Dangerous Covid Complication Casts a Shadow Over College Sports

A dangerous possible side effect of Covid-19 is looming over college athletics as some universities get set to take the field this fall.

About a dozen student athletes have experienced heart inflammation after being diagnosed with the disease caused by the coronavirus, the NCAA’s chief medical officer said Thursday, two days after the Big Ten and Pac-12 announced they would postpone fall sports.

Dr. Brian Hainline, the NCAA’s chief medical officer, said during a Thursday media briefing held by the Infectious Diseases Society of America that he was aware of about a dozen cases of myocarditis, a heart condition that can cause sudden death in young athletes. It’s not clear how many student athletes have been infected with the coronavirus since some schools aren’t releasing that information.

“I think we’re playing with fire. One case of myocarditis in an athlete is too many,” said Colleen Kraft, a fellow of the society and an associate professor of medicine at Emory University. “I don’t want to see stories of athletes who can no longer play who had promising careers.”

The Big Ten and Pac-12 scrapped sports this fall following tense discussions about the possible risks to players. The remaining three conferences that make up college football’s Power Five signaled they’d continue with their plans to play. Across pro sports, all the major leagues have begun or are about to start their seasons.

Baseball Outbreaks

How to play sports safely amid a pandemic has ignited fierce controversy. Outbreaks on the Miami Marlins and St. Louis Cardinals have threatened the professional baseball season. A number of college football programs have experienced cases of Covid-19 among its players, including Clemson University and Rutgers University.

Covid-19 tends to be milder in children and younger people. However, it’s a “myth” that to say they can’t become sick, said American Heart Association Chief Science Officer Mariell Jessup.

Myocarditis is one of the more frightening possible complications tied to Covid-19. It weakens the heart’s ability to pump blood and can cause abnormal rhythm, which in rare cases can result in sudden death.

It’s too early to say how many people with Covid-19 develop the heart inflammation, though viruses like influenza are known to also cause it in some patients, particularly young people. Recently published research from Germany suggested even people who weren’t hospitalized may be at risk.

Heart issues are especially dangerous for competitive athletes. Exercising intensely can create the ideal conditions for an abnormal heart rhythm, said Dr. Stephen Andrew McCullough, cardiologist and assistant professor of medicine at Weill Cornell Medicine and New York-Presbyterian. In some cases, an arrhythmia can cause a person to collapse and die.

“Forget about Covid,” said Dr. Rajat Deo, an associate professor of medicine at the Hospital of the University of Pennsylvania. “If you have an elite college athlete or even if you have a high school athlete on the JV swimming team with some degree of cardiac involvement, are you going to let that person compete?”

German Study

The German study found 78 of 100 recovered Covid-19 patients had cardiac impairment and 60 displayed heart inflammation. The median age of the people analyzed was 49, which cardiologists say makes it harder to translate the findings to young people.

Still, the results should be in the back of doctors’ minds as they evaluate athletes who have recovered from Covid-19, said Dr. Jeffrey Lander, co-director for sports cardiology at RWJBarnabas Health.

“There might be something going on heart-wise that we don’t know about,” said Lander, who is also the team cardiologist for Seton Hall University.

Dangerous Covid Complication Casts a Shadow Over College Sports

Doctors caution the phenomenon is probably very rare despite a few high-profile examples. Boston Red Sox star pitcher Eduardo Rodriguez was forced to opt out of the season after an MRI uncovered myocarditis, a diagnosis that calls for no physical activity for three to six months. Major League Baseball mandates that players who have tested positive for Covid-19 undergo a cardiac evaluation before returning, according to a person familiar with the league’s policies.

Doctors say athletes should be informed of what researchers know -- and what they don’t know -- about the possible risks, including myocarditis.

“What percentage of patients of Covid-19 will get it? We don’t know that number,“ McCullough said. “Even if that number is incredibly low, we have to ask the question is one death too many for something like an elective sport?”

©2020 Bloomberg L.P.

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