The World Health Organisation (WHO) formally proclaimed COVID-19, the illness spread by a zoonotic SARS-CoV-2, as a pandemic in March 2020, after it had started to spread in late 2019. Even though the pandemic is on the wane, new studies and evidence about it continue to emerge. And, addressing myocardial infarction, recent studies have shown that 1-4% of Athletes untimely die due to myocarditis caused by COVID-19.
Covid-19 and Risk of Myocarditis in Athletes: Recent Studies
There is growing evidence that the SARS-CoV-2 version of the Covid-19 virus can directly infiltrate myocardial cells. The infiltration is also frequently accompanied by a potent inflammatory cytotoxic T-cell response and an innate and adaptive immune system hyperactivation driven by interferons.
Moreover, autopsy reports show that cardiac necrosis, lymphocytic infiltration of the myocardium, small coronary vessel micro thrombosis, and cardiac dilatation are the most common pathological findings regarding cardiac involvement.
Latest ECG Study on Myocarditis by Covid by UK Team
Cardiovascular Clinical Academic Group, St. George’s, University of London recently studied electrocardiographic abnormalities in 511 professional soccer players with SARS-CoV-2 infections.
They selected 511 SARS-CoV-2-infected soccer players from 36 clubs in the United Kingdom, Brazil, and the Netherlands. The population consisted of 88% male players with a mean age of 21 (x̄). Players previously received an electrocardiogram (ECG) performed an average of 239 days before infection. And after the illness, they had their ECG 11 days later on average.
12-Lead ECG statistics of Athletes
In 17 (3%) of the athletes, the researchers discovered de-novo ECG alterations. Low-amplitude, flat, or inverted T waves were among the abnormalities.
Following COVID-19 infection, 3% of athletes showed de novo ECG abnormalities, and 88% of these individuals had cardiac inflammation. The majority of impacted athletes reported cardiac symptoms.
Compared to 12% of athletes who did not have de-novo ECG changes and had Covid-19 symptoms for just two days, athletes with de-novo ECG alterations had a greater prevalence of cardiovascular symptoms and a median symptom duration of five days.
Different studies have found varying rates of COVID-19-related myocarditis in the population of athletes, although the overall estimated rate is meager —around 1%. However, the estimation rate is about 4% if a CMR examination is ordered because of a clinical-instrumental suspicion. Recognizing and treating myocarditis is crucial even if the rate continues to be low because it is still one of the leading causes of SCD among athletes.
Like other critically ill COVID-19 patients, athletes also appear to benefit from steroids. Providers should consider concomitant myocarditis if patients with COVID-19 show signs of cardiac damage, such as ECG abnormalities or increased troponin. In most cases, echocardiography is sufficient for diagnosis, but if more sophisticated techniques are available, they can be used.
ECG accessibility with high accuracy also becomes vital in such scenarios. As a Medical Professional, you can also try our 12L Pro ECG device to capture hospital-grade ECG anytime, anywhere. Finally, Takotsubo cardiomyopathy should be considered in COVID-19 patients with acute cardiac failure since it exhibits a clinical picture resembling viral myocarditis.