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.
𝐀𝐧𝐝, 𝐭𝐡𝐚𝐭 𝐦𝐚𝐤𝐞𝐬 𝐦𝐞 𝐜𝐚𝐮𝐭𝐢𝐨𝐮𝐬 𝐟𝐨𝐫 𝐨𝐮𝐫 𝐭𝐞𝐞𝐧𝐚𝐠𝐞 𝐚𝐭𝐡𝐥𝐞𝐭𝐞𝐬, 𝐜𝐨𝐥𝐥𝐞𝐠𝐞 𝐚𝐭𝐡𝐥𝐞𝐭𝐞𝐬, 𝐚𝐧𝐝 𝐲𝐨𝐮𝐧𝐠 𝐚𝐝𝐮𝐥𝐭𝐬. 𝐋𝐞𝐭 𝐦𝐞 𝐬𝐡𝐨𝐰 𝐲𝐨𝐮 𝐰𝐡𝐲:
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% 𝑤𝑒𝑟𝑒 𝑎𝑠𝑦𝑚𝑝𝑡𝑜𝑚𝑎𝑡𝑖𝑐) found that 15% had myocarditis. 𝟏𝟓% 𝐢𝐬 𝐬𝐭𝐢𝐥𝐥 𝐚 𝐩𝐞𝐫𝐜𝐞𝐧𝐭𝐚𝐠𝐞 𝐭𝐨 𝐰𝐚𝐭𝐜𝐡 𝐚𝐦𝐨𝐧𝐠 𝐭𝐡𝐞 𝟏,𝟎𝟎𝟎𝐬 𝐨𝐟 𝐡𝐢𝐠𝐡 𝐬𝐜𝐡𝐨𝐨𝐥, 𝐜𝐨𝐥𝐥𝐞𝐠𝐞, 𝐚𝐧𝐝 𝐩𝐫𝐨𝐟𝐞𝐬𝐬𝐢𝐨𝐧𝐚𝐥 𝐚𝐭𝐡𝐥𝐞𝐭𝐞𝐬 𝐢𝐧 𝐚𝐥𝐥 𝐬𝐩𝐨𝐫𝐭𝐬. 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
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