According to guidelines released today by the American College of Cardiology (ACC), student athletes between the ages of 14 and 25 infected with COVID-19 do not need to undergo diagnostic testing for myocarditis in the absence of cardiac symptoms.
Dr. Kimberly Harmon, section chief of sports medicine at the University of Washington School of Medicine, was a member of the ACC subgroup that authored its “Return to Play” recommendations.
Large registry-based studies have shown that the incidence of heart problems is not as high as initially feared and that diagnostic tests should be based on symptoms. If people have chest pain during their infection or upon returning to play, then they should have a diagnostic work-up, but other than that they should gradually return to exercise.”
Dr. Kimberly Harmon, Section Chief of Sports Medicine, University of Washington School of Medicine
When COVID-19 emerged, early patient data indicated that many infections appeared to involve the heart. In 2020, some single institution studies suggested that up to 50% of athletes could suffer from myocarditis, an inflammation of the heart, as a result of COVID-19 infection.
“Part of the reason the Pac-12 and Big 12 (college athletic conferences) halted play in August 2020. So we created the ORCCA Registry to track athletes across the country and see what happened to them after COVID infections.Our registry showed that 0.5% to 1% of athletes developed COVID-associated myocarditis – something we still need to pay attention to, but it’s well under 50%. And most athletes with myocarditis had cardiac symptoms,” Harmon said.
The new guidelines should help primary care providers and clinicians who perform sports physical exams, she added, as they have grappled with changing guidelines for patient recovery during the pandemic.
The return-to-play guidance was part of a larger report detailing the ACC’s recommended assessment and care for people experiencing cardiovascular effects from COVID-19.
Gluckman, Ty J. et al. (2022) 2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play: A Report of the American College of Cardiology Solution Set Oversight Committee. Journal of the American College of Cardiology. doi.org/10.1016/j.jacc.2022.02.003.