Cardiopulmonary assessment prior to returning to high-hazard occupations post-symptomatic COVID-19 infection: a position statement of the Aviation and Occupational Cardiology Task Force of the European Association of Preventive Cardiology

Author:

Rienks Rienk1,Holdsworth David23,Davos Constantinos H4ORCID,Halle Martin5ORCID,Bennett Alexander26,Parati Gianfranco78ORCID,Guettler Norbert9,Nicol Edward D21011

Affiliation:

1. Central Military Hospital, University Hospital , Lundlaan 1, 3584 EZ Utrecht , The Netherlands

2. Defence COVID-19 Recovery Service, Defence Medical Rehabilitation Centre , Stanford Hall, Stanford Hall Estate, Stanford On Soar, Loughborough, Leicestershire, LE12 5QW , UK

3. Oxford University Hospitals NHS Foundation Trust , Headley Way, Oxford OX3 9DU , UK

4. Biomedical Research Foundation, Academy of Athens , 4 Soranou Ephessiou St., 115 27 Athens , Greece

5. Department of Prevention, Rehabilitation and Sports Medicine, Medical Faculty, University Hospital, Technical University Munich, Georg-Brauchle-Ring 56, Munchen , Germany

6. Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre , Stanford Hall, Stanford on Soar, Loughborough LE12 5QN , UK

7. Department of Medicine and Surgery, University of Milano-Bicocca , Piazza dell'Ateneo Nuovo, 1, Milan, Province of Milan 20126 , Italy

8. Department of Cardiology, Istituto Auxologico Italiano, IRCCS, San Luca Hospital , Mosè Bianchi Street, 90 - 20149 Milan , Italy

9. Air Force Centre of Aerospace Medicine , Fuerstenfeldbruck , Germany

10. Department of Cardiology, Royal Brompton Hospital , Sydney Street, London, SW3 6NP , UK

11. School of Biomedical Engineering and Imaging Sciences, Kings College , London, Strand London, WC2R 2LS , UK

Abstract

Abstract This article provides an overview of the recommendations of the Aviation and Occupational Cardiology Task Force of the European Association of Preventive Cardiology on returning individuals to work in high-hazard occupations (such as flying, diving, and workplaces that are remote from healthcare facilities) following symptomatic Coronavirus Disease 2019 (COVID-19) infection. This process requires exclusion of significant underlying cardiopulmonary disease and this consensus statement (from experts across the field) outlines the appropriate screening and investigative processes that should be undertaken. The recommended response is based on simple screening in primary healthcare to determine those at risk, followed by first line investigations, including an exercise capacity assessment, to identify the small proportion of individuals who may have circulatory, pulmonary, or mixed disease. These individuals can then receive more advanced, targeted investigations. This statement provides a pragmatic, evidence-based approach for those (in all occupations) to assess employee health and capacity prior to a return to work following severe disease, or while continuing to experience significant post-COVID-19 symptoms (so-called ‘long-COVID’ or post-COVID-19 syndrome).

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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