Sports – ABC CARDIOL

IJCS

Original Article

Cardiovascular Risk Assessment after COVID-19 Infection before Resuming Sports Activities – Practical Flowchart and Meta-Analysis

Luís Puga et al. Paulo Dinis Rogério Teixeira Joana Maria Ribeiro … Hélder Dores Lino Gonçalves

Abstract

Background:

The risk of sports-related sudden cardiac arrest after COVID-19 infection can be a serious problem. There is an urgent need for evidence-based criteria to ensure patient safety before resuming exercise.

Objective:

To estimate the pooled prevalence of acute myocardial injury caused by COVID-19 and to provide an easy-to-use cardiovascular risk assessment toolkit prior to resuming sports activities after COVID-19 infection.

Methods:

We searched the Medline and Cochrane databases for articles on the prevalence of acute myocardial injury associated with COVID-19 infection. The pooled prevalence of acute myocardial injury was calculated for hospitalized patients treated in different settings (non-intensive care unit [ICU], ICU, overall hospitalization, and non-survivors). Statistical significance was accepted for p values <0.05. We propose a practical flowchart to assess the cardiovascular risk of individuals who recovered from COVID-19 before resuming sports activities.

Results:

A total of 20 studies (6,573 patients) were included. The overall pooled prevalence of acute myocardial injury in hospitalized patients was 21.7% (95% CI 17.3-26.5%). The non-ICU setting had the lowest prevalence (9.5%, 95% CI 1.5-23.4%), followed by the ICU setting (44.9%, 95% CI 27.7-62.8%), and the cohort of non-survivors (57.7% with 95% CI 38.5-75.7%). We provide an approach to assess cardiovascular risk based on the prevalence of acute myocardial injury in each setting.

Conclusions:

Acute myocardial injury is frequent and associated with more severe disease and hospital admissions. Cardiac involvement could be a potential trigger for exercise-induced clinical complications after COVID-19 infection. We created a toolkit to assist with clinical decision-making prior to resuming sports activities after COVID-19 infection.

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IJCS

Viewpoint

Home Physical Activity Programs for Children and Adolescents as a Healthy Strategy During Social Isolation Caused by COVID-19: viewpoint

Rafaela Catherine da Silva Cunha de Medeiros et al. Isis Kelly dos Santos Jason Azevedo de Medeiros Ricardo Ney Cobucci … Tatiane Andreza Lima da Silva Juliany de Souza Araujo Phelipe Wilde de Alcântara Varela Breno Guilherme de Araújo Tinoco Cabral Paulo Moreira Silva Dantas

Background

The recent outbreak of coronavirus disease (COVID-19) is considered a global health emergency. The global impact of this viral infection is of great concern to everyone. As the COVID-19 outbreak continues to appear unstoppable, preventive and hygiene measures have been implemented to safeguard against infection. Among these precautions, social isolation is considered to have the greatest potential for reducing contagion, at least until a vaccine becomes available. This isolation measure works as a kind of “necessary evil” for preventing a wide-reaching disaster. Thus, social distancing and staying home remain the most effective restrictive measures to prevent the exponential increase in contagion.

One of the crucial focal points of this strategy was oriented toward the closure of schools, thus affecting thousands of children and adolescents, who comprise approximately half of the global student population. The closure of educational institutions could have a significant impact on their lives, requiring them to adapt to new routines. Considering that they are now being confined to their homes due to the new situation generated by the pandemic, this cohort may experience moments of stress.

[…]

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IJCS

Editorial

Physical Activity, Exercise and Sports and Covid-19: What Really Matters

Claudio Gil Soares de Araújo

The ability to move is essential for an independent life. It is widely recognized that those who spend the most time either lying down or sitting and are physically inactive tend to have limited autonomy, poor health-related quality of life, and adverse prognosis of outcomes.

This editorial will briefly discuss the relationship between COVID-19 and physical movement. To better address this important relationship and for sake of clarity, some concepts should be defined first. In sport and exercise sciences, “physical activity” is defined as any bodily movement produced by skeletal muscles that results in energy expenditure, “exercise” is a subset of physical activity that is planned, structured, and repetitive and “sport” is an activity that most often, but not always, involves exercise and predetermined rules and participation in games or races or competitions.

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Letter to the Editor

Declaring Physical Activity as ‘Essential’ During the COVID-19 Pandemic May not be a Good Measure

Rogério Tosta Almeida et al. Ciro Oliveira Queiroz Estela M. L. Aquino

Dear Editor,

We congratulate the authors on the viewpoint entitled “Should Physical Activity Be Considered Essential During the COVID-19 Pandemic?”, and we are thankful for the opportunity to provide some contributions on this current and relevant topic.

[…]

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IJCS

Editorial

The Truth is that Doctors do not Prescribe Physical Activities

Lorena Christine A. Albuquerque et al. Nabil Ghorayeb

Considering the well-established health benefits of regular physical activity, doctors have a primary role in counseling, encouragement, and education. In fact, they should be proactive in promoting health. Multiple published manuscripts attempted to link the doctors’ level of physical activity to the encouragement of their patients’ physical activity. Sufficient evidence has been provided that medical advice alone does not lead to sustained changes in the behavior of their patients.

There was statistical significance in the manuscript that we analyzed, by Meira DT, et al.: “Talk the Talk and Walk the Walk! Association between Weekly Exercise Load and Knowledge about Recommendations for Fighting Inactivity”, demonstrating a linear association between the amount of physical exercise recommended per week and the knowledge of the WHO recommendations against a sedentary lifestyle among the health professionals attending the Conference of the Society of Cardiology of Rio de Janeiro in 2017.

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Viewpoint

Exercise, Sports & Cardiovascular Health: Relevant Questions and Answers

Claudio Gil Araujo et al. Barry Franklin Jari Laukkanen Jonathan Myers … Josef Niebauer Jurgen Scharhag Philip J. Millar

Introduction

Currently, it is quite common for a clinical cardiologist to be questioned about exercise and sports, topics that are rarely discussed during formal medical education. In this regard, there is a clear need to access high-quality data and evidence-based information to give patients and family members the best advice.

Aiming to present the state-of-the art scientific information on the topic, we have invited several experts from different countries, all of them “knowledge-producers” in exercise and sports cardiology, to contribute with their expertise by answering specific and relevant questions in the matter. The answers were limited to about 250 words and they were asked to preferentially refer to their own publications.

[…]

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IJCS

Original Article

Talk the talk and walk the walk! Association between Weekly Exercise Load and Knowledge about Recommendations for Fighting Innactivity

Diogo Thadeu Meira et al. Leonardo Giglio Gonçalves Luiz Henrique Araújo Matheus Gasparini … Bernardo Souza Cunha Amanda Monteiro Michele Heringer Christiane Prado Andre Volschan Fabrício Braga da Silva

Abstract

Background:

The World Health Organization (WHO) recommends as a weekly “target dose” of exercise 150 minutes of moderate exercise or 75 minutes of intense exercise. Public health policies have prioritized the practice of exercise as a strategy for disease prevention and health promotion, with health professionals as their main promoters.

Objective:

To assess the interaction between the amount of exercise per week and the knowledge about recommendations for fighting a sedentary lifestyle among health care professionals attending a congress of cardiology.

Methods:

Participants of the 2017 Rio de Janeiro Society of Cardiology Congress were interviewed. Knowledge about the World Health Organization (WHO) recommendations for fighting a sedentary lifestyle was assessed by asking participants the question: “How much weekly exercise is recommended by the WHO?” Responders were stratified by the weekly exercise load reported. A multivariate logistic model was created to determine independent predictors of knowledge.

Results:

A total of 426 participants were interviewed (45.5% men, median age 31 years, 37.8% physicians, 65.8% of the physicians were cardiologists). The overall knowledge level was 44.6%; 38.1%, 52.7% and 56.6% among non-physicians, non-cardiologists and cardiologists, respectively (p = 0.002). Of all participants, 21.8% were inactive, 15% were lightly active, 34.7% moderately active and 28.4% highly active, and the percentage of individuals who gave a correct answer to the question on exercise recommendations was 30.1%, 42%, 48% and 52.9% respectively (p < 0.0001). In the multivariate analysis, being highly active (OR = 2.25, IC95%, 1.238 – 4.089), moderately active (OR = 1.93, IC 95% 1.105 – 3.39) and being a cardiologist (OR = 2.01, IC 95% 1.243 – 3,267) were predictors of knowledge.

Conclusions:

There was a linear association between exercise level and knowledge about the WHO recommendations on exercise. Policies to stimulate the practice of exercise among health professionals can positively impact campaigns for reducing sedentary lifestyle in the general population.

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Viewpoint

Sudden Cardiac Death in Sports: Not a Fatality!

Nabil Ghorayeb et al. Clea Simone Sabino de Souza Colombo Ricardo Contesini Francisco, Thiago Ghorayeb Garcia

Abstract

Sudden cardiac death in sports is still controversial. Despite being a rare event, the death of an apparently healthy young athlete causes a major impact on the media. On the other hand, for being a rare event, it is clearly undervalued. Sports preparticipation cardiological assessment is one of the most effective preventive medical actions for professional and amateur endurance athletes. The regular and supervised practice of physical exercise does not kill. We believe that deaths are triggered by excessive physical training and use of drugs, in individuals with not diagnosed or undervalued heart diseases. It is necessary to make health professionals and athletes aware of the athletes’ physiological limits, in addition to preparing the athletes properly when they try to overcome human limits.

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