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Most professional athletes who received COVID-19 did not develop heart inflammation

A new study suggests that most professional athletes who received COVID-19 did not suffer heart damage.

The researchers examined 789 players who tested positive for SARS-CoV-2 infections for signs of myocarditis or pericarditis, inflammation of the heart or surrounding sac. The researchers reported March 4 in JAMA Cardiology. These results contrast with findings from previous studies by college athletes, who suggested that up to 15 percent of young athletes may develop life-threatening heart disease after a coronavirus infection (SN: 9/11/20).

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Particularly for asymptomatically infected players, “we’re not seeing a lot of heart damage in relation to COVID,” says study co-author Jonathan Kim, head of sports cardiology at Emory University School of Medicine in Atlanta. None of the 329 asymptomatic or very mild symptoms showed any signs of heart damage. The five athletes who withdrew from the game presented with moderate symptoms of COVID-19, such as dry cough, loss of smell, and taste and fatigue. Previous research has shown that myocarditis is a disease that afflicts people who have had more severe cases of coronavirus disease. This suggests that it is important to consider the severity of COVID-19 symptoms when deciding whether to examine athletes and non-athletes for heart inflammation, Kim says.

All athletes in the previous study had their hearts examined with MRI or MRI, regardless of whether the athletes were asymptomatic or had symptoms of COVID-19. The researchers also performed other tests to identify signs of inflammation. In addition to heart images, most college athletes had no other signs of heart inflammation, says Meagan Wasfy, a sports cardiologist at Massachusetts General Hospital in Boston who did not participate in either study. Because the other test results did not consistently match the MRI results, "we do not know the clinical significance of those findings." He said people’s hearts, especially those of athletes, have not been MRI scanned to find out what is normal and what is a true indication of heart damage from viral illnesses.

What may look like myocarditis on an MRI of an athlete’s heart may be a common adaptation to sport or vigorous, sustained exercise, says Sawalla Guseh, also a cardiologist at Massachusetts General Hospital.

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The new study in professional athletes evaluated his heart with three tests to detect inflammation before undergoing MRI. Players in the professional sports leagues of men's soccer, baseball, ice hockey, men's and women's soccer and basketball have received blood tests for troponin, a heart muscle protein that can signal heart damage when found in the blood. the heart and echocardiographs, which use ultrasound to examine the heart. Of the nearly 800 players with coronavirus infections, 30 had results relative to one or more of those tests. Only players with abnormal results got an MRI, which reduced the list to five players who had to sit for a while.

“This paints a more reassuring picture than previous MRI work,” says Wasfy.

The results of this study may be difficult to apply to the general public due to different ages, fitness levels, and different degrees of severity of the average person’s disease compared to professional athletes.

The findings suggest that people, even young, healthy ones, need to take COVID-19 seriously and rest when they are sick to protect their heart, gradually returning to activity after recovering. “Be honest with yourself about your symptoms,” Guseh says. Chest tension, shortness of breath, and extreme fatigue after exertion are symptoms of COVID-19 and heart inflammation.

“For the individual, the risk seems low” of developing coronavirus-derived heart damage, he says. But considering the millions of people who have contracted the virus, "even if it's 1 or a half percent, it's still a considerable number of people."

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