Cardiac Events in College Athletes 1 Year After SARS-CoV-2 Infection

SUMMARY

A prospective registry study confirms extremely low risk for adverse cardiac outcomes.

Concerns about the high frequency of myocarditis in athletes infected with SARS-CoV-2, and the possibility of life-threatening arrhythmias, led to various protocols and the development of prospective registries. In the current study, the Outcomes Registry for Cardiac Conditions in Athletes Study Group prospectively followed 3675 athletes from 45 colleges and universities to assess their risk for adverse cardiovascular events after SARS-CoV-2 infection.

Cardiovascular testing including electrocardiogram, troponin, echocardiogram, or cardiac magnetic resonance imaging was performed in 97% of athletes. Definite or probable myocarditis was found in 21 athletes (0.6%), who were temporarily restricted from sport and later cleared to resume.

During a median follow-up of 1.2 years among all athletes, only two cardiac events occurred (incidence rate, 0.05%). One was a cardiac arrest in an athlete subsequently discovered to have a preexisting genetic structural cardiac disease, and the other was atrial fibrillation that was possibly related to SARS-CoV-2 infection.

COMMENT

"The fear of SARS-CoV-2–related cardiac complications in young athletes is exaggerated. In this large prospective registry study, myocarditis was rare, and cardiac events even rarer. While we still need to work up and treat athletes with cardiac symptoms, universal screening of all athletes who acquire SARS-CoV-2 infection is unnecessary".

Petek BJ et al. Cardiovascular outcomes in collegiate athletes following SARS-CoV-2 infection: 1-year follow-up from the Outcomes Registry for Cardiac Conditions in Athletes. Circulation 2022 May 31; 145:1690

Summary by NEJM