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Vitamin D Status and Cardiovascular Disease in College Athletes After SARS-CoV-2 Infection
William L Hollabaugh1,2, Alicia Hymel1, Jacquelyn S Pennings1,3
1Division of Sports Medicine, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Objective:
To evaluate the association between vitamin D status and CV disease after COVID-19 in college athletes.
Design:
Retrospective cohort study.
Setting:
National College Athletic Association Division-I college athletes from a single academic institution.
Patients:
A total of 157 athletes (60 female; median age: 20 years) from 9 sports with a positive SARS-CoV-2 test, cardiac magnetic resonance imaging (CMR), and vitamin D level.
Independent Variables:
Serum 25-hydroxyvitamin D level (primary); age, sex (regression models).
Main Outcomes Measures:
Differences in age, sex, race, ethnicity, myocarditis, pericarditis, and CMR metrics by vitamin D status were analyzed. Regression models were used to assess the relationship between vitamin D status and CMR metrics accounting for age and sex.
Results:
Low vitamin D (LVD) was found in 33 (21.0%) of athletes, particularly Black males ( P < 0.001). Athletes with LVD had higher biventricular and lower mid-ventricular extracellular volumes, but these differences were not significant when corrected for age and sex. Athletes with LVD had higher left ventricle (LV) mass ( P < 0.001) and LV mass index ( P = 0.001) independent of age and sex. Differences in global circumferential strain were noted but are likely clinically insignificant. Vitamin D status did not associate with myocarditis and pericarditis ( P = 0.544).
Conclusions:
LVD is common in athletes, particularly in Black males. Although athletes with LVD had higher LV mass, cardiac function and tissue characterization did not differ by vitamin D status. Future studies are needed to determine if the differences in LV mass and LV mass index by vitamin D status are clinically significant. This study suggests that vitamin D status does not impact the development of myocarditis or pericarditis after COVID-19 infection.
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