Cardiac complications found to be rare in college athletes infected with COVID-19

In a small study, researchers found that college athletes infected with COVID-19 rarely had heart complications. Most had mild COVID symptoms that did not require treatment, and a small proportion of patients who underwent abnormal heart examination showed no evidence of heart damage on special imaging tests.All athletes returned to sports without health concerns, according to a new study published today in the American Heart Association’s flagship journal. circulation..

In the spring of 2020, COVID-19 athletes’ concerns about heart damage, especially inflammation, recommended heart screening based on symptomatology severity before resuming training and competition. The preferred diagnostic test for cardiac inflammation is cardiac MRI, or magnetic resonance imaging of the heart. Researchers do not recommend cardiac MRI as an initial screening test based solely on COVID symptoms, as the Standard Recommendations of the American Heart Association Sports & Exercise Cardiac Council, published in May 2020, suggests the severity of symptoms. We investigated whether was associated with cardiac inflammation or poor recovery after COVID-19.

Our findings support an approach to cardiac screening guided by patient symptoms and severity of COVID disease, in line with current recommendations from the Athletic Heart Disease Group, before resuming exercise or sports. doing. “

Ranjit R. Philip, MD, Senior Research Author, Pediatric Cardiology Specialist at Lubon Hoy Arched Lens Hospital, Assistant Professor of Pediatric Cardiology at the University of Tennessee Health Sciences Center in Memphis

From July 9, 2020 to October 21, 2020, researchers at the University of Tennessee Health Sciences Center reviewed health records and 137 college athletes referred for cardiac screening (mean age 20, 68%). Male) has been identified. COVID-19 positive. On average, athletes were evaluated 16 days after testing for COVID-19 virus positivity. Almost half of the participants were African-American students, almost half were Caucasian students, and 7% were Hispanic students. Of the 11 sports represented by the three universities, more than one-third of athletes are soccer players, including dance, basketball, baseball, softball, tennis, soccer, cheering, track, volleyball, and golf athletes. Continued.

Most (82%) of athletes had COVID-19 symptoms. Symptoms were mild in the majority (68%). No treatment or hospitalization was required. The most common symptoms were odor / taste loss (58%), fever (less than 2 days, 42%), headache (41%), and malaise (40%). Less commonly reported symptoms were shortness of breath (12%) and chest pain / tension (11%). African-American and Hispanic athletes were more often symptomatological than white athletes (86% and 100% vs. 75%, respectively). There was no difference in symptoms or severity by gender or sports.

All athletes underwent initial cardiac imaging tests such as ultrasonography and electrocardiography of the heart, screened for possible heart damage, and underwent blood tests (troponin levels). Troponin is a protein that is released into the blood and is found in the muscles of the heart when it damages the heart. Only participants with abnormal test results underwent cardiac MRI.

Researchers have found the following:

• Less than 4% (5) of the 137 athletes showed heart abnormalities on the first screening test.
• Further screening by cardiac MRI of the five confirmed athletes showed no cardiac damage or inflammation.
• After the recovery of COVID-19, all athletes were able to resume full training and competition regimens without complications.

“These athletes had few abnormal tests, and those who had an abnormal test in the initial screening had a negative cardiac MRI and had no problems after returning to exercise or sports,” Benjamin S said. .. Doctor of Medicine Hendrickson, co-author of Le Bonheuer Children’s Hospital, pediatric and congenital cardiologist, and assistant professor of pediatrics (cardiology) at the University of Tennessee Health Sciences Center.

“Our findings may reassure high school athletes, coaches and parents who may have limited resources for testing,” Philip added.

Limitations that may affect the results of the study include the lack of a control group without COVID-19 and regular use as opposed to a sensitive troponin test.

A new study by Dr. Philip and colleagues also confirms a recent study published on April 17. circulation, It did not discover any adverse cardiac events associated with SARS-CoV-2 infection observed among more than 3,000 college athletes during short-term clinical surveillance. The findings also suggested a return to safe play without a heart test for asymptomatic or mildly symptomatic athletes.

Other efforts to track the impact of COVID-19 on college athletes include the American Heart Association and American Sports Medicine Association (AMSSM) initiatives to accelerate important new research initiatives to study the condition of athletes’ hearts. It is included. Launched in January 2021, the Collaborative Data Registry will support the study of COVID-19 and, in the long run, develop a deep knowledge base for athletes’ heart disease beyond the pandemic.