AAP updates sports participation guidance during COVID-19


The American Academy of Pediatrics (AAP) has updated their guidance on participating in sports during the COVID-19 pandemic.

Children all over the United States have continued to play sports during the pandemic, taking into consideration the recommendations from a number of health organizations. The American Academy of Pediatrics has recently updated their guidance for protecting children and adolescents during sports participation and created easy-to-follow checklists for families and sports organizers to follow.1

Before the season or sports event begins, the guidance recommends that both groups:

  • Ensure that the sport or activity is allowed by the local and state government.
  • Be aware of the latest safety rules and expectations for participation. Parents should discuss these with the child.
  • Each child who is participating in the activity should have a number of items labeled with his or her name including tissues, water bottle, towel, hand sanitizer, and some form of cloth face covering.
  • A child should have an up-to-date physical completed before participating.

Before either practice or games start, sports organizers and families should ensure:

  • Any participant who is not feeling well or exhibiting COVID-19 symptoms should not come to practice or games.
  • Hands should be washed before arriving. Hand sanitizer should be used in situations when soap and water are not available.
  • Bring the personalized items mentioned above as well as the child’s personal sports equipment.
  • Remain in the car or other designated spot until the practice or game is ready to start.
  • Children and adults should not gather in groups before and after practice. They should also practice social distancing and wear a mask or other face covering.

During practice, children and sports staff should:

  • Maintain social distancing as much as possible
  • Wear a mask or other face covering at all times during the event. Swimming and diving participants don’t need to wear masks when actively participant because wet masks can make it difficult to breathe. Cheer and gymnastic participants can also refrain from wearing masks during active participation because the mask could get caught on equipment or move and cover the participant’s eyes.
  • Do not engage in certain common sports behaviors such as huddles, sharing food or drinks with teammates, cheering in close proximity, or spitting.
  • A child’s personal items should be stored 6 to 8 feet away from other people’s equipment
  • Sanitize hands before and after using communal equipment such as bats.
  • ​A child should tell a coach or other staff member if he or she is feeling unwell and leave the game or practice as soon as a parent or legal guardian arrives.

In the case of a child becoming infected with COVID-19, the child should only return to exercise or sports after approval from the doctor. There should be a minimum of 10 days with no exercise or competition and then a gradual return to activity over at least 7 days. Due to the cardiovascular after-effects that have been noted with COVID-19, the child should receive a screening that looks at symptoms such as shortness of breath, fatigue, chest pain, fainting, or irregular heartbeat. If a child has a screening that finds those symptoms, he or she may require an electrocardiogram or other cardiac tests. If the child is diagnosed with multisystem inflammatory syndrome in children or has a severe COVID-19 case, he or she should not exercise or compete for 3 to 6 months and should be seen by a pediatric cardiologist before resuming physical activity.


1. American Academy of Pediatrics. Youth sports participation during covid-19: a safety checklist. HealthyChildren.com. Updated December 4, 2020. Accessed December 4, 2020. https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Youth-Sports-Participation-During-COVID-19-A-Safety-Checklist.aspx.

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Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago
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