Aug 15, 2020 - Health

The cardiac threat coronavirus poses to athletes

Illustration of a Coronavirus cell in the shape of a heart symbol.

Illustration: Annelise Capossela/Axios

Cardiologists are increasingly concerned that coronavirus infections could cause heart complications that lead to sudden cardiac death in athletes.

Why it matters: Even if just a tiny percentage of COVID-19 cases lead to major cardiac conditions, the sheer scope of the pandemic raises the risk for those who regularly conduct the toughest physical activity — including amateurs who might be less aware of the danger.

Driving the news: Both the Big 10 and Pac-12 conferences announced this week that they wouldn't play college football in the fall because of health concerns about the COVID-19 pandemic.

  • According to ESPN, a major factor driving those decisions has been fear that COVID-19 could lead to a rise in myocarditis among athletes.

Myocarditis is an inflammation of the heart caused by viral infections that can lead to rapid or abnormal heart rhythms and even sudden cardiac death.

  • Myocarditis causes about 75 deaths per year in young athletes between the ages of 13 and 25, often without any warning. The 27-year-0lld Boston Celtics star Reggie Lewis collapsed at a practice and soon died from myocarditis in 1993.
  • While research is still in its infancy, a July study of 100 adult patients in Germany had recovered from COVID-19 found that 60% had findings of ongoing myocardial inflammation.
  • Worryingly, patients with mild COVID-19 symptoms developed myocarditis as frequently as those who were hospitalized, raising the possibility that those who may not even know they have COVID-19 could be at risk.
  • That's important because athletes with myocarditis must cease intense physical activity for weeks or even months until the conditions clears up. Otherwise, says Emory University sports cardiologist Jonathan Kim, they put themselves in danger of "cardiac arrest and a catastrophic outcome."

By the numbers: NCAA chief medical officer Brian Hainline said in a press call Thursday that at least a dozen college athletes so far had been found to have myocarditis after testing positive for COVID-19.

College athletes and to a greater extent professional ones have the benefit of more frequent COVID-19 tests and oversight from doctors who know to look out for signs of myocarditis.

  • But amateur athletes may be largely on their own, even though they too would be at risk from myocarditis and sudden death should they continue to engage in vigorous exercise after a COVID-19 infection.
  • "For your high-end marathoners and triathletes, [myocarditis] is a reasonable consideration," says Kim. "It's something to discuss with your doctor or consult with a sports cardiologist before you get back to training."
  • Yes, but: Those of us who exercise to stay healthy but have no intention of entering the Ironman Triathlon likely don't have much to worry about.

The bottom line: The more we learn about COVID-19, the more varied the threat it poses becomes. But little seems scarier then the possibility of sudden cardiac death in the fittest among us.

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