Prevalence of Heart Disease in Professional Athletes with Pre-COVID-19 Infection

Among professional athletes who tested positive for coronavirus disease 2019 (COVID-19 infection of 0.6% there were imaging findings that suggested inflammatory heart disease that resulted in ban from participation, according to a screening protocol approved by the American Heart Association (AHA) / American College of Cardiology (ACC), researchers report JAMA Cardiology.

As of May 2020, several major North American professional sports leagues — including Major League Soccer, Major League Baseball, National Hockey League, National Football League, and the men and women National Basketball Association — implemented a conservative return-to-play (RTP) cardiac testing program in accordance with AHA / ACC recommendations for all athletes who test positive for acute respiratory distress coronavirus 2019 (SARS-CoV-2), the virus that causes COVID-19. In this cross-sectional study, the investigators sought to assess the prevalence of detected inflammatory heart disease in professional athletes with prior SARS-CoV-2 infection consistent with current screening recommendations. RTP.

The analysis included 789 professional athletes who were positively tested SARS-CoV-2 from May 2020 to October 2020 and subjected to RTP cardiac screening. The mean age in the cohort was 25 ± 3 (range, 19–41) years, and 777 (98.5%) were males. Among athletes, 460 (58.3%) had prior symptoms of COVID-19 disease, and 329 (41.7%) were asymptomatic or paucisymptomatic but tested positive for SARS-CoV-2.

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SARS-CoV-2 positive was diagnosed by polymerase chain reaction (PCR) testing in 587 (74.4%) athletes and antibody testing in 202 (25.6%) athletes. For athletes who tested positive for SARS-CoV-2 with a PCR test, cardiac screening was performed a mean 19 ± 17 (range, 3–156) days after a positive SARS-CoV-2 test. 2.

A total of 30 athletes had initial abnormal screening results and were sent for further testing. Cardiac magnetic resonance imaging (CMR) was performed on 27 athletes in this group. The sex test confirmed diagnosis of inflammatory heart disease in 5 (18.5%) of 27 athletes (0.6% of the total cohort); 3 athletes had CMR-confirmed myocarditis (0.4% of the total cohort), and 2 athletes had CMR-confirmed pericarditis (0.3% of the total cohort).

Athletes with confirmed inflammatory heart disease are barred from participating in their sport in accordance with RTP testing recommendations. The remaining 25 (83.3%) athletes who underwent further testing later had no findings suggesting severe heart damage and returned to play. No clinical cardiac events occurred in any of the athletes who had a heart examination and continued full activity in professional sports, as of late December 2020.

This study has significant limitations, according to the researchers. RTP diagnostic tests are performed in a clinical setting and are often reviewed and evaluated by team physicians and cardiologists throughout the United States and Canada, which can lead to different determinations of potential heart pathology and should for remote testing. There was also a time difference between the SARS-CoV-2 test and the heart test, and 98.5% of the athletes were male.

“We observed rare cases in athletes with potential cardiac involvement,” the study authors said. “This reporting on the systematic heart examination of RTP, even if not all in all athletic populations, can provide clinical guidance for other athletic organizations preparing and optimizing RTP protocols. . “

Revelation: Some of the authors report associating with sports leagues, associations, and teams. Please see the original reference for a full list of disclosures.


Martinez MW, Tucker AM, Bloom OJ, et al. Prevalence of coronary heart disease among professional athletes with prior COVID-19 infection who received systematic back-to-game cardiac screening. JAMA Cardiol. Published online March 4, 2021. doi: 10.1001 / jamacardio.2021.0565

This article originally appeared The Cardiology Advisor

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