ArticleFrontiers in cardiovascular medicine2026
Long-term cardiovascular function and cardiopulmonary performance in athletes after COVID-19: results from the COSMO study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Most studies in athletes have focused on short-term outcomes after SARS-CoV-2 infection, whereas long-term data on cardiac function and exercise performance remain limited. This prospective study evaluated 12-month changes in cardiac structure, myocardial deformation, and cardiopulmonary performance in elite and recreational athletes after mild COVID-19. Methods: Fifty-two athletes (median age 32.5 (24.8-46.3) years; 27 females) from endurance, power, and mixed sports underwent echocardiography, cardiopulmonary exercise testing (CPET), and bioimpedance analysis after infection (T0; median 88 days post-infection) and again at 12-month follow-up (T1). Measurements included left and right ventricular global longitudinal strain (LV/RV GLS), RV free wall strain (FWS), left atrial strain, CPET performance and ventilatory parameters, and anthropometric variables. Longitudinal changes were evaluated using paired comparisons and linear mixed-effects models. Univariable and multivariable regressions were performed to identify predictors of follow-up VO Results: Cardiac structure, LV and RV systolic function, and myocardial deformation remained stable over 12 months, with no evidence of adverse remodeling. A significant reduction in E/E' medial was observed at follow-up ( Conclusion: Athletes recovering from mild SARS-CoV-2 infection show no evidence of impaired myocardial structure, strain, or cardiopulmonary performance at 12 months post-infection. Minor variations in diastolic indices and body composition appeared physiological, and baseline aerobic fitness was the strongest predictor of follow-up performance. These findings indicate a stable 1-year cardiopulmonary outcome and support the safety of return to sport in asymptomatic athletes.
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