Youth Sports and COVID-19
10 Dec 2020

Youth Sports and COVID-19

COVID is not going away, and although we are not seeing kids get really sick nationally, we are seeing some interesting side effects and complications that are going to keep parents, coaches, and caregivers on their toes.  I have reviewed the most recent studies and documents and want to share the recommendations to get our kids back into sports post COVID safely.

First of all, athletes, families, and participants have a social and moral responsibility to report symptoms of COVID-19.  Self-reporting all symptoms consistent with COVID-19 not only to decrease transmission of the virus but to also monitor kids adequately for issues that may happen after infection.  That is why it is imperative to understand the increased risk for transmission of COVID-19 associated with sports.

The Centers for Disease Control and Prevention (CDC) has put information on the level of risks with sports, and it varies depending on the type of sport the child is participating in.

Lowest Risk

Performing skill-building drills or conditioning at home, alone or with another member of the household.

Increasing Risk

Team-based practices.

More Risk

Team competition.

Higher Risk

Full competition between teams from the same local geographic area.

Highest Risk

Full competition between teams in different geographic areas.

Studies are showing although it is low risk, we are seeing an increased incidence of multisystem inflammatory syndrome in children (MIS-C) that is associated with COVID-19.  The most severe cases of this syndrome are affecting younger children, but 15% of severe symptoms are occurring in high school and college athletes.  This can have cardiac involvement, and about 1/3 of all youth infected with COVID-19 have some cardiac involvement, even if they were asymptomatic.  This is important for families and kids to determine if playing a sport is worth the risk, especially if the child has any underlying health condition.

Providers need to have the same consistent message for those that are participating.

Do not attend OR participate in group/team sports or practice if:

  • You are feeling ill.  Symptoms of the coronavirus can include fever (temperature of 100.0 as defined by the CDC), cough, difficulty breathing, and other symptoms as outlined by the CDC website.
  • If you have been exposed to COVID-19 in the prior 14 days.
  • If unsure about whether to attend or participate in practice due to possible symptoms OR exposure, it is recommended you contact your health care provider.

Know what risk level each sport is:

Low-Risk Sports: Individual running events, cross country with staggered starts, golf, sideline cheerleading, weightlifting, bowling, fishing, swimming individual races, diving, and bicycling

Moderate Risk Sports: Basketball, volleyball, soccer, baseball, softball, ice hockey, tennis, swimming relays, and women’s lacrosse

High-Risk Sports: Football, wrestling, men’s lacrosse, competitive cheerleading, dance, martial arts, and field hockey

Some high- or moderate-risk sports can lower their risk in practice/competition if they are able to physically distance appropriately, limit or eliminate contact, wear masks, and appropriately sanitize. Similarly, some sports may raise their risk if they are not able to physically distance appropriately, limit contact, wear masks, and sanitize.

After the COVID-19 infection, the health care provider is key to determine when it is safe to begin a graduated return to play progression based on the child’s medical history, symptoms, severity of illness, and previous level of activity. A graduated return to play progression is the best plan of action to ensure they have no lingering symptoms of COVID-19 infection.

The algorithms from Children’s Mercy can help in determining when it is safe for the athletes to return to sport.  The links are below.

https://www.childrensmercy.org/siteassets/media/covid-19/return-to-sport/cardiology-return-to-play-algorithm.pdf

https://www.childrensmercy.org/siteassets/media/covid-19/return-to-sport/return-to-play-flowchart.pdf

https://jamanetwork.com/journals/jamacardiology/fullarticle/2772399