{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:09:42Z","timestamp":1771502982503,"version":"3.50.1"},"reference-count":38,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2021,11,14]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>SARS-CoV-2 infection might be associated with cardiac complications in low-risk populations, such as in competitive athletes. However, data obtained in adults cannot be directly transferred to preadolescents and adolescents who are less susceptible to adverse clinical outcomes and are often asymptomatic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We conducted this prospective multicentre study to describe the incidence of cardiovascular complications following SARS-CoV-2 infection in a large cohort of junior athletes and to examine the effectiveness of a screening protocol for a safe return to play.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Junior competitive athletes suffering from asymptomatic or mildly symptomatic SARS-CoV-2 infection underwent cardiac screening, including physical examination, 12-lead resting ECG, echocardiogram and exercise ECG testing. Further investigations were performed in cases of abnormal findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 571 competitive junior athletes (14.3\u00b12.5 years) were evaluated. About half of the population (50.3%) was mildly symptomatic during SARS-CoV-2 infection, and the average duration of symptoms was 4\u00b11\u2009days. Pericardial involvement was found in 3.2% of junior athletes: small pericardial effusion (2.6%), moderate pericardial effusion (0.2%) and pericarditis (0.4%). No relevant arrhythmias or myocardial inflammation was found in subjects with pericardial involvement. Athletes with pericarditis or moderate pericardial effusion were temporarily disqualified, and a gradual return to play was achieved after complete clinical resolution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The prevalence of cardiac involvement was low in junior athletes after asymptomatic or mild SARS-CoV-2 infection. A screening strategy primarily driven by cardiac symptoms should detect cardiac involvement from SARS-CoV-2 infection in most junior athletes. Systematic echocardiographic screening is not recommended in junior athletes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2021-104764","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T13:20:18Z","timestamp":1638192018000},"page":"264-270","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["SARS-CoV-2 infection and return to play in junior competitive athletes: is systematic cardiac screening needed?"],"prefix":"10.1136","volume":"56","author":[{"given":"Luna","family":"Cavigli","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Cillis","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Mochi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Frascaro","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Mochi","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, USL Toscana Centro, Italy, Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnel","family":"Hajdarevic","sequence":"additional","affiliation":[{"name":"Medical Lab, Center for Sports Medicine and Rehabilitation, Asti, Italy"},{"name":"Turin E. 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Center for Sports Medicine, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Roselli","sequence":"additional","affiliation":[{"name":"Institute of Sports Medicine, Firenze, Italy"},{"name":"Center for Sports Medicine, Sam Miniato, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Capitani","sequence":"additional","affiliation":[{"name":"Center for Sports Medicine, National Health Service, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Alvino","sequence":"additional","affiliation":[{"name":"Center for Sports Medicine, National Health Service, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Giovani","sequence":"additional","affiliation":[{"name":"Center for Sports Medicine, National Health Service, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Lisi","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, USL Toscana Centro, Italy, Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Cappellini","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, USL Toscana Centro, Italy, Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa Anna","family":"Colloca","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, USL Toscana Centro, Italy, Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia Elena","family":"Mandoli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serafina","family":"Valente","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Cardiology Uniti, Cardiothoracic and Vascular Department, University Hospital Le Scotte, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Focardi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Bonifazi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0947-6836","authenticated-orcid":false,"given":"Flavio","family":"D'Ascenzi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"2025080113354003000_56.5.264.1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.120.049836"},{"key":"2025080113354003000_56.5.264.2","doi-asserted-by":"crossref","first-page":"4382","DOI":"10.1093\/eurheartj\/ehaa448","article-title":"Return to sports after COVID-19 infection","volume":"41","author":"Schellhorn","year":"2020","journal-title":"Eur Heart J"},{"key":"2025080113354003000_56.5.264.3","article-title":"Coronavirus disease (COVID-19) and pediatric patients: a review of epidemiology, symptomatology, laboratory and imaging results to guide the development of a management algorithm","volume":"12","author":"Hasan","year":"2020","journal-title":"Cureus"},{"key":"2025080113354003000_56.5.264.4","doi-asserted-by":"crossref","DOI":"10.1093\/eurheartj\/ehaa288","article-title":"COVID-19-related myocarditis in a 21-year-old female patient","volume":"41","author":"Kim","year":"2020","journal-title":"Eur Heart J"},{"key":"2025080113354003000_56.5.264.5","doi-asserted-by":"crossref","first-page":"e204","DOI":"10.1097\/INF.0000000000002788","article-title":"COVID-19-Associated myocarditis in an adolescent","volume":"39","author":"Trogen","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"2025080113354003000_56.5.264.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048360"},{"key":"2025080113354003000_56.5.264.7","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1001\/jamacardio.2020.2136","article-title":"A game plan for the resumption of sport and exercise after coronavirus disease 2019 (COVID-19) infection","volume":"5","author":"Phelan","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2025080113354003000_56.5.264.8","doi-asserted-by":"crossref","unstructured":"Rajpal S , Tong MS , Borchers J , et al . 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