The Protocol of the Ministry of Health lists the various cases and the checks to be made to return to training and competing, even for the Masters
To return to sporting activity after recovering from Covid-19, a competitive athlete must perform some specific tests to regain sporting fitness – FMSI Protocol.
This applies to both professional and amateur athletes, for example Masters, who are required to report themselves in case of contagion and to pass the exams listed by the Ministry of Health based on the specific case.
Athletes who have presented “asymptomatic or presymptomatic infection” or “Mild disease” and who in any case have not resorted to hospitalization and / or antibiotic, cortisone or heparin therapies due to Sars-COV-2 infection
These athletes are recommended to integrate the medical examination and the instrumental and laboratory tests required by the regulations for certification to the practice of the specific sport discipline with the following diagnostic insights:
- ECG left;
- Stress test with continuous electrocardiographic monitoring (also with step-test) up to achievement of at least 85% of HR max, for athletes under 40 years of age and with a negative history of pathologies identified as cardiovascular risk factors; or
- Maximal incremental ergometric test with electrocardiographic monitoring, for athletes over 40 years of age and / or for athletes with a history of pathologies identified as cardiovascular risk factors
These tests must be performed no earlier than 7 days have elapsed from healing from SARS-CoV-2 ascertained according to current legislation for athletes under 40 years of age, with a negative history of pathologies identified as cardiovascular risk factors and who have received the dose booster, or have completed the vaccination course
primary within the previous 120 days, or have recovered from SARS-CoV-2 infection within the previous 120 days;
or not before 14 days have elapsed for athletes over 40, for athletes with medical history
positive for diseases identified as cardiovascular risk factors and for athletes who have not received the booster dose, or have not completed the primary vaccination course in the previous 120 days, or have not recovered from SARS-CoV-2 infection in the previous 120 days .
For professional athletes and athletes of national and international interest who have had “asymptomatic or presymptomatic infection” or “mild disease” it is necessary to perform a medical examination carried out by the specialist in Sports Medicine, compulsorily integrated with the following diagnostic investigations:
Athletes who have presented “Moderate disease” (SpO2 ≥ 94% and clinical or radiological evidence of pneumonia) or who have in any case resorted to hospitalization and / or antibiotic, cortisone or heparin therapies due to Sars-COV-2 infection.
These athletes are recommended to integrate the medical examination and the instrumental and laboratory tests required by the regulations for certification to the practice of the specific sport discipline with the following diagnostic insights:
- Maximal incremental ergometric test with electrocardiographic monitoring and evaluation of O2 saturation at rest, during and after the test;
- ECG Holter 24hr. Including a training or effort session;
- Ecocardiogramma Color Doppler
- Spirometric examination with determination of: forced vital capacity (FVC), forced expiratory volume in the first second (FEV-1), Tiffenau index, peak expiratory flow and flows at intermediate volumes and maximum voluntary ventilation (MVV);
- Blood chemistry tests (Complete blood count, ALT / AST, Gamma GT, Creatininemia, CPK cardiac isotypes, LDH, PT / PTT, INR, Protein electrophoresis, PCR, Ferritin, Complete urine test).
These tests can be performed immediately following the successful recovery from SARSCoV-2 ascertained according to current legislation.
Athletes with “Severe Illness” or “Critical Illness” (SpO2 <94%, PaO2 / FiO2 < 300, frequenza respiratoria > 30 acts / min in the adult, or pulmonary infiltrates> 50% – Respiratory failure, septic shock and / or multi-organ failure).
In addition to the exams listed for athletes who have had “Moderate Illness”, Cardiopulmonary Exercise Test (CPET) is also required.
Once the examination process has been completed, the evaluating doctor will issue:
- The Certificate of fitness for the practice of competitive sport “in case of first release / periodic renewal of the medical examination
- The “Return to Play” Certificate as per Attachment C (to be kept in copy in the athlete’s evaluation sheet, together with the results of the medical examination and the tests performed), in case of Sars infection -CoV-2 with valid certification.
Once the “Return to activity” qualification or certification has been acquired, the athlete will be able to gradually resume training and / or activity, under the careful control of the health manager of the sports club.
If the athlete needs, for national or international competitive reasons, to reduce the period between the recovery and the resumption of activity, the examination and test protocol provided by the Italian Sports Medical Federation for the resumption of sporting activity of professional athletes that can be consulted clicking here.
In any case, the evaluating doctor will be entitled to request further investigations, if during the medical examination and / or from what emerged from the documentation examined he deems it necessary.
For this purpose, specific protocols have been issued by the Italian Sports Medical Federation, such as, in particular, the Cardiological Protocols for the Judgment of Fitness for Competitive Sport (COCIS 2017, rev. 2018).
Click here to consult them
Covid-19 (negative) athletes and asymptomatic (untested) athletes in the period of the pandemic
These Athletes will have to carry out the health checks required by the legislation for the purpose of any recognition of eligibility, as well as further specialist and instrumental tests requested by the evaluating doctor on justified clinical suspicion.
Finally, it is believed that for athletes who have not tested positive and for athletes “asymptomatic not tested for Covid-19” it is necessary to carry out a fitness visit in compliance with the natural expiration of the previous certification.
All athletes at the end of the visit must sign the document called “Attachment A” (to be kept in copy in the athlete’s evaluation sheet).
If the Sars-COV-2 infection occurs during the validity of the certification of suitability to practice competitive sport, or if the athlete shows symptoms suggestive of Sars-COV-2 after the date of issue of the certification of suitability for practice of competitive sports, the athlete is required to inform his or her general practitioner or the free choice pediatrician and the doctor of the sports club or federation if present.
After healing, he is also required to send the attached form called “Annex B” (to be kept in copy in the athlete’s evaluation sheet) to the Sports Medicine Specialist or the Sports Medicine Facility certifying the eligibility in progress. so that the opportunity to proceed with the issue of the “Return to the activity” certificate can be evaluated.
By clicking here it is possible to access the complete document issued by the Ministry of Health with relative attachments
Did you like this article? Then put a I like to ours Official page on Facebook!
Follow us on Instagram!
Follow us on Telegram!
Swim4Life – All rights reserved
Support Swim4Life Magazine – Click here to find out how you can help us
.