In a small study, researchers found that college athletes who contracted COVID-19 rarely had heart complications. Most had mild symptoms of COVID that did not require treatment, and in a small percentage of those who had abnormal heart tests, there was no evidence of heart damage on special imaging tests. All athletes have returned to the sport without any health concerns, according to a new study published today in the flagship journal of the American Heart Association. Circulation.
In the spring of 2020, concerns about heart damage, particularly inflammation, in athletes with COVID-19 led to recommendations for cardiac screening based on the severity of symptoms before resuming training and competition. The preferred diagnostic test for cardiac inflammation is an MRI of the heart or cardiac magnetic resonance imaging. The standard recommendations of the Sports and Exercise Cardiology Council of the American College of Cardiology, released in May 2020, do not recommend cardiac MRI as an initial screening test based solely on symptoms of COVID. therefore investigated whether the severity of symptoms was associated with heart inflammation or poor recovery after COVID. -19.
“The results of our study support an approach to cardiac screening guided by the patient’s symptoms and the severity of the COVID disease in accordance with current recommendations from sports cardiology groups before resuming exercise or sports,” said the Lead author of the study Ranjit R. Philip, MD, pediatric cardiologist at Le Bonheur Children’s Hospital and assistant professor of pediatric cardiology at the Health Sciences Center at the University of Tennessee in Memphis.
From July 9, 2020 to October 21, 2020, researchers at the University of Tennessee Health Sciences Center examined health records to identify 137 varsity athletes (mean age 20, 68% male) who have been referred for cardiac screening to return to play after testing. positive for COVID-19. On average, athletes were tested 16 days after testing positive for the COVID-19 virus. Almost half of the participants were African American students, almost half were white students, and 7% were Hispanic students. Of the 11 sports represented at three universities, more than a third of the athletes were football players, followed by dance, basketball, baseball, softball, tennis, football, cheer, and athletics, volleyball and golf.
Most (82%) of the athletes had symptoms of COVID-19; the symptoms were mild for the majority (68%); and none required treatment or hospitalization. The most common symptoms were loss of smell / taste (58%), fever (less than 2 days, 42%), headache (41%) and fatigue (40%). Less commonly reported symptoms were shortness of breath (12%) and chest pain / tightness (11%). African American and Hispanic athletes were more often symptomatic than white athletes (86% and 100% vs. 75%, respectively). No difference in symptoms or severity was found based on gender or sport.
All athletes underwent initial cardiac imaging tests, including an ultrasound of the heart and an EKG to check for possible cardiac damage, and received a blood test (troponin level). Troponin is a protein that is released into the blood and is found in the muscles of the heart when heart damage occurs. Only participants who had abnormal test results received a cardiac MRI.
The researchers found:
- Less than 4% (5) of 137 athletes presented with cardiac abnormalities on initial screening tests.
- Further screening by cardiac MRI of the 5 identified athletes revealed no cardiac damage or inflammation.
- After recovery from COVID-19, all athletes were able to resume their full training and competitive regimen without any complications.
“We were encouraged to find so few abnormal tests in these athletes as well as negative cardiac MRIs in those who had an abnormal test during the initial screening, and no athlete had any problems after returning to exercise. and sports, ”said Benjamin S. Hendrickson, MD, co-author and pediatric and congenital cardiologist at Le Bonheur Children’s Hospital and assistant professor of pediatrics (cardiology) at the University of Tennessee Health Science Center.
“Our results can reassure high school athletes, coaches and parents, where resources for testing may be limited,” added Philip.
Limitations that could have affected the study results include the lack of a control group without COVID-19 and the use of a regular troponin test as opposed to the high sensitivity troponin test.
The new study by Dr Philip and his colleagues also confirms recent research published on April 17 in Circulation, who found no adverse cardiac events related to SARS-CoV-2 infections observed in more than 3,000 college athletes during short-term clinical surveillance. The results also suggested a safe return to play without a heart test for asymptomatic or mildly symptomatic athletes.
Other efforts to track the impact of COVID-19 on varsity athletes include an initiative by the American Heart Association and the American Medical Society for Sports Medicine (AMSSM) to accelerate a crucial new research initiative on heart disease in athletes. The Collaborative Data Registry, launched in January 2021, is facilitating research on COVID-19 and, in the long term, will develop an in-depth knowledge base on heart disease in athletes beyond the pandemic.