COVID-19 Linked To Pericardial Inflammation In Recovering Athletes

More than a third of college athletes recovering from uncomplicated COVID-19 infections show signs of pericardial inflammation, new findings show.

"Although subtle changes in myocardial structure and function were identified, no athlete showed specific imaging features to suggest an ongoing myocarditis," Dr. Partho Sengupta of West Virginia University in Morgantown and colleagues write. "Further studies are needed to understand the clinical implications and long-term evolution of these abnormalities in COVID-19."

Many patients with severe COVID-19 infection have myocardial injury, and there is evidence that some have lasting changes in ventricular structure and function, the authors note in JACC: Cardiovascular Interventions.

They looked at 54 athletes, 85% male, who tested positive for SARS-CoV-2, 38 of whom were symptomatic and 16 of whom had no symptoms. Twenty-four percent of the symptomatic patients had cardiac symptoms, versus 6% of the asymptomatic group.

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Echocardiography found ejection fraction of less than 50% with global hypokinesis in one symptomatic patient, while 11% of symptomatic and 13% of asymptomatic patients had reduced global longitudinal strain (GLS).

Forty-eight athletes underwent screening echocardiography and sequential cardiac magnetic resonance (CMR) imaging, which identified abnormalities in 27 (56.3%). Pericardial disease with pericardial enhancement was the most common abnormality, in 13 patients, while there were no signs of myocardial inflammation in any patients. Six of the patients with pericardial enhancement had additional myocardial abnormalities.

"It remains unclear whether the pericardial involvement seen in our study represents a primary viral involvement or identifies a more generalized COVID-19 related multisystem inflammatory syndrome," the authors note.

"While the immediate and long-term clinical relevance of these findings remain unclear, our study underscores that a mild or asymptomatic COVID-19 is not a benign illness considering that over half of the younger individuals showed subclinical myocardial and pericardial disease," they conclude.

—Reuters Staff

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