Resurgence of sport in the wake of COVID-19: cardiac considerations in competitive athletes

The COVID-19 pandemic brought the global world of sports to a staggering halt. In unprecedented fashion and with few exceptions, professional leagues, mass participation endurance events, and youth sport around the globe went silent. In the face of a rapidly evolving health crisis, the decision to cancel or postpone sporting events was a logical and necessary step. COVID-19 is a highly contagious, potentially fatal virus that is transmitted primarily through contact with aerosolised or surface-dwelling respiratory secretions, a process that requires close human contact.1 Competitive sport as we know it, from athletes ‘elbowing’ one another for position on the pitch to arenas packed with fans, may be the quintessential antithesis of social distancing. There is concern that the Champions League match between Atalanta and Valencia in Milan may have influenced the trajectory of COVID-19 cases in Europe.2 In the absence of a vaccination or curative intervention, physical distancing emerged as the key step to slow or stop the spread of COVID-19. Thus, the decision to turn off the lights and to silence competitive athletics represented a logical, essential and highly visible component in the global fight against COVID-19. This has been an unusually quiet time for the sports medicine community. Athletic training rooms have gone dark, and many clinicians have been repurposed to meet the needs of patients with COVID-19. Fortunately, this will not last forever. The great American …