Post COVID-19 fitness to dive assessment findings in occupational and recreational divers

Introduction: It is now known that COVID-19 has long term effects that may not correlate with clinical severity of disease. The known pulmonary and cardiovascular changes as well as thrombotic tendency could predispose to diving accidents. We aimed to investigate COVID-19 related changes that may cause disqualification from diving among divers who recovered from the disease. Methods: Occupational and recreational divers who applied for fitness to dive (FTD) assessment after COVID-19 infection were included. Routine FTD assessments were performed. Details of COVID-19 history were evaluated. Lung computed tomography (CT) scans were advised if not previously performed or if there were COVID-19 related changes in previous scans. Divers with pathological findings were restrained from diving and followed prospectively. Results: Forty-three divers were analysed. Thirteen divers were restrained from diving, all due to persistent COVID-19 related changes in lung CT. The prevalence of CT with at least one lung lesion was 68.2% at the time of diagnosis, 73.3% in the first three months after diagnosis and 19.2% later. The most common CT findings were glass ground opacities and fibrotic changes. Demographic characteristics and COVID-19 history of divers deemed ‘unfit’ were similar to those deemed ‘fit’. Conclusions: Divers who recover from COVID-19 should undergo FTD assessments before resuming diving. A chest CT performed at least three months after diagnosis may be suggested.