Covid-19 and Sports – Episode 41, To Your Health With Dr. Jim Morrow

Covid-19 and Sports – Episode 41, To Your Health With Dr. Jim Morrow

Dr. Morrow discusses various considerations around Covid-19 and sports, questions of safety, and much more. Dr. Morrow also offers an update on the Covid-19 vaccine. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

Covid-19 and Sports

• To date, limited data are available on COVID-19 and its effects on children and adolescents.
  • We know that 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 (MIS-C)
    • 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 (EKG, 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 question still remains about what to do with others infected with SARS-CoV-2
  • or who had close contact with an individual with COVID-19.
  • Because of the growing literature about the relationship between COVID-19 and myocarditis,
    • all children and adolescents with exposure to SARS-CoV-2, regardless of symptoms,
      • require a minimum 14-day resting period
      • and must be asymptomatic for >14 days before returning to exercise and/or competition.
      • Because of the limited information on COVID-19 and exercise, the AAP strongly encourages that all patients with COVID-19 be cleared for participation by their primary care physician.
      • The focus of their return to participation screening should be for cardiac symptoms,
        • including but not limited to chest pain,
        • shortness of breath,
        • fatigue,
        • palpitations,
        • or syncope.
      • All individuals with a history of a positive test result for SARS-CoV-2 should have a gradual return to physical activity.
        • If primary care physicians have any questions regarding their patients’ readiness to return to competition,
          • they should not hesitate to consult with and refer individuals to the appropriate pediatric medical subspecialist.

What Could Happen?

• There are complications that will stay with a Covid-19 patient for the rest of their lives.
  • The severe complications are
    • pulmonary fibrosis
    • and myocarditis.
    • The likelihood is that in order to develop these complications,
      • a patient will likely have to be moderately ill,
      • that is, having been hospitalized
      • and likely to have required supplemental oxygen therapy.
    • But there is still not a lot of data about this.
  • What is obvious now, that was not obvious at all obvious early on, is that young people are at risk.
    • They are at risk of contracting the virus
    • and they are at risk of having a moderate or severe case.
    • We have already had one football player, in California, die from complications caused by Covid-19.
      • There could be many more.
    • Because of these possibilities,
      • two conferences in the Power 5 decided not to play football this year.
      • They felt that it might be safer in the Spring of 2021.
      • I am not sure what they thought was going to change by then.
    • Recently, the Big Ten conference has reversed their position and decided to play.
      • The main reason cited is advances in availability of testing.

Testing, Covid-19 and Sports

• The ACC is conducting coronavirus testing three times per week
• The updated Medical Advisory Group report requires all team members to be tested
  • within three days of game day.
  • one test must be performed the day before kickoff, and must be conducted by a third party the ACC office selects.
  • another test must be done 48 hours after the game.
  • In addition, every student-athlete who tests positive for COVID-19 will undergo a cardiac evaluation that includes an
    • electrocardiogram,
    • a troponin test
    • and an echocardiogram before a phased return to exercise.
    • Many ACC schools already had procedures in place to screen for any possible heart issues.

Should parents and other spectators attend their children’s sports practices and games?

• Parents/guardians should follow current local regulations for social distancing and use of cloth face coverings when considering game attendance.
  • Attending outdoor events may bear less risk than indoor events with less space and ventilation.
    • No one should attend any sports function as a spectator if they are exhibiting signs or symptoms of COVID-19.
    • Parents and other spectators with high-risk health conditions should strongly consider not attending indoor events or events held outdoors where appropriate social distancing cannot be maintained.
    • Live streaming or recording of athletic events, when available, may allow individuals who are unable to attend to participate in viewing events.