COVID associated with heart inflammation in college athletes, small study suggests

Increasing evidence suggests that coronoviruses can damage young and physically fit hearts.

Research published Friday in the journal JAMA Cardiology found that 4 out of 26 college athletes had signs of a heart condition called myocarditis after recovering from COVID-19.

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The findings were indicated in late August, when the director of athletic medicine at Penn State, Drs. Wayne Sebastianelli said during a discussion with school board members that 30 percent of Big Ten athletes who had COVID-19 showed signs of condition, heart muscle inflammation.

Scott Gilbert, a spokesman for Penn State Health, told NBC News that Sebastianelli had at the time misjudged the findings and apologized for any confusion. Gilbert said Penn State was not involved with the research, and the school has not had cases of myocarditis in COVID-19 positive student-athletes.

In fact, the new study was conducted by doctors at Ohio State University Wexner Medical Center, who were considering the safest ways to send athletes back in the fall. In the end, the Big Ten Conference, which includes both Ohio State and Penn State, decided against playing this fall.

Ohio State cardiologist Drs. Saurabh Rajpal said, “We were asked the question what would be the safest way to send him back in competitive sports.” “We decided in our own group that in addition to the general recommendations, which was a clinical examination and looking for symptoms, we would look into cardiac MRI to get more information and to see what happens in the heart of athletes. Will also do. “

The research included both male and female athletes in basketball, lacrosse, track, soccer and football. All were confirmed to have recovered from COVID-19, and none required hospitalization or specific treatment. 12 of the athletes reported mild COVID-19 symptoms, including a sore throat and shortness of breath or fever, while the remaining 14 were asymptomatic.

To study the effects of the virus on the heart, several tests were performed as well as an MRI of the heart to image the athletes’ heart.

MRI revealed that four athletes – all men with pre-existing conditions – had symptoms of myocarditis. Reported having two mild COVID-19 symptoms; The other two were asymptomatic.

It was surprising that not all athletes with myocarditis had the symptoms of Dr. Brett Torsdale, COVID-19, a sports medicine physician for special surgery at a New York City hospital. This was because myocarditis was initially recognized in hospitalized patients with COVID-19.

“This study suggests that myocarditis can occur after less severe and even asymptomatic cases of COVID-19,” said Torsdahl, who was not involved with the research. “Therefore, an athlete’s risk of myocarditis may not be related to severity. Their symptoms

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Another eight athletes also had evidence of cardiac scarring, but it is unclear whether this was related to COVID-19 or general adaptation to the heart.

While the condition often goes away on its own, in rare cases, it can lead to sudden death from cardiac arrest.

Rajpal cautioned that the study was small, and more research is needed to confirm whether COVID-19 contributed to myocarditis of athletes.

In fact, athletes’ hearts typically undergo changes as they adapt to high intensity training, which allows their heart to perform more efficiently. But the director of sports cardiology at UCLA, Drs. Ali Nsair said the findings were unusual for an athlete.

Based on what has been revealed about the virus, Rajpal said, it is likely that the heart condition was associated with COVID-19. In fact, earlier research found evidence of cardiac inflammation in recovered COVID-19 patients.

However, the athlete’s MRI was the only evidence of heart damage. None of the athletes had any abnormalities in other tests, including an EKG, which measures heart rhythm, or a blood test for troponin levels, a protein that indicates damage to the heart.

The NSAR, which was also not involved with the research, said that it was related to whether the abnormalities were raised only on MRI and not on bloodletting or EKG. This raises the question of whether any athlete who has tested positive for coronovirus should have an MRI of their heart before being cleared for competitive sports, he said.

At Ohio State, Rajpal stated that COVID-19 recovered before returning to strenuous activity is the current protocol for athletes.

Rajpal said that athletes with myocarditis are advised to rest for three months before returning to play, as per the guidelines of the American Heart Association. And when they return, they should be alert to symptoms, especially if they experience unusual shortness of breath or chest pain.

Others agreed that comfort is necessary.

“If we see any patient, professional athlete or otherwise, with this amount of inflammation, we will definitely consult them against any exercise until it has been shown to be clear,” Sustair said.

Toresdahl gave his advice to an athlete with signs of myocarditis, saying, “One just needs to rest because we don’t know the risk of sudden cardiac arrest as a result of COVID-19 myocarditis.”

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