUG-2021.pdf [Accessed October 27, 2021]."},{"key":"2024051414592763000_56.16.913.20","unstructured":"Lee M . Slowed and sidelined, some athletes struggle to return from long-haul covid. Available: https:\/\/www.washingtonpost.com\/sports\/2021\/04\/19\/athletes-long-haul-covid-justin-foster\/ [Accessed 19 Apr 2021]."},{"key":"2024051414592763000_56.16.913.21","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-104080"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsports-2021-104644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T22:22:01Z","timestamp":1715725321000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsports-2021-104644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,1]]},"references-count":21,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,7,29]]},"published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1136\/bjsports-2021-104644"],"URL":"https:\/\/doi.org\/10.1136\/bjsports-2021-104644","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,1]]}}}