Cardiologists say spread of COVID-19 not the only concern with returning to sports

Medical Watch

As debate rages on about safety and sports during the pandemic – particularly college football – cardiologists have a warning about post-COVID heart damage that could be a game-changer.

Many teams have been sidelined by the threat of COVID-19, but it’s not just about the risk of the potential for transmission.

Dr. John Erwin, a cardiologist at NorthShore University HealthSystem, says there have been people with relatively mild COVID symptoms that developed a potentially serious complication of the virus: myocarditis or inflammation of the heart.

“Typically there is some chest discomfort, some palpitations, some lightheadedness, possibly even passing out, increasing shortness of breath when they exert themselves  – and that is a fairly common symptom when people are recovering from COVID right now is that shortness of breath,” Erwin said.

The question of to play or not to play is causing widespread debate this fall among schools and student athletes. Erwin knows football; he played in college.

“I am quick to tell people that any inkling of success that I’ve had in my life comes more from what I learned on the field and the weight room than I really learned in a classroom,” he said.  “Endurance, camaraderie – and it takes a whole team to make success.”

Myocarditis is not specific to SARS-CoV-2, the virus that causes COVID-19. Other viruses can enter the heart and cause the same problems. Some patients may not have symptoms but Northwestern Medicine cardiologist Dr Sadiya Khan says that’s not always the case.

“Some people may never have any symptoms or problems related to that others may and they may develop heart failure, their heart muscle may weaken or stay weak for a long time to come,” Khan said.

“One of our biggest concerns is that we know inflammation or myocarditis can put people at risk for having heart rhythm problems and even potentially collapsing or dying so that is of course the gravest concern,” Khan said. “How common is that, how likely is that? We don’t have those answers yet, but is any risk of that enough to be able to tolerate saying that we are going to let our children and our young adults play?”

While the rate of myocarditis in older COVID-19 patients is estimated to be 20 percent or higher, doctors don’t yet know how prevalent the condition is among younger patients who have had the virus.

“It’s hard to know so far because those tests aren’t routinely being done in young patients who are not in the hospital and who are not necessarily even being tested,” Khan said. “So we don’t have great information in young adults other than the cases that we’ve heard from some of the athletes that have come forward that have myocarditis or that inflammation.”

“What we do know is we have a very low mortality rate in student-athlete aged population at this point,” Erwin said.

And what about the weekend warriors? Are those who exercise at risk? If you have any symptoms of myocarditis like shortness of breath, chest discomfort or palpitations and lightheadedness Erwin said to see a doctor.

“I think the biggest thing I can tell our audience is to make sure and get that checked out,” he said. “Don’t say, ‘Oh, I’m still trying to recover and I’m just weak.’ Go get it checked out.”

When it comes to college sports, Erwin belives there’s a middle ground. He’s advocating for a return to the field with specific protocols in place, including diligent monitoring of student athletes who have tested positive for the virus – but schools must have the proper medical resources available.

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