Heart Trouble Could Be Lurking for Athletic Patients with COVID-19

We’ve heard for months that patients with preexisting conditions such as diabetes and obesity are at increased risk for severe disease and death with COVID-19. Paradoxically, there’s now evidence that athletes could also be in danger, though not in the same way as other high-risk groups. A Research Letter just published by the Journal of the American Medical Association reveals that myocardial inflammation is occurring in (and has killed) competitive athletes after recovery from COVID-19—including those who experienced only mild symptoms or who were asymptomatic. Researchers performed cardiac magnetic resonance (CMR) imaging in competitive college athletes with a mean age of 19.5 years whose sports included football, soccer, lacrosse, basketball, and track. None of them required hospitalization for the virus, and none received COVID-19–specific antiviral therapy. Fifteen percent—all males—had CMR findings consistent with myocarditis. Another 31% exhibited late gadolinium enhancement without T2 elevation suggestive of prior myocardial injury. While this imaging modality is likely beyond the scope of most urgent care centers, awareness of this phenomenon should alert providers to be especially vigilant for signs that athletes who have had COVID-19 could be experiencing cardiac issues.