Low rates of inflammatory heart disease among athletes with Covid 19; JAMA Cardiology
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Aspirin should be favoured over warfarin to prevent blood clotting in children who undergo a surgery that replumbs their hearts, according to a new study.
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In a recent study report, in cardiac screening for professional athletes testing positive for COVID-19, 0.6% (5 of 789 athletes) have shown imaging findings suggestive of inflammatory heart disease, that resulted in restriction from play in alignment with American Heart Association/ACC guidelines. The findings have been put forth in JAMA Cardiology.
The major North American professional sports leagues were among the first to return to full-scale sport activity during the coronavirus disease 2019 (COVID-19) pandemic. Given the unknown incidence of adverse cardiac sequelae after COVID-19 infection in athletes, these leagues implemented a conservative return-to-play (RTP) cardiac testing program aligned with American College of Cardiology recommendations for all athletes testing positive for COVID-19.
Researchers undertook the study to assess the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, using current RTP screening recommendations.
The study was designed as a cross-sectional study reviewed RTP cardiac testing performed between May and October 2020 on professional athletes who had tested positive for COVID-19. The professional sports leagues (Major League Soccer, Major League Baseball, National Hockey League, National Football League, and the men's and women's National Basketball Association) implemented mandatory cardiac screening requirements for all players who had tested positive for COVID-19 prior to resumption of team-organized sports activities.
Troponin testing, electrocardiography (ECG), and resting echocardiography were performed after a positive COVID-19 test result. Interleague, deidentified cardiac data were pooled for collective analysis. Those with abnormal screening test results were referred for additional testing, including cardiac magnetic resonance imaging and/or stress echocardiography. The prevalence of abnormal RTP test results potentially representing COVID-19–associated cardiac injury, and results and outcomes of additional testing generated by the initial screening process.
Data analysis revealed some interesting facts.
- The study included 789 professional athletes (mean [SD] age, 25 [3] years; 777 men [98.5%]). A total of 460 athletes (58.3%) had prior symptomatic COVID-19 illness, and 329 (41.7%) were asymptomatic or paucisymptomatic (minimally symptomatic).
- Testing was performed a mean (SD) of 19 (17) days (range, 3-156 days) after a positive test result.
- Abnormal screening results were identified in 30 athletes (3.8%; troponin, 6 athletes [0.8%]; ECG, 10 athletes [1.3%]; echocardiography, 20 athletes [2.5%]), necessitating additional testing; 5 athletes (0.6%) ultimately had cardiac magnetic resonance imaging findings suggesting inflammatory heart disease (myocarditis, 3; pericarditis, 2) that resulted in restriction from play.
- No adverse cardiac events occurred in athletes who underwent cardiac screening and resumed professional sport participation.
"The results of this study provide an early opportunity to assess the potential for clinical effectiveness of current athletic RTP screening recommendations and the prevalence of relevant COVID-19–associated cardiac pathology in a large-scale setting. The low prevalence of clinically detectable inflammatory heart disease in this athlete population with nonsevere COVID-19 illness offers a counterpoint to findings of higher rates of COVID-19 myocarditis and pericarditis reported in recent small cohort and CMR-based observational studies in athletes."thw team concluded.
For the full article follow the link: 10.1001/jamacardio.2021.0565
Primary source: JAMA Cardiology
