Diagnosing COVID-19 myocarditis in athletes using cMRI
Palak Patel1, Paul D Thompson1
1Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, United States.
Trends in Cardiovascular Medicine
|December 26, 2021
Summary
COVID-19 myocarditis in athletes may be over-diagnosed. Individualized evaluation and adherence to current guidelines are crucial for managing athletes post-COVID-19 infection to prevent unnecessary training restrictions.
Area of Science:
- Sports Cardiology
- Infectious Diseases
- Cardiovascular Medicine
Background:
- Early reports linked SARS-CoV-2 (COVID-19) to myocardial involvement, with elevated cardiac troponin I (cTnI) in hospitalized patients.
- Myocarditis, inflammation of the heart muscle, is associated with sudden cardiac death in athletes, raising concerns during the COVID-19 pandemic.
Purpose of the Study:
- To review the incidence and diagnostic approaches for myocarditis in athletes following COVID-19 infection.
- To assess the adherence to diagnostic guidelines and the heterogeneity in evaluating athletes post-COVID-19.
Main Methods:
- Systematic review of published reports on myocardial involvement in athletes after COVID-19 infection before June 2021.
- Analysis of studies using cardiac magnetic resonance imaging (cMRI) and adherence to myocarditis diagnostic criteria.
Main Results:
- Reported incidence of myocarditis in athletes post-COVID-19 ranged from 0% to 15.4% via cMRI, with significant heterogeneity in evaluation methods.
- Few studies followed established myocarditis diagnostic guidelines or included control groups of uninfected athletes.
- Evidence suggests a potential over-diagnosis of COVID-19 myocarditis in athletes.
Conclusions:
- The evaluation and management of myocarditis post-COVID-19 in athletes should be individualized and guided by current clinical standards.
- Appropriate management can prevent unnecessary training restrictions and allow athletes to return to competitive sports safely.
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