Q
ere on RunLovers we have always strongly supported the idea that in order to enjoy running (and playing any sport) you need to know your body well and have medical checkups from time to time.
The sports medical examination
, as it is normally conducted, has in the past two years undergone changes and assessments have been added due to the progression of the pandemic from
Sars-CoV-2
which has been raging around the world since the early 2020s.
As knowledge about the virus and its spread has progressed and as variants (sometimes more aggressive, sometimes – fortunately – less so) have proliferated, the protocol of examinations has shifted, and from the first subdivision relatively simple made at the beginning of last year, we moved to a somewhat more complex list that also depends on by age and by what the need Of the athlete.
The new protocol, or it would be better to say the modification to the current protocol, introduces the concept of distinction based on the age of the athlete, which is set at 40 years old, and based on what the athletic performance is.
The new division arrangements are described by the Ministerial Circular dated January 18, 2022 (you can read it
here
), which supplements the provisions of the Ministerial Circular of January 13, 2021 (
here
).
Athletes are again divided into two macrogroups, Athletes A, who were positive, and Athletes B, who were always were negative for Sars-CoV-2. For the latter, the examination modalities are those usually carried out by the sports physician, without any supplementation. Group A athletes, on the other hand, will be divided in turn according to the severity of the infection, starting from grade A1 (asymptomatic or paucisymptomatic) to grade A3 (severe illness or hospitalization). This distinction was already provided for in the protocol, so so far nothing changes from what has been done in the past year. However, with the new ministerial circular, an age limit of 40 is introduced, after which the athlete will have to make additional assessments.
LET’S TRY TO SUMMARIZE
A1 Athletes who are younger than 40 years of age and who do not have diseases defined as risk, may resume athletic activity at
7 days
from negativization with favorable baseline ECG examination and stress test;
A1 Athletes who are over 40 years of age, or who, being under 40 years of age have conditions defined as risk, may resume athletic activity at
14 days
from negativization with favorable baseline ECG examination and stress test;
A1 athletes
of national significance or amateur athletes who intend to take up sporting activity immediately will have to undergo an examination that includes a baseline ECG, a maximal incremental ergometric test with electrocardiographic monitoring, and a Color Doppler echocardiogram. These tests can be performed on the same day as the negativization and, if favorable, the athlete can
immediately
resume athletic activity.
Things get more complicated (rightly so) as one goes along with the degree of illness the athlete has faced. For A2 and A3 athletes, in any case, the resumption of sports activities cannot take place before the
30 days
from the negativization, and that is the minimum time limit that the medical specialist will have to wait before giving approval for the resumption of sports activities.
The
A2 athletes
will have to pass the medical examination by performing a maximal incremental ergometric test with electrocardiographic monitoring and oxygen saturation monitoring before, during and after the test; a Color Doppler echocardiogram; H24 monitoring by cardiac holter including stress test; spirometric examination that can record lung capacity according to detailed criteria (I will not list them because they are very technical); blood tests with determination of several parameters (including CBC, creatinine, ferritin, and many others); urine examination.
Finally, for the A3 athletes Who are cured of the most severe form of the CoViD-19 are provided, in addition to the tests seen for A2 athletes, additional tests for dynamic pulmonary capacity evaluation (CPET), both at rest and under stress, and Any additional tests that the specialist deems necessary.
Only if the examination is found favorable can a certificate of fitness for athletics (in case it had expired) or a certificate of return to competitive activity (in case our certificate had been suspended for positivity) be issued.
COSTS.
As far as B athletes’ examinations are concerned, of course, nothing changes from what is already provided for the sports medical examination that is routinely done. For athletes, on the other hand, who will have to undergo the examination for return to athletic activity after overcoming illness, the costs change depending on the number of supplementary tests to be performed, and they obviously increase as the number of parameters to be checked increases. If the expense is normally in the range of 50 to 100 euros, therefore, it is plausible to expect the cost to at least double for athletes in group A1 and triple for those in groups A2 and A3. It will be money well spent, either way.