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Recently published collaborative research evaluated the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, using current return-to-play screening recommendations. The major North American professional sports leagues were among the first to return to full-scale sport activity during the COVID-19 pandemic. Each of these professional sports leagues (MLS, MLB, NHL, NFL, and the men’s and women’s NBA) implemented a program for all players who had tested positive for COVID-19 prior to resumption of team-organized sports activities. “Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systemic Return-To-Play Cardiac Screening” was published in JAMA Cardiology.
The goal of the study is to assess the prevalence of clinically detectable and relevant cardiac injury in athletes testing positive for COVID-19 and the efficacy of consensus screening recommendations in achieving a safe return to competitive sports. This cross-sectional study reviewed return-to-play cardiac testing performed between May and October 2020 on professional athletes who had tested positive for COVID-19. Troponin testing, electrocardiography (ECG), and resting echocardiography were performed after a positive COVID-19 test result. Those with abnormal screening test results were referred for additional testing, including cardiac magnetic resonance imaging and/or stress echocardiography.
The study included 789 professional athletes. The results show a total of 460 athletes had prior symptomatic COVID-19 illness and 329 were asymptomatic or minimally symptomatic but had tested positive for the virus. Using the return-to-play cardiac screening algorithm, 6 athletes had an abnormal troponin level, 10 athletes had ECG abnormalities warranting further cardiac evaluation, and 20 athletes had an echocardiographic finding necessitating additional testing to exclude acute cardiac injury. No adverse cardiac events occurred in athletes who underwent cardiac screening and resumed professional sport participation.
The study team concluded “while long-term follow-up is ongoing, few cases of inflammatory heart disease have been detected, and a safe return to professional sports activity has thus far been achieved.” Further research is needed to understand whether there may be long-term cardiac effects among athletes infected with COVID-19, whether or not they were symptomatic.
This study was co-authored by Dr. Andrew Tucker, Medical Director of MedStar Union Memorial Hospital Sports Medicine and. Dr. Tucker also serves on the US National Football League General Medical Committee.
Jama Cardiology, 2021. DOI: 10.1001/jamacardio.2021.0565