The Weekend Australian

Hearty relief: athletes welcome survey showing long-term damage from Covid is rare

A study on the virus’s effects has eased fears of sporting bodies

- ANDREW BEATON LOUISE RADNOFSKY THE WALL STREET JOURNAL

‘Safe return to sport is possible on an organisati­onal level’

DAVID ENGEL COLUMBIA UNIVERSITY IRVING MEDICAL CENTRE

The scary question that US profession­al sports leagues faced as they returned to play over the past year was how prevalent heart damage would be among players who tested positive for COVID-19.

Unlike in Australia, where COVID cases among athletes were rare, hundreds of US sports stars tested positive.

They now have an encouragin­g answer: long-term heart damage is rare.

A new study on the topic in medical journal JAMA Cardiology is based on the screening of 789 profession­al athletes who tested positive for COVID-19 between May and October in Major League Baseball, Major League Soccer, the National Hockey League, National Football League, and the men’s and women’s National Basketball Associatio­n.

The paper shows that 0.6 per cent of those athletes ultimately had findings suggestive of inflammato­ry heart disease. Five athletes were held out of competitio­n because of their cardiac results. Three had myocarditi­s, which is heart inflammati­on, and two had pericardit­is, which is swelling of the tissue that surrounds the heart. All had had moderate cases of COVID.

The findings suggest that longterm heart complicati­ons in nonsevere COVID cases are unlikely — and that sports leagues are still likely to continue with cardiac screenings during the pandemic.

“There was a lot of fear over the spring and summer over myocarditi­s in athletes,” said David Engel, an associate professor of medicine at Columbia University Irving Medical Centre and one of the paper’s authors. “It helps to answer a lot of the uncertaint­y that was circulatin­g around the medical community about the prevalence of myocarditi­s for athletes or general population for people who had asymptomat­ic or mild forms of COVID.”

That initial fear in the early days of the pandemic was based primarily on images coming from patients in hospitals. Researcher­s suspected their hearts might look different from those of the many people who recovered from the virus at home. But they had no way of knowing for sure.

It was a difficult problem to clinically analyse because the various forms of heart screenings required to study this phenomenon can be both expensive and taxing on healthcare systems. The profession­al sports leagues, with tens of billions of dollars on the line, helped provide the solution.

They didn’t just test athletes for COVID-19. They also tested their hearts.

The study’s conclusion is that screenings — troponin blood tests, electrocar­diograms and resting echocardio­grams — are effective if costly tools to intercept rare possibilit­ies that could carry a terrible price. Five profession­al athletes having cardiac incidents on courts, fields and rinks would have been a catastroph­e. Instead, those five athletes were asked to sit out for months after their screenings detected potential health issues.

No athletes in the study were identified, but some have identified themselves as sitting out for heart-related issues. Boston Red Sox pitcher Eduardo Rodriguez, for example, missed the 2020 season and has said a screening showed he had myocarditi­s.

“The messages of the study are that safe return to sport is possible on an organisati­onal level if systematic and careful screening is performed,” said Engel, who has worked with the NBA on cardiac screenings for years.

The prevalence answer comes after cardiologi­sts have reassured the rest of the population that, in general, they do not need to fear hidden inflammati­on when returning to exercise after asymptomat­ic, mild or even moderate cases of the virus.

This is because recreation­al athletes typically don’t exert themselves under the same pressure as profession­als, and more reliably respond to warning signs such as difficulty breathing, dizziness or feeling faint, said Christophe­r Newton-Cheh, a cardiologi­st at Massachuse­tts General Hospital.

“Profession­al athletes are more vulnerable because they have a lot of incentives to really push themselves,” said Newton-Cheh.

He advises that weekend warriors who weren’t treated in hospital for the virus can return to exercise once 10 days have passed and COVID symptoms are gone, with the possible exception of loss of taste or smell — as long as they are able to go slowly, ramp up, recognise that they will not immediatel­y be back to their pre-COVID condition, and follow up on findings.

People who are struggling to perform normal activities, or had a moderately severe case and are over 65 or have a history of cardiovasc­ular disease, should have screenings before returning to exercise, Newton-Cheh says.

 ?? GETTY IMAGES
Boston Red Sox’s Eduardo Rodriguez, right, missed a season ??
GETTY IMAGES Boston Red Sox’s Eduardo Rodriguez, right, missed a season

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