It was later found that five of 789 professional athletes infected with COVID-19 had inflammatory heart disease in the largest study to date on the cardiac impact of the virus in sports.
In data published Thursday in JAMA Cardiology, doctors affiliated with six U.S. leagues tracked the 789 infected players last year between May and October.
Before the athletes returned to play, they underwent three non-invasive tests that detected heart rhythm, took an ultrasound of their hearts and measured a protein in their blood that could be a signal of heart damage. Thirty athletes had abnormal test results and were referred for a cardiac MRI. Doctors diagnosed five cases of inflammatory heart disease (0.6% of the total), including three cases identified as myocarditis and two pericarditis.
Dr. David Engel, a cardiologist at Columbia University Irving Medical Center and one of the paper’s lead authors, said the results were consistent with current assessments that COVID-19 heart injury was linked to the severity of symptoms. The study included infected athletes who were symptomatic and asymptomatic. All five cases of heart disease contained symptoms that “exceeded the empirical definitions of mild COVID-19 disease,” according to the newspaper.
Doctors are waiting for even bigger datasets compiled by the Big Ten Athletics Conference and the NCAA. Individual universities have published data of their own performances with mixed results. A study from Ohio State University made headlines in the fall when researchers found that four out of 26 athletes – or 15% – had signs of myocarditis after COVID-19. In a later study from the University of Wisconsin, only two cases were found out of 145 athletes.
Myocarditis is a rare but known effect of viral infections, including those that cause colds, H1N1 flu or mononucleosis. If left untreated and untreated, it can cause heart damage and sudden cardiac arrest, which can be fatal.
Concerns about it and other heart ailments have sparked initial debates about sport during the pandemic, especially this past summer because it is related to university football. Angel attributed some of the concerns to confusion about how to interpret studies that used heart MRIs to identify diseases.
The professional sports leagues that contributed data to the JAMA cardiology document – the NBA, WNBA, NFL, NHL, Major League Baseball and Major League Soccer – followed a standardized screening procedure recommended by the American College of Cardiology. These included blood tests, an electrocardiogram, and a resting echocardiogram or cardiac ultrasound. Further tests, and eventually diagnosis, were based on deviations from the initial screening.
“There has been a lot of controversy about how to interpret these cardiac MRI studies and really what the significance of these findings was,” Engel said. “This study had a very clinically relevant approach. Patients who tested positive underwent the recommended selection from the American College of Cardiology. It was only after abnormalities occurred for further testing. Using this step-by-step approach, we found what we considered to be clinically relevant incidents of myocarditis and pericarditis was fairly low. ‘
Ten of the doctors involved in the study revealed that they had received financial compensation or were employed by one of the leagues or associations involved. Angel is the NBA’s consulting cardiologist.
The five players diagnosed with heart disease, who were not identified for the purposes of the study, were all three to six months away from their sports and will continue to be tested to see the effects of the disease on their physical long-term. determined. state. Over time, the American College of Cardiology has recommended eliminating the screening for athletes who have had asymptomatic or mild cases, while retaining the same screening process for those who have had moderate or severe symptoms.
“What is reassuring is that all the athletes who passed the selection, the 784 out of 789, were able to achieve a safe return to play,” Engel said. “It was unknown. Early in the pandemic when these answers were not known … we were able to show that we could achieve a safe return to play through a strict and systematic approach to screening.
In a joint statement, the six leagues state in part: ‘As with other lessons learned by professional sports about COVID-19, the results of this study are widely shared to continue to contribute to the growing amount of knowledge about the virus – a commitment that we share jointly with each other and our players for the benefit of society outside of sports. ‘
The study results appear to be good news for athletes suffering from COVID-19, co-author, dr. Jonathan Kim, a sports cardiologist at Emory University in Atlanta who also works as a team cardiologist for the Atlanta Falcons, said.
“All four major sports are finished in 2020, all have finally returned to a season – including the athletes included in this register – and some sports like the NBA have now been transferred to a new season,” Kim told Kaiser said. Health news. “Of course, the athletes are still playing and doing well.”
The study did not shed light on what would happen in the long run with the players diagnosed with heart inflammation. They will still be monitored with MRIs to see if the effects disappear over time.
“Only time will tell whether we will have an epidemic of failed hearts in five years’ time,” said Dr. Robert Bonow, a cardiologist at Northwestern University and editor of JAMA Cardiology, said that was not related to the study. “But I think that’s unlikely.”
The results of the two other upcoming studies on the possible COVID heart link are expected to be published soon, pending peer review.
ESPN’s Paula Lavigne and Mark Schlabach and Kaian Health News reporter Markian Hawryluk contributed to this report.