Key result
SARS-CoV-2 infection in highly trained athletes was associated with a modest 4.7% frequency of cardiac involvement on CMR, with no difference in CMR parameters compared to matched healthy controls.
Why the study?
The cardiovascular consequences of SARS-CoV-2 infection in highly trained, otherwise healthy athletes were not well defined compared with healthy athletic and less active controls.
Does SARS-CoV-2 infection cause cardiac involvement on CMR in highly trained athletes compared to matched controls?
Observational (n=147)
Does SARS-CoV-2 infection cause cardiac involvement on CMR in highly trained athletes compared to matched controls?
Cardiac involvement after SARS-CoV-2 infection in highly trained athletes is uncommon (4.7%), with definite myocarditis being rare (1.4%), and CMR parameters do not differ significantly from healthy matched athletes.
Does not support routine CMR screening in athletes post-SARS-CoV-2; leaves open need for prospective outcome studies.
OBJECTIVES: To investigate the cardiovascular consequences of SARS-CoV-2 infection in highly trained, otherwise healthy athletes using cardiac magnetic resonance (CMR) imaging and to compare our results with sex-matched and age-matched athletes and less active controls. METHODS: SARS-CoV-2 infection was diagnosed by PCR on swab tests or serum immunoglobulin G antibody tests prior to a comprehensive CMR examination. The CMR protocol contained sequences to assess structural, functional and tissue-specific data. RESULTS: One hundred forty-seven athletes (94 male, median 23, IQR 20-28 years) after SARS-CoV-2 infection were included. Overall, 4.7% (n=7) of the athletes had alterations in their CMR as follows: late gadolinium enhancement (LGE) showing a non-ischaemic pattern with or without T2 elevation (n=3), slightly elevated native T1 values with or without elevated T2 values without pathological LGE (n=3) and pericardial involvement (n=1). Only two (1.4%) athletes presented with definite signs of myocarditis. We found pronounced sport adaptation in both athletes after SARS-CoV-2 infection and athlete controls. There was no difference between CMR parameters, including native T1 and T2 mapping, between athletes after SARS-CoV-2 infection and the matched athletic groups. Comparing athletes with different symptom severities showed that athletes with moderate symptoms had slightly greater T1 values than athletes with asymptomatic and mildly symptomatic infections (p<0.05). However, T1 mapping values remained below the cut-off point for most patients. CONCLUSION: Among 147 highly trained athletes after SARS-CoV-2 infection, cardiac involvement on CMR showed a modest frequency (4.7%), with definite signs of myocarditis present in only 1.4%. Comparing athletes after SARS-CoV-2 infection and healthy sex-matched and age-matched athletes showed no difference between CMR parameters, including native T1 and T2 values.
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Szabó et al. (2021) conducted an observational in SARS-CoV-2 infection (n=147). SARS-CoV-2 infection vs. Sex-matched and age-matched athletes and less active controls was evaluated on Cardiac involvement on CMR. SARS-CoV-2 infection in highly trained athletes was associated with a modest 4.7% frequency of cardiac involvement on CMR, with no difference in CMR parameters compared to matched healthy controls.
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