CV injury rare for professional athletes with mild COVID-19
Professional athletes who had COVID-19 rarely presented with cardiac events or injury after undergoing return-to-play testing, researchers reported.
To assess the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, researchers performed a cross-sectional study of return-to-play cardiac testing mandated by six professional sports leagues on 789 professional athletes from May to October 2020.
According to the researchers, imaging evidence of inflammatory heart disease that resulted in restriction from play was identified in five athletes (0.6%). No adverse cardiac events occurred in the athletes who underwent cardiac screening and resumed playing professional sports.
“This indicates that the majority of those with COVID-19 should not be concerned about immediate heart involvement and do not require heart testing. After a quarantine period, returning to exercise without symptoms indicates a good short-term outcome in those without symptoms or mild symptoms with COVID-19,” Cardiology Today Editorial Board Member Matthew W. Martinez, MD, director of sports cardiology at Morristown Medical Center in New Jersey, told Healio.
In the cohort, the mean athlete age was 25 years (range, 19-41 years), and 98.5% were men. Among the cohort, 58.3% had prior symptoms reflecting COVID-19 illness, and 41.7% were asymptomatic or paucisymptomatic but had tested positive for the SARS-CoV-2 virus. COVID-19 positivity was diagnosed by polymerase chain reaction assay or antibody testing, according to the researchers.
Cardiac screening revealed abnormal results in 3.8% of athletes — 0.8% had elevated troponin, 1.3% had an abnormal ECG and 2.5% had an abnormal echocardiogram — necessitating additional testing.
Among those needing more testing, five athletes (0.6% of the total cohort) had cardiac MRI results showing inflammatory heart disease (myocarditis in three and pericarditis in two), the researchers wrote.
No athletes were documented with severe COVID-19 illness. One athlete was hospitalized overnight for observation, but no athlete was admitted to a hospital for cardiopulmonary symptoms, the researchers wrote.
According to the researchers, longitudinal assessment of athletes with prior COVID-19 is warranted to enhance the understanding of the short-term and potential long-term pathologic cardiac sequelae of COVID-19.
“While small single-center studies have reported much higher incidences of cardiac injury using cardiac magnetic resonance as a screening tool, I believe we can be more reassured by this much larger study that approaches screening in a more clinically meaningful way,” Dermot Phelan, MD, PhD, medical director of cardiovascular imaging and director of the sports cardiology program at Atrium Health Sanger Heart & Vascular Institute, told Healio.
For more information:
Matthew W. Martinez, MD, can be reached Sports Cardiology, 111 Madison Ave., Suite 301, Morristown, NJ 07960.
Dermot Phelan, MD, PhD, can be reached at Sports Cardiology Center, 1001 Blythe Blvd., Suite 300, Charlotte, NC 28203.