Covid Infected Pro Athletes & Inflammatory Heart Disease


When the Covid-19 management strategy unfolded over 2020 – which included assessment, treatment, prevention, and immunization – return to normal safety protocols became a complex, yet vital part, of preventing further devastation to human life and the world’s economy.

As time and the control of the coronavirus disease unfolded, the major North American professional sports leagues were among the first to implement a return- to-play (RTP) scenario – with the appropriate prevention measures in place – like no fans, player and staff bubbles, daily Covid-19 testing, sequestering players that tested positive, and much more.

As a result of the unknown incidence of “cardiac sequelae” (consequences of a particular condition) – resulting from Covid-19 infection, a conservative RTP cardiac testing program mirroring the American College of Cardiology
recommendations, was implemented for all athletes, who tested positive for Covid-19.

In new research – Prevalence of Inflammatory Heart Disease Among Professional Athletes with Prior COVID-19 Infection Who Received Systemic Return-to-Play Cardiac Screening – which appeared in March of 2021 in the online issue of JAMA Cardiology (Journal of the American College of Cardiology), a diverse group of medical experts sought to, “to assess the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, using current RTP screening recommendations.”

This descriptive study, a cross-sectional evaluation of cardiac testing performed between May to October 2020, followed the Strobe (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.

It included 789 professional athletes from Major League Soccer, Major League Baseball, National Hockey League, National Football League, and the men’s and women’s National Basketball Association – with an average age of 25 – composed of 777 men, of which 460 athletes had prior symptomatic COVID-19 illness, and 329 were asymptomatic or paucisymptomatic (minimally symptomatic)

A summary of the study group’s cardiac health status was as follows: “Thirty athletes were sent for additional cardiac testing, as a result of abnormalities on the initial cardiac screening tests that raised concern for potential COVID-19–associated cardiac injury. Cardiac magnetic resonance (CMR) imaging was performed in 27 of these 30 athletes. Downstream testing confirmed diagnoses of inflammatory heart disease in 5 of 27 athletes: 3 athletes with CMR-confirmed myocarditis (inflammation of the heart muscle) and 2 athletes with CMR- confirmed pericarditis (swelling of the thin, saclike tissue surrounding the heart).

The remaining 25 of 30 athletes (83.3%) who underwent additional testing, did not ultimately have findings to suggest acute cardiac injury and returned to play.” RTP cardiac screening for professional athletes testing positive for COVID-19, noted the investigators, “demonstrated that 0.6% (5 of 789 athletes) had imaging findings, “suggestive of inflammatory heart disease, that resulted in restriction from play in alignment with American Heart Association/ACC guidelines.”

The researchers concluded that, “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.”

Interested in Listening to a Podcast? Check out Maximum Wellness, Episode 100: The Covid-19 Pandemic Changed the Way We Exercise