Should College Athletes Compete After COVID-19 Infection?

In a research letter published by the JAMA Cardiology on September 11, 2020, researchers performed cardiac MRIs on college athletes (20 years of age; 58% men) who were referred to the sports medicine clinic after testing positive for COVID-19 between June and August 2020. None of the patients required hospitalization or were treated with antiviral therapy for COVID-19.

Of 26 competitive athletes, 4 (15%) had cardiac magnetic resonance (CMR) findings suggestive of myocarditis, and 8 additional athletes (30.8%) exhibited late gadolinium enhancement (LGE) without T2 elevation, which is suggestive of prior myocardial injury.

These researchers concluded saying 'cardiac magnetic resonance imaging has the potential to identify a high-risk cohort for adverse outcomes and may, importantly, risk stratify athletes for safe participation because CMR mapping techniques have a high negative predictive value to rule out myocarditis.'

This analysis is important since previous studies have identified myocarditis is a significant cause of sudden cardiac death in competitive athletes and can occur with normal ventricular function.