Small study shows heart damage after COVID-19 uncommon in co
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In a small study, researchers found college athletes who contracted COVID-19 rarely had cardiac complications. Most had mild COVID symptoms that did not require treatment, and in a small percentage of those with abnormal cardiac testing, there was no evidence of heart damage on special imaging tests. All athletes returned to sports without any health concerns, according to new research published today in the American Heart Association’s flagship journal Circulation.

In spring 2020, concerns about heart damage, especially inflammation, among athletes with COVID-19 led to recommendations for cardiac 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 American College of Cardiology’s Sports & Exercise Cardiology Council’s standard recommendations, issued in May 2020, do not advise cardiac MRI as an initial screening test based on COVID symptoms alone, so researchers investigated if symptom severity was associated with heart inflammation or poor recovery after COVID-19.

“This study results support an approach to cardiac screening guided by patient symptoms and severity of COVID illness in line with current recommendations from sports-cardiology groups before resuming exercise or sports,” said senior study author.

Researchers reviewed health records to identify 137 college athletes (average age of 20, 68% male) who were referred for cardiac screening to return to play after testing positive for COVID-19. On average, the athletes were evaluated 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 football players, followed by dance, basketball, baseball, softball, tennis, soccer, cheer, track, volleyball and golf athletes.

Most (82%) of the athletes had COVID-19 symptoms; the symptoms were mild for the majority (68%); and none required treatment or hospitalization. The most frequent symptoms were the loss of smell/taste (58%), fever (less than 2 days, 42%), headache (41%) and fatigue (40%). Less frequently reported symptoms were shortness of breath (12%) and chest pain/tightness (11%). African American and Hispanic athletes were more often symptomatic compared to white athletes (86% and 100% vs. 75%, respectively). No differences in symptoms or severity were found based on gender or sport.

All of the athletes underwent initial heart imaging tests, including ultrasound of the heart and electrocardiogram to screen for possible heart damage, and received a blood test (troponin level). Troponin is a protein that is released in the blood and found in the muscles of the heart when there is heart damage. Only participants who had abnormal test results received a cardiac MRI.

Researchers found:

-- Less than 4% (5) of the 137 athletes showed heart abnormalities on initial screening tests.
-- Further screening via cardiac MRI of the 5 athletes identified found no heart damage or inflammation.
-- After COVID-19 recovery, all athletes were able to resume their full training and competition regimens without any complications.

“We were encouraged to find so few abnormal tests in these athletes as well as negative cardiac MRIs in those who did have an abnormal test during the initial screening, and no athlete had any problems after returning to exercise and sport,” said study co-author.