Key result
Asymptomatic or mildly symptomatic COVID-19 infection in high-level athletes was associated with a very low rate of cardiac abnormalities, with CMR scar prevalence comparable to uninfected controls (1.0% vs 3.6%).
Why the study?
Data were lacking on the cardiovascular sequelae of asymptomatic or mildly symptomatic SARS-CoV-2 infections among high- and elite-level athletes.
Does asymptomatic or mildly symptomatic COVID-19 infection cause cardiovascular sequelae in high-level athletes?
Cohort (n=950)
Yes
Does asymptomatic or mildly symptomatic COVID-19 infection cause cardiovascular sequelae in high-level athletes?
The very low incidence of cardiac abnormalities in athletes with mild or asymptomatic COVID-19 suggests that systematic cardiac screening before resuming training is unnecessary.
Answers are grounded in this paper and cite their sources.
Supports safe return to sport without routine cardiac screening after mild COVID in athletes; extends observational data but requires confirmation in larger cohorts.
BACKGROUND: There is a paucity of data on cardiovascular sequelae of asymptomatic/mildly symptomatic SARS-Cov-2 infections (COVID). OBJECTIVES: The aim of this prospective study was to characterize the cardiovascular sequelae of asymptomatic/mildly symptomatic COVID-19 among high/elite-level athletes. METHODS: 950 athletes (779 professional French National Rugby League (F-NRL) players; 171 student athletes) were included. SARS-Cov-2 testing was performed at inclusion, and F-NRL athletes were intensely followed-up for incident COVID-19. Athletes underwent ECG and biomarker profiling (D-Dimer, troponin, C-reactive protein). COVID(+) athletes underwent additional exercise testing, echocardiography and cardiac magnetic resonance imaging (CMR). RESULTS: )]. 2.6% COVID(+) athletes had abnormal ECGs, while 0.4% had an abnormal echocardiogram. During stress testing (following 7-day rest), COVID(+) athletes had a functional capacity of 12.8 ± 2.7 METS with only stress-induced premature ventricular ectopy in 10 (4.3%). Prevalence of CMR scar was comparable between COVID(+) athletes and controls [COVID(+) vs. COVID(-); 1/102 (1.0%) vs 1/28 (3.6%)]. During 289 ± 56 days follow-up, one athlete had ventricular tachycardia, with no obvious link with a SARS-CoV-2 infection. The proportion with troponin I and CRP values above the upper-limit threshold was comparable between pre- and post-infection (5.9% vs 5.9%, and 5.6% vs 8.7%, respectively). The proportion with D-Dimer values above the upper-limit threshold increased when comparing pre- and post-infection (7.9% vs 17.3%, P = 0.01). CONCLUSION: The absence of cardiac sequelae in pauci/asymptomatic COVID(+) athletes is reassuring and argues against the need for systematic cardiac assessment prior to resumption of training (clinicaltrials.gov; NCT04936503).
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Cochet et al. (2022) conducted a cohort in Asymptomatic or mildly symptomatic COVID-19 (n=950). Asymptomatic or mildly symptomatic COVID-19 infection vs. Uninfected athletes (COVID-19 negative) was evaluated on Prevalence of CMR scar. Asymptomatic or mildly symptomatic COVID-19 infection in high-level athletes was associated with a very low rate of cardiac abnormalities, with CMR scar prevalence comparable to uninfected controls (1.0% vs 3.6%).
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