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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 a small percentage of those with abnormal heart tests had no evidence of heart damage on special imaging tests. All athletes returned to the sport with no health concerns. This is based on new research published today in the American Heart Association's flagship journal Circulation.
In the spring of 2020, concerns about heart damage, particularly inflammation, in athletes with COVID-19 led to recommendations for heart screening based on symptom severity before resuming training and competition. The preferred diagnostic test for heart inflammation is an MRI of the heart or cardiac magnetic resonance imaging. The standard recommendations issued in May 2020 by the Sports & Exercise Cardiology Council of the American College of Cardiology do not recommend a cardiac MRI as an initial screening test based solely on COVID symptoms. Therefore, the researchers looked at whether the severity of symptoms was linked to heart inflammation or poor recovery from COVID -19.
"Our study results support an approach to cardiac screening that is based on the patient's symptoms and the severity of the COVID illness and is in line with current recommendations from exercise cardiology groups before resuming exercise or exercise," said the lead study author Ranjit R. Philip, MD, pediatric cardiologist at Le Bonheur Children's Hospital and assistant professor of pediatric cardiology at the University of Tennessee Health Science Center, Memphis.
From July 9, 2020 to October 21, 2020, researchers from the University of Tennessee Health Sciences Center reviewed health records to identify 137 college athletes (mean age 20, 68% men) who were referred for heart screening after the test to get back to gaming positive for COVID-19. On average, athletes were scored 16 days after testing positive for the COVID-19 virus. Nearly half of the participants were African American students, nearly 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 soccer players, followed by dance, basketball, baseball, softball, tennis, soccer, cheering, track, volleyball and golf athletes.
Most (82%) of the athletes had COVID-19 symptoms; Symptoms were mild for the majority (68%). and no treatment or hospitalization required. 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 likely to be symptomatic than white athletes (86% and 100% versus 75%, respectively). No differences in symptoms or severity based on gender or exercise were found.
All athletes had initial cardiac imaging tests, including an ultrasound of the heart and an electrocardiogram to check for possible heart damage, and were given a blood test (troponin levels). Troponin is a protein that is released in the blood and is found in the muscles of the heart when the heart is damaged. Only participants with abnormal test results received a cardiac MRI.
- Less than 4% (5) of the 137 athletes showed cardiac abnormalities on initial screening tests.
- A further screening with cardiac MRI of the 5 identified athletes showed no heart damage or inflammation.
- After the COVID-19 recovery, all athletes were able to resume their full training and competition program without 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 problems after returning to exercise and exercise," 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 when testing resources can be limited," added Philip.
Limitations that could have affected the study's results include the lack of a control group without COVID-19 and the use of a regular troponin test as opposed to the highly sensitive troponin test.
The new study by Dr. Philip and colleagues also confirms the research recently published in Circulation on April 17, which 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 suggest a safe return to play without a heart test for asymptomatic or mildly symptomatic athletes.
Other efforts to track how COVID-19 is affecting college athletes include an initiative by the American Heart Association and the American Medical Society for Sports Medicine (AMSSM) to accelerate a major new research initiative to study heart disease in athletes. The collaborative data register, which was launched in January 2021, supports research into COVID-19 and will, in the long term, build a deep knowledge base about heart diseases in athletes beyond the pandemic.
SARS-CoV-2 heart involvement is low among university athletes
Edition (2021). DOI: 10.1161 / CIRCULATIONAHA.121.053982
American Heart Association
Small study shows heart damage after COVID-19 unusual in college athletes (2021, May 10)
accessed on May 10, 2021
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