Preliminary Evaluation of Collegiate Athlete Recovery From COVID-19 Using Institutional Protocols: Impact of Exercise

Introduction: The novel coronavirus, first discovered in 2019 (COVID-19) in China, set off a global pandemic. COVID-19 has been associated with lasting physiological effects even in young, healthy individuals, such as athletes. Studies focused on elite and professional athletes have shown cardiac abnormalities resulting from COVID-19 infection. Consequently, return-to-play (RTP) protocols were developed, yet there is limited research on examining these RTP protocols in National Collegiate Athletic Association (NCAA) Division III (DIII) athletes. The purpose of this study was to examine the changes in cardiovascular parameters, such as heart rate (HR), rate pressure product, SpO 2 (pulse oxygen saturation), and blood pressure, during recovery from COVID-19 in NCAA DIII athletes and whether the response to acute exercise mediated time in protocol. Methods: A preliminary retrospective analysis was conducted on 46 athletes undergoing institutional RTP protocol during 2021. Acute exercise responses and baseline cardiovascular values were analyzed using repeated-measures analysis of variance (ANOVA), linear regression, and Kaplan–Meier survival analysis. Results: HR and rate pressure product increased significantly with exercise ( P < 0.001), while SpO 2 decreased ( P < 0.001). Postexercise HR and baseline SpO 2 were predictive of prolonged RTP duration (HR: β = −0.060, P = 0.009; SpO 2 : β = −0.949, P = 0.024). Blood pressure classification (normal vs elevated) did not significantly influence RTP time ( P = 0.35). Conclusion: These preliminary findings suggest that postexercise HR and reduced baseline SpO 2 may identify athletes at risk for delayed convalescence following COVID-19. Cost-effective and noninvasive measurements, like HR and SpO 2 , could be useful tools for RTP planning and implementation by athletic trainers and coaches.