Cardiovascular Evaluation After COVID-19 in 137 Collegiate Athletes: Results of an Algorithm-Guided Screening
2021; Lippincott Williams & Wilkins; Volume: 143; Issue: 19 Linguagem: Inglês
10.1161/circulationaha.121.053982
ISSN1524-4539
AutoresBenjamin Hendrickson, Ryan E. Stephens, James V. Chang, Jacob M. Amburn, Lindsey L. Pierotti, Jessica L. Johnson, John C. Hyden, Jason N. Johnson, Ranjit Philip,
Tópico(s)Cardiac Imaging and Diagnostics
ResumoHomeCirculationVol. 143, No. 19Cardiovascular Evaluation After COVID-19 in 137 Collegiate Athletes: Results of an Algorithm-Guided Screening Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBCardiovascular Evaluation After COVID-19 in 137 Collegiate Athletes: Results of an Algorithm-Guided Screening Benjamin S. Hendrickson, Ryan E. Stephens, James V. Chang, Jacob M. Amburn, Lindsey L. Pierotti, Jessica L. Johnson, John C. Hyden, Jason N. Johnson and Ranjit R. Philip Benjamin S. HendricksonBenjamin S. Hendrickson Division of Pediatric Cardiology, Department of Pediatrics (B.S.H., J.V.C., J.N.J., R.R.P.), University of Tennessee Health Sciences Center, Memphis. Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). , Ryan E. StephensRyan E. Stephens College of Nursing (R.E.S.), University of Tennessee Health Sciences Center, Memphis. Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). , James V. ChangJames V. Chang Division of Pediatric Cardiology, Department of Pediatrics (B.S.H., J.V.C., J.N.J., R.R.P.), University of Tennessee Health Sciences Center, Memphis. Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). , Jacob M. AmburnJacob M. Amburn College of Medicine (J.M.A.), University of Tennessee Health Sciences Center, Memphis. , Lindsey L. PierottiLindsey L. Pierotti Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). , Jessica L. JohnsonJessica L. Johnson Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). , John C. HydenJohn C. Hyden Division of Sports Medicine, Department of Family Medicine (J.C.H.), University of Tennessee Health Sciences Center, Memphis. , Jason N. JohnsonJason N. Johnson https://orcid.org/0000-0003-0712-1123 Division of Pediatric Cardiology, Department of Pediatrics (B.S.H., J.V.C., J.N.J., R.R.P.), University of Tennessee Health Sciences Center, Memphis. Division of Pediatric Radiology, Department of Radiology (J.N.J.), University of Tennessee Health Sciences Center, Memphis. Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). and Ranjit R. PhilipRanjit R. Philip Ranjit R. Philip, MD, 49 North Dunlap Street, Memphis, TN 38104. Email E-mail Address: [email protected] https://orcid.org/0000-0003-3748-0215 Division of Pediatric Cardiology, Department of Pediatrics (B.S.H., J.V.C., J.N.J., R.R.P.), University of Tennessee Health Sciences Center, Memphis. Le Bonheur Children's Hospital, Heart Institute, Memphis, TN (B.S.H., R.E.S., J.V.C., L.L.P., J.L.J., J.N.J., R.R.P.). Originally published10 May 2021https://doi.org/10.1161/CIRCULATIONAHA.121.053982Circulation. 2021;143:1926–1928Concerns for cardiovascular sequelae of coronavirus disease 2019 (COVID-19), including myocardial injury or myocarditis, brought about recommendations for evaluating athletes after infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 Assessments that were based on symptoms, disease severity, and cardiovascular testing were refined to guide decision making and safe return to play in various groups.2 However, cardiac magnetic resonance (CMR) findings of myocarditis in athletes have ranged from as high as 15% (4 out of 26 athletes in one study) to as low as 1.4% (2 out of 145 athletes in another study), many of whom had no or only mild symptoms, have raised concerns around testing in this population.3,4 CMR is a recognized tool for diagnosing myocarditis yet is not generally recommended for athletes after COVID-19 without an elevated index of suspicion.2,5 Given limited data in competitive athletes after infection with SARS-CoV-2, we report our initial experience with an algorithm-guided screening of collegiate athletes and intermediate-term follow-up.Collegiate athletes were evaluated in sports cardiology clinic no sooner than 10 days after testing positive for SARS-CoV-2 by reverse transcriptase polymerase chain reaction. A 12-lead ECG, transthoracic echocardiogram, and conventional cardiac troponin I (cTn) level were obtained from all athletes regardless of symptom history or illness severity. Anyone with an abnormal test result or clinical evaluation of concern was referred for CMR. Those with normal evaluations and negative testing results or negative CMR were returned to full participation after a graduated reintroduction of exercise. Clinical follow-up occurred through communication with university athletic staff. The study was approved by the University of Tennessee Institutional Review Board. The data will be made available on reasonable request.We evaluated 137 athletes from July 9, 2020, to October 21, 2020. Athletes were young adults (median, 20 years; range, 18–27 years), majority male (n=93, 68%), and of various racial/ethnic backgrounds (Black, n=66, 48%; White, n=65, 47%; Hispanic, n=10, 7%). Median time to evaluation was 16 days (interquartile range, 12–34). A broad range of athletics was represented: football (n=51, 37%), dance (n=18, 13%), basketball (n=16, 12%), baseball (n=13, 10%), tennis (n=8, 6%), softball (n=7, 5%), soccer (n=7, 5%), cheer (n=6, 4%), track (n=5, 4%), volleyball (n=4, 3%), and golf (n=2, 1%). Students represented 3 universities and competed across National Collegiate Athletic Association Divisions 1 (majority), 2, and 3.Most athletes were symptomatic (n=112, 82%) and experienced only mild (n=75, 67%) or moderate (n=37, 33%) symptoms. The most frequent symptoms were loss of smell/taste (n=65, 58%), fever (<2 days, n=47, 42%), headache (n=46, 41%), and fatigue (n=45, 40%). Less frequently, shortness of breath (n=14, 12%) and chest pain/tightness (n=13, 11%) were reported. Black and Hispanic athletes were more often symptomatic than White athletes (86% and 100%, respectively, vs. 75%, P=0.046). No differences in symptoms occurred based on sex (P=0.34) or sport (P=0.64). No athlete had new symptoms or any problems after resuming exercise or during competition (days from positive test: median follow-up, 143; range, 113–239).Abnormal testing results were rare. No ECG was abnormal for an athlete. Echocardiography demonstrated no ventricular systolic or diastolic dysfunction, wall motion abnormalities, elevated right ventricular pressure estimates, or significant pericardial findings. Trace or small pericardial effusions were observed in 4 athletes (2.9%) with otherwise normal evaluations. cTnI levels were abnormal in 4 athletes (2.9%), ranging from 0.038 ng/mL to 0.103 ng/mL (laboratory 99th percentile, 0.034 ng/mL). One patient with elevated cTn (0.061 ng/mL) experienced no symptoms. Coronary artery ectasia was seen in 2 athletes (1.5%), 1 with elevated cTn (0.038 ng/mL).Five athletes (3.6%) with abnormal testing (eg, elevated cTn, coronary artery ectasia) were referred for CMR. No athlete had abnormal findings detected by CMR: no ventricular dysfunction, delayed myocardial enhancement, abnormal T2 weighted imaging, or pericardial pathology. Trace pericardial effusions were seen in 2. Athlete data and CMR results are shown in the Table.Table. Athletes With Abnormal Screening Tests and CMRI DataAthleteSexRace/ethnicityAge, ySportSymptomsAbnormal screeningTime to CMR, dLeft atrium size, ml/m2LV EDVi, ml/m2LVEF, %RV EDVi, ml/m2RVEF, %T2 weighted imagingLate gadolinium enhancementPericardial effusionCMR result1MaleBlack19FootballFatigue, anosmiaTroponin I (0.103 ng/mL)44381115310052NegativeNoTrivialNormal2MaleBlack23FootballUpper respiratory illness, fatigueCoronary artery ectasia1628102548260NegativeNoTrivialNormal3MaleBlack21FootballUpper respiratory illness, anosmiaTroponin I (0.051 ng/mL)152192569352NegativeNoNoNormal4MaleBlack19FootballUpper respiratory illness, fatigue, anosmiaTroponin I (0.038 ng/mL), coronary artery ectasia153793628862NegativeNoNoNormal5MaleBlack18BasketballNoneTroponin I (0.061 ng/mL)223090559552NegativeNoNoNormalCMRI indicates cardiac magnetic resonance imaging; EDVi, end-diastolic volume index; EF, ejection fraction; and LV, left ventricle.To conclude, in a moderately large and diverse group of collegiate athletes evaluated after testing positive for SARS-CoV-2, more than mild symptoms were uncommon, no one had severe illness, and there were few abnormal cardiovascular screening tests. CMR evaluations after an abnormal screening, which were almost all elevated cTn, demonstrated no imaging evidence consistent with myocardial injury or myocarditis. No athlete experienced new symptoms or problems after return to training and competition. On the basis of the outcomes and follow-up in our cohort, it is reasonable to defer cardiovascular screening in asymptomatic athletes or those with milder COVID-19 as outlined in current recommendations.2Limitations to this study include the retrospective and descriptive nature, absence of a SARS-CoV-2 negative control group, and screening with a non–high-sensitivity cTn. More comprehensive initial testing, such as ambulatory rhythm monitoring or exercise testing, was not used for screening, and asymptomatic arrhythmia or exercise abnormalities could have been undetected. In addition, the lack of systematic cardiac magnetic resonance imaging assessment of the entire cohort and limitations in the imaging protocol (absence of T1 mapping, T2 mapping, extracellular volume) could have lowered detection of possible myocardial abnormalities.Disclosures None.Footnoteshttps://www.ahajournals.org/journal/circRanjit R. Philip, MD, 49 North Dunlap Street, Memphis, TN 38104. Email rphilip@uthsc.eduReferences1. Phelan D, Kim JH, Chung EH. A game plan for the resumption of sport and exercise after coronavirus disease 2019 (COVID-19) infection.JAMA Cardiol. 2020; 5:1085–1086. doi:10.1001/jamacardio.2020.2136CrossrefMedlineGoogle Scholar2. Kim JH, Levine BD, Phelan D, Emery MS, Martinez MW, Chung EH, Thompson PD, Baggish AL. Coronavirus disease 2019 and the athletic heart: emerging perspectives on pathology, risks, and return to play.JAMA Cardiol. 2021; 6:219–227. doi: 10.1001/jamacardio.2020.5890CrossrefMedlineGoogle Scholar3. Rajpal S, Tong MS, Borchers J, Zareba KM, Obarski TP, Simonetti OP, Daniels CJ. Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19 infection.JAMA Cardiol. 2021; 6:116–118. doi: 10.1001/jamacardio.2020.4916CrossrefMedlineGoogle Scholar4. Starekova J, Bluemke DA, Bradham WS, Eckhardt LL, Grist TM, Kusmirek JE, Purtell CS, Schiebler ML, Reeder SB. Evaluation for myocarditis in competitive student athletes recovering from coronavirus disease 2019 with cardiac magnetic resonance imaging [published online January 14, 2021].JAMA Cardiol. 2021;e207444. doi:10.1001/jamacardio.2020.7444CrossrefGoogle Scholar5. Phelan D, Kim JH, Elliott MD, Wasfy MM, Cremer P, Johri AM, Emery MS, Sengupta PP, Sharma S, Martinez MW, et al. Screening of potential cardiac involvement in competitive athletes recovering from COVID-19: an expert consensus statement.JACC Cardiovasc Imaging. 2020; 13:2635–2652. doi: 10.1016/j.jcmg.2020.10.005CrossrefMedlineGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Snyders C, Dyer M, Sewry N, Jordaan E and Schwellnus M (2024) Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWARE VIII, Journal of Sport and Health Science, 10.1016/j.jshs.2023.10.005, 13:3, (280-287), Online publication date: 1-May-2024. Øvrebotten T, Mecinaj A, Stavem K, Ghanima W, Brønstad E, Durheim M, Lerum T, Josefsen T, Grimsmo J, Heck S, Omland T, Ingul C, Einvik G and Myhre P (2024) Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities, BMC Cardiovascular Disorders, 10.1186/s12872-024-03854-7, 24:1 Philip R, Sentilles C, Johnson J, Merlocco A, Ramakrishnan K, Ryan K, Boston U and Sathanandam S (2024) Lessons from the Pandemic: Role of Percutaneous ECMO and Balloon Atrial Septostomy in Multi-System Inflammatory Syndrome in Children, Journal of Clinical Medicine, 10.3390/jcm13082168, 13:8, (2168) CASTELLETTI S, GERVASI S, BALLARDINI E, CASASCO M, CAVARRETTA E, COLIVICCHI F, CONTURSI M, CUCCARO F, D'ASCENZI F, GAZALE G, MOS L, NISTRI S, PALMIERI V, PATRIZI G, SCORCU M, SPAMPINATO A, TIBERI M, ZITO G, ZORZI A, ZEPPILLI P and SCIARRA L The athlete after COVID-19 infection: what the scientific evidence? What to do? A position statement, Panminerva Medica, 10.23736/S0031-0808.22.04723-1, 66:1 Van Name J, Wu K and Xi L (2024) Myocarditis – A silent killer in athletes: Comparative analysis on the evidence before and after COVID-19 pandemic, Sports Medicine and Health Science, 10.1016/j.smhs.2024.03.003, Online publication date: 1-Mar-2024. de la Guía-Galipienso F, Palau P, Berenguel-Senen A, Perez-Quilis C, Christle J, Myers J, Haddad F, Baggish A, D'Ascenzi F, Lavie C, Lippi G and Sanchis-Gomar F (2024) Being fit in the COVID-19 era and future epidemics prevention: Importance of cardiopulmonary exercise test in fitness evaluation, Progress in Cardiovascular Diseases, 10.1016/j.pcad.2024.03.001, 83, (84-91), Online publication date: 1-Mar-2024. Li H, Cheng Z, Fu X, Liu M, Liu P, Cao W, Liang Z, Wang F and Sun B (2024) Decoding acute myocarditis in patients with COVID-19: Early detection through machine learning and hematological indices, iScience, 10.1016/j.isci.2023.108524, 27:2, (108524), Online publication date: 1-Feb-2024. Hofbauer T, Humann K, Neidenbach R and Scharhag J (2023) Myocarditis Screening Methods in Athletes After SARS-CoV-2 Infection – a Systematic Review, International Journal of Sports Medicine, 10.1055/a-2099-6725, 44:13, (929-940), Online publication date: 1-Dec-2023. Squeo M, Monosilio S, Gismondi A, Perrone M, Gregorace E, Lemme E, Di Gioia G, Mango R, Prosperi S, Spataro A, Maestrini V, Di Giacinto B and Pelliccia A (2023) Periodic health evaluation in athletes competing in Tokyo 2020: from SARS-CoV-2 to Olympic medals, BMJ Open Sport & Exercise Medicine, 10.1136/bmjsem-2023-001610, 9:4, (e001610), Online publication date: 1-Nov-2023. Broberg M, Mazer M and Cheifetz I (2023) Cardiovascular effects of COVID-19 in children, Annals of the Academy of Medicine, Singapore, 10.47102/annals-acadmedsg.V52N10p533, 52:10, (533-541) Broberg M, Mazer M and Cheifetz I (2023) Cardiovascular effects of COVID-19 in children, Annals of the Academy of Medicine, Singapore, 10.47102/annals-acadmedsg.202386, 52:10 - Correct DOI, (533-541) Flanagan H, Cooper R, George K, Augustine D, Malhotra A, Paton M, Robinson S and Oxborough D (2023) The athlete's heart: insights from echocardiography, Echo Research & Practice, 10.1186/s44156-023-00027-8, 10:1 Monosilio S, Prosperi S, Squeo M, Spataro S, Spataro A and Maestrini V (2023) Short and Long-Term Cardiovascular Sequelae after SARS-CoV-2 Infection: A Narrative Review Focusing on Athletes, Viruses, 10.3390/v15020493, 15:2, (493) Rezler Z, Ko E, Jin E, Ishtiaq M, Papaioannou C, Kim H, Hwang K, Lin Y, Colautti J, Davison K and Thakkar V (2023) The Impact of COVID-19 on the Cardiovascular Health of Emerging Adults Aged 18-25: Findings From a Scoping Review, CJC Pediatric and Congenital Heart Disease, 10.1016/j.cjcpc.2022.11.005, 2:1, (33-50), Online publication date: 1-Feb-2023. Chakraborty A, Johnson J, Spagnoli J, Amin N, Mccoy M, Swaminathan N, Yohannan T and Philip R (2022) Long-Term Cardiovascular Outcomes of Multisystem Inflammatory Syndrome in Children Associated with COVID-19 Using an Institution Based Algorithm, Pediatric Cardiology, 10.1007/s00246-022-03020-w, 44:2, (367-380), Online publication date: 1-Feb-2023. Ruberg F, Baggish A, Hays A, Jerosch-Herold M, Kim J, Ordovas K, Reddy G, Shenoy C, Weinsaft J and Woodard P (2022) Utilization of Cardiovascular Magnetic Resonance Imaging for Resumption of Athletic Activities Following COVID-19 Infection: An Expert Consensus Document on Behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention Leadership and Endorsed by the Society for Cardiovascular Magnetic Resonance, Circulation: Cardiovascular Imaging, 16:1, (e014106), Online publication date: 1-Jan-2023. Faghy M, Ashton R, Parizher G, Smith A, Arena R, Gough L and Emery M (2023) COVID-19 and elite sport: Cardiovascular implications and return-to-play, Progress in Cardiovascular Diseases, 10.1016/j.pcad.2022.11.014, 76, (61-68), Online publication date: 1-Jan-2023. Maestrini V, Penza M, Filomena D, Birtolo L, Monosilio S, Lemme E, Squeo M, Mango R, Di Gioia G, Serdoz A, Fiore R, Fedele F, Pelliccia A and Di Giacinto B (2023) Low prevalence of cardiac abnormalities in competitive athletes at return-to-play after COVID-19, Journal of Science and Medicine in Sport, 10.1016/j.jsams.2022.10.015, 26:1, (8-13), Online publication date: 1-Jan-2023. Alosaimi B, AlFayyad I, Alshuaibi S, Almutairi G, Alshaebi N, Alayyaf A, Alturaiki W and Shah M (2022) Cardiovascular complications and outcomes among athletes with COVID-19 disease: a systematic review, BMC Sports Science, Medicine and Rehabilitation, 10.1186/s13102-022-00464-8, 14:1, Online publication date: 1-Dec-2022. Mohammad K, Lin A and Rodriguez J (2022) Cardiac Manifestations of Post-Acute COVID-19 Infection, Current Cardiology Reports, 10.1007/s11886-022-01793-3, 24:12, (1775-1783), Online publication date: 1-Dec-2022. Rienks R, Holdsworth D, Davos C, Halle M, Bennett A, Parati G, Guettler N and Nicol E (2022) Cardiopulmonary assessment prior to returning to high-hazard occupations post-symptomatic COVID-19 infection: a position statement of the Aviation and Occupational Cardiology Task Force of the European Association of Preventive Cardiology, European Journal of Preventive Cardiology, 10.1093/eurjpc/zwac041, 29:13, (1724-1730), Online publication date: 18-Oct-2022. Rout A, Suri S, Vorla M and Kalra D (2022) Myocarditis associated with COVID-19 and its vaccines - a systematic review, Progress in Cardiovascular Diseases, 10.1016/j.pcad.2022.10.004, 74, (111-121), Online publication date: 1-Sep-2022. Ruuskanen O, Luoto R, Valtonen M, Heinonen O and Waris M (2022) Respiratory Viral Infections in Athletes: Many Unanswered Questions, Sports Medicine, 10.1007/s40279-022-01660-9, 52:9, (2013-2021), Online publication date: 1-Sep-2022. Lemes I, Smaira F, Ribeiro W, Favero N, Matos L, Pinto A, Dolan E and Gualano B (2022) Acute and post-acute COVID-19 presentations in athletes: a systematic review and meta-analysis, British Journal of Sports Medicine, 10.1136/bjsports-2022-105583, 56:16, (941-947), Online publication date: 1-Aug-2022. Temple V COVID-19 Pandemic and Individuals With Intellectual Disability: Special Olympics as an Example of Organizational Responses and Challenges, Adapted Physical Activity Quarterly, 10.1123/apaq.2021-0137, 39:3, (285-302) Symanski J, Tso J, Phelan D and Kim J (2022) Myocarditis in the Athlete, Clinics in Sports Medicine, 10.1016/j.csm.2022.02.007, 41:3, (455-472), Online publication date: 1-Jul-2022. Ling R, Ramanathan K, Tan F, Tai B, Somani J, Fisher D and MacLaren G (2022) Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis, The Lancet Respiratory Medicine, 10.1016/S2213-2600(22)00059-5, 10:7, (679-688), Online publication date: 1-Jul-2022. Maestrini V, Filomena D, Birtolo L, Serdoz A, Fiore R, Tatangelo M, Lemme E, Squeo M, Mango R, Di Gioia G, Fedele F, Gualdi G, Spataro A, Pelliccia A and Di Giacinto B (2022) Systematic Cardiovascular Screening in Olympic Athletes before and after SARS-CoV-2 Infection, Journal of Clinical Medicine, 10.3390/jcm11123499, 11:12, (3499) Holdsworth D, Chamley R, Barker-Davies R, O'Sullivan O, Ladlow P, Mitchell J, Dewson D, Mills D, May S, Cranley M, Xie C, Sellon E, Mulae J, Naylor J, Raman B, Talbot N, Rider O, Bennett A, Nicol E and Cysique L (2022) Comprehensive clinical assessment identifies specific neurocognitive deficits in working-age patients with long-COVID, PLOS ONE, 10.1371/journal.pone.0267392, 17:6, (e0267392) Doeblin P, Jahnke C, Schneider M, Al-Tabatabaee S, Goetze C, Weiss K, Tanacli R, Faragli A, Witt U, Stehning C, Seidel F, Elsanhoury A, Kühne T, Tschöpe C, Pieske B and Kelle S (2022) CMR findings after COVID-19 and after COVID-19-vaccination—same but different?, The International Journal of Cardiovascular Imaging, 10.1007/s10554-022-02623-x, 38:9, (2057-2071) Romagnoli S, Sbrollini A, Marcantoni I, Morettini M and Burattini L (2022) Review on Cardiorespiratory Complications after SARS-CoV-2 Infection in Young Adult Healthy Athletes, International Journal of Environmental Research and Public Health, 10.3390/ijerph19095680, 19:9, (5680) Satterfield B, Bhatt D and Gersh B (2021) Cardiac involvement in the long-term implications of COVID-19, Nature Reviews Cardiology, 10.1038/s41569-021-00631-3, 19:5, (332-341), Online publication date: 1-May-2022. Gluckman T, Bhave N, Allen L, Chung E, Spatz E, Ammirati E, Baggish A, Bozkurt B, Cornwell W, Harmon K, Kim J, Lala A, Levine B, Martinez M, Onuma O, Phelan D, Puntmann V, Rajpal S, Taub P and Verma A (2022) 2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play, Journal of the American College of Cardiology, 10.1016/j.jacc.2022.02.003, 79:17, (1717-1756), Online publication date: 1-May-2022. Modica G, Bianco M, Sollazzo F, Di Murro E, Monti R, Cammarano M, Morra L, Nifosì F, Gervasi S, Manes Gravina E, Zeppilli P and Palmieri V (2022) Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis, International Journal of Environmental Research and Public Health, 10.3390/ijerph19074279, 19:7, (4279) Patel P and Thompson P (2022) Diagnosing COVID-19 myocarditis in athletes using cMRI, Trends in Cardiovascular Medicine, 10.1016/j.tcm.2021.12.009, 32:3, (146-150), Online publication date: 1-Apr-2022. Petersen S, Friedrich M, Leiner T, Elias M, Ferreira V, Fenski M, Flamm S, Fogel M, Garg R, Halushka M, Hays A, Kawel-Boehm N, Kramer C, Nagel E, Ntusi N, Ostenfeld E, Pennell D, Raisi-Estabragh Z, Reeder S, Rochitte C, Starekova J, Suchá D, Tao Q, Schulz-Menger J and Bluemke D (2022) Cardiovascular Magnetic Resonance for Patients With COVID-19, JACC: Cardiovascular Imaging, 10.1016/j.jcmg.2021.08.021, 15:4, (685-699), Online publication date: 1-Apr-2022. Raman B, Bluemke D, Lüscher T and Neubauer S (2022) Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus, European Heart Journal, 10.1093/eurheartj/ehac031, 43:11, (1157-1172), Online publication date: 14-Mar-2022. Casasco M, Iellamo F, Scorcu M, Parisi A, Tavcar I, Brugin E, Martini B, Fossati C and Pigozzi F (2022) Return to Play after SARS-CoV-2 Infection in Competitive Athletes of Distinct Sport Disciplines in Italy: A FMSI (Italian Federation of Sports Medicine) Study, Journal of Cardiovascular Development and Disease, 10.3390/jcdd9020059, 9:2, (59) Koźlik M, Błahuszewska A and Kaźmierski M (2022) Cardiovascular System during SARS-CoV-2 Infection, International Journal of Environmental Research and Public Health, 10.3390/ijerph19031184, 19:3, (1184) Ruberg F, Baggish A, Hays A, Jerosch-Herold M, Kim J, Ordovas K, Reddy G, Shenoy C, Weinsaft J and Woodard P (2022) Utilization of cardiovascular magnetic resonance (CMR) imaging for resumption of athletic activities following COVID-19 infection: an expert consensus document on behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention (CVRI) Leadership and endorsed by the Society for Cardiovascular Magnetic Resonance (SCMR), Journal of Cardiovascular Magnetic Resonance, 10.1186/s12968-022-00907-8, 24:1, (73), Online publication date: 1-Jan-2022. van Hattum J, Spies J, Verwijs S, Verwoert G, Planken R, Boekholdt S, Groenink M, Malekzadeh A, Pinto Y, Wilde A and Jorstad H (2021) Cardiac abnormalities in athletes after SARS-CoV-2 infection: a systematic review, BMJ Open Sport & Exercise Medicine, 10.1136/bmjsem-2021-001164, 7:4, (e001164), Online publication date: 1-Oct-2021. Udelson J, Rowin E and Maron B (2021) Return to Play for Athletes After COVID-19 Infection, JAMA Cardiology, 10.1001/jamacardio.2021.2079, 6:9, (997), Online publication date: 1-Sep-2021. FILOMENA D, BIRTOLO L, PENZA M, GUALDI G, DI GIACINTO B and MAESTRINI V The role of cardiovascular magnetic resonance in the screening before the return-to-play of elite athletes after COVID-19: utility o futility?, The Journal of Sports Medicine and Physical Fitness, 10.23736/S0022-4707.21.12764-1, 61:8 May 11, 2021Vol 143, Issue 19 Advertisement Article InformationMetrics © 2021 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.121.053982PMID: 33970675 Originally publishedMay 10, 2021 Keywordscollegiate athletesCOVID-19myocarditisreturn to playPDF download Advertisement SubjectsBlood-Brain BarrierCADASILComputerized Tomography (CT)EchocardiographyElectrocardiology (ECG)Ethics and PolicyMagnetic Resonance Imaging (MRI)Nuclear Cardiology and PETThrombosis
Referência(s)