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Is cardiac involvement prevalent in highly trained athletes after SARS-CoV-2 infection? A cardiac magnetic resonance study using sex-matched and age-matched controls.

Authors
  • Szabó, Liliána1
  • Juhász, Vencel1
  • Dohy, Zsófia1
  • Fogarasi, Csenge1
  • Kovács, Attila1
  • Lakatos, Bálint Károly1
  • Kiss, Orsolya1, 2
  • Sydó, Nóra1, 2
  • Csulak, Emese1
  • Suhai, Ferenc Imre1
  • Hirschberg, Kristóf1
  • Becker, Dávid1
  • Merkely, Béla1, 2
  • Vágó, Hajnalka3, 2
  • 1 Heart and Vascular Center, Semmelweis University, Budapest, Hungary. , (Hungary)
  • 2 Department of Sports Medicine, Semmelweis University, Budapest, Hungary. , (Hungary)
  • 3 Heart and Vascular Center, Semmelweis University, Budapest, Hungary [email protected] , (Hungary)
Type
Published Article
Journal
British Journal of Sports Medicine
Publisher
BMJ
Publication Date
May 01, 2022
Volume
56
Issue
10
Pages
553–560
Identifiers
DOI: 10.1136/bjsports-2021-104576
PMID: 34848398
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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. 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. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

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