The American Academy of Pediatrics (AAP) has released interim guidance for return to sports after COVID-19 infection.

The AAP notes that to date, limited data are available on COVID-19 and its effects on children and adolescents. Those with severe presentations (hypotension, arrhythmias, requiring intubation or extracorporeal membrane oxygenation [ECMO] support, kidney or cardiac failure) or with multisystem inflammatory syndrome in children  must be treated as though they have myocarditis and restricted from exercise and participation for a duration of 3 to 6 months. These athletes must be cleared to resume participation by their primary care physician and appropriate pediatric medical subspecialist, preferably in consultation with a pediatric cardiologist. Cardiac testing (electrocardiogram, echocardiogram, 24-hour Holter monitor, exercise stress test, and if warranted, cardiac resonance imaging) must have returned to normal before return to activity. 

Those with moderate symptoms must be asymptomatic for at least 14 days and obtain clearance from their primary care physician before return to exercise and competition. 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. 

The interim guidance also includes recommendations regarding testing and face coverings for children and adolescents participating in sports.

American Academy of Pediatrics (AAP). COVID-19 Interim Guidance: Return to Sports. September 18, 2020. Available at: click here. Accessed September 21, 2020.