๐‚๐Ž๐•๐ˆ๐ƒ-๐Ÿ๐Ÿ—, ๐Ÿ๐จ๐จ๐ญ๐›๐š๐ฅ๐ฅ, ๐š๐ง๐ ๐š๐ญ๐ก๐ฅ๐ž๐ญ๐ž๐ฌ


I grew up in a great town that revolved around Friday night lights (go Wildcats!). Nowadays, I throw a living-room-tailgate for my family every Saturday to watch college football – which involves “fun” food, as my kids say. For me, the fall weather, football, and rhythm of a new school year is something I look forward to every year.
Then COVID-19 hit and disrupted fall plans for football. I want to give a bit of an epidemiology perspective on why it’s important to watch the data among athletes (from college to professional athletes). And, why erring on the side of caution makes sense during a pandemic.


We have known for a while that a major way COVID-19 affects someone’s body is the heart. In fact, many, many long-haulers of COVID-19 (people who continue to experience symptoms months after initial infection) have blood pressure problems, heart arrhythmias, heart disease, and other types of heart damage. (See this post for more info – https://tinyurl.com/y2nomqkj).


Many of these long-haulers had no underlying health conditions or co-morbidities prior to COVID-19 – and many are younger. Frankly, we simply do not know the long-term (1, 2, or 5 year) ramifications of having COVID-19 is among anyone yet.

๐€๐ง๐, ๐ญ๐ก๐š๐ญ ๐ฆ๐š๐ค๐ž๐ฌ ๐ฆ๐ž ๐œ๐š๐ฎ๐ญ๐ข๐จ๐ฎ๐ฌ ๐Ÿ๐จ๐ซ ๐จ๐ฎ๐ซ ๐ญ๐ž๐ž๐ง๐š๐ ๐ž ๐š๐ญ๐ก๐ฅ๐ž๐ญ๐ž๐ฌ, ๐œ๐จ๐ฅ๐ฅ๐ž๐ ๐ž ๐š๐ญ๐ก๐ฅ๐ž๐ญ๐ž๐ฌ, ๐š๐ง๐ ๐ฒ๐จ๐ฎ๐ง๐  ๐š๐๐ฎ๐ฅ๐ญ๐ฌ. ๐‹๐ž๐ญ ๐ฆ๐ž ๐ฌ๐ก๐จ๐ฐ ๐ฒ๐จ๐ฎ ๐ฐ๐ก๐ฒ:
1. The American Heart Association highlighted a few athletes (see source #1 below for the full story). – A 24 year old lacrosse player was diagnosed with COVID-19 but was asymptomatic. After his season, his doctors found his tests showed he was at “high risk for cardiac arrest with high-intensity training”. – Boston Red Sox pitcher was diagnosed with myocarditis (inflammation of the heart muscle which can lead to arrhythmias during physical exertion) after COVID-19.
2. In a recent study published in JAMA (top tier science journal), heart abnormalities were found among healthy adults in their 40s-50s with mild-moderateish symptoms (only 1/3 required hospitalizations). Nearly 3 months after the diagnosis, 78% had heart abnormalities and 60% showed signs of myocarditis. Long-term effects? We don’t know yet.
3. Remember the Big 10’s initial decision to postpone? That was largely based on preliminary findings that 30% of athletes showed myocarditis on MRIs. The published final study among college competitive athletes (27% were mildly symptomatic, 73% ๐‘ค๐‘’๐‘Ÿ๐‘’ ๐‘Ž๐‘ ๐‘ฆ๐‘š๐‘๐‘ก๐‘œ๐‘š๐‘Ž๐‘ก๐‘–๐‘) found that 15% had myocarditis. ๐Ÿ๐Ÿ“% ๐ข๐ฌ ๐ฌ๐ญ๐ข๐ฅ๐ฅ ๐š ๐ฉ๐ž๐ซ๐œ๐ž๐ง๐ญ๐š๐ ๐ž ๐ญ๐จ ๐ฐ๐š๐ญ๐œ๐ก ๐š๐ฆ๐จ๐ง๐  ๐ญ๐ก๐ž ๐Ÿ,๐ŸŽ๐ŸŽ๐ŸŽ๐ฌ ๐จ๐Ÿ ๐ก๐ข๐ ๐ก ๐ฌ๐œ๐ก๐จ๐จ๐ฅ, ๐œ๐จ๐ฅ๐ฅ๐ž๐ ๐ž, ๐š๐ง๐ ๐ฉ๐ซ๐จ๐Ÿ๐ž๐ฌ๐ฌ๐ข๐จ๐ง๐š๐ฅ ๐š๐ญ๐ก๐ฅ๐ž๐ญ๐ž๐ฌ ๐ข๐ง ๐š๐ฅ๐ฅ ๐ฌ๐ฉ๐จ๐ซ๐ญ๐ฌ. The data was published in a letter and definitely needs follow-up studies to confirm the findings.

What does this mean? It’s something to watch with caution. Even if athletes are asymptomatic, there is a risk of heart damage. We will have to wait to see the long-term effects of this.


-Friendly neighbor epidemiologist


Source:

1. American Heart Association story:
2. Heart abnormalities in healthy adults, 40-50 years of age: https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916
3. MRI results:https://jamanetwork.com/journals/jamacardiology/fullarticle/2770645?alert=article

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