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Updated: Oct 24, 2025
Effects of Surgical Masks on Cardiopulmonary Function in Healthy Subjects
Published on: February 12, 2021
Cardio-pulmonary function among children with mild or asymptomatic COVID-19 infection needing certification for
Daniela Chicco1, Francesco Rispoli2, Laura De Nardi2
1Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.
Insights
Children with mild or no symptoms after SARS-CoV-2 infection showed no cardio-pulmonary impairment when returning to sports. This suggests pre-return diagnostic tests may have low yield in asymptomatic or mildly symptomatic pediatric athletes.
Area of Science:
- Pediatric cardiology
- Sports medicine
- Infectious diseases
Background:
- Mild or asymptomatic SARS-CoV-2 (the virus causing COVID-19) infection in children is common.
- Concerns exist regarding potential long-term cardio-pulmonary effects in young athletes post-infection.
- Guidelines recommend evaluations for pediatric athletes before returning to competitive sports.
Purpose of the Study:
- To assess the cardio-pulmonary function of children returning to sports after mild or asymptomatic SARS-CoV-2 infection.
- To determine the necessity and yield of pre-return-to-play cardiac and pulmonary testing in this population.
Main Methods:
- A consecutive case series of pediatric patients (aged 8-17) evaluated for return-to-play clearance.
- Participants underwent cardiologic (echocardiogram, electrocardiogram, treadmill ECG) and pneumologic (pulmonary function tests) assessments.
- Data collected from patients evaluated at the Institute for Maternal and Child Health, Trieste, Italy.
Main Results:
- 127 children (mean age 12.8 years) with prior mild (66.1%) or asymptomatic (33.9%) SARS-CoV-2 infection were analyzed.
- No child exhibited evidence of cardio-pulmonary function impairment.
- Evaluations occurred an average of 77 days post-SARS-CoV-2 positivity.
Conclusions:
- This preliminary study indicates that cardio-pulmonary function is generally preserved in children after mild or asymptomatic SARS-CoV-2 infection.
- Routine diagnostic testing before return-to-play sports may have a low diagnostic yield in this specific pediatric group.
- Further research is warranted to confirm these findings in larger cohorts.
Aim:
To explore the cardio-pulmonary function of children returning to play sports after mild or asymptomatic SARS-CoV-2 infection.
Methods:
This is a consecutive case series conducted at the Institute for Maternal and Child Health, Trieste, Italy. Paediatric patients who accessed the Institute for cardiologic and pneumological evaluation before the return-to-play competitive sports were recruited, according to the Italian Sports Medical Federation recommendations. Echocardiogram, electrocardiogram, treadmill ECG test and pulmonary function tests were performed.
Results:
One hundred and thirty-two patients (aged 8-17 years old, mean age 12.8 ± 2.5) were recruited. Among these, 127 children were considered for the final analysis (49.6% females). Out of 127, 84 (66.1%) had a mild symptomatic form of SARS-CoV-2 infection, while 43 (33.9%) were asymptomatic. The main referred symptoms were fever (n = 37, 44%), asthenia (n = 14, 16.7%), rhinitis (n = 16, 19%), ageusia (n = 19, 22.6%), anosmia (n = 24, 28.6%), sore throat (n = 3, 3.6%), cough (n = 9, 10.7%), arthralgia-myalgia (n = 11, 13.1%), headache (n = 23, 27.4%) and gastrointestinal symptoms (n = 7, 8.3%). No child presented evidence of cardio-pulmonary function impairment after an average time of 77.3 days (SD 35) from SARS-CoV-2 swab positivity and a median of 68 days (IQ1 52, IQ3 92.5).
Conclusion:
This preliminary study suggests that, in the absence of specific symptoms, the diagnostic yield of cardio-pulmonary tests before returning to play sports may be very low.
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