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Cardiac Troponin Testing as a Component of Return to Play Cardiac Screening in Young Competitive Athletes Following SARS‐CoV‐2 Infection

2022; Wiley; Volume: 11; Issue: 16 Linguagem: Inglês

10.1161/jaha.122.025369

2047-9980

Nathaniel Moulson, Bradley J. Petek, Timothy W. Churchill, Jonathan A. Drezner, Kimberly G. Harmon, Stephanie Kliethermes‌, Pranav Mellacheruvu, Manesh R. Patel, Aaron L. Baggish, Irfan M. Asif, Aaron L. Baggish, James Borchers, Jonathan A. Drezner, Katherine M. Edenfield, Michael S. Emery, Kyle Goerl, Brian Hainline, Kimberly G. Harmon, Pei‐Ni Jone, Jonathan H. Kim, Stephanie Kliethermes‌, William E. Kraus, Rachel Lampert, Matthew Leiszler, Benjamin D. Levine, Matthew W. Martinez, Nathaniel Moulson, Francis G. O’Connor, Manesh R. Patel, Bradley J. Petek, Dermot Phelan, Lawrence D. Rink, Herman A. Taylor, Carl J. Ade, Aryan Aiyer, Jarrah Alfadhli, Chloe Amaradio, Scott F. Anderson, Stephanie Arlis‐Mayor, Jonathan S. Aubry, Andrea M. Austin, Brenden J. Balcik, Timothy A. Beaver, Nicolas Benitez, Brant Berkstresser, Thomas M. Best, Tiffany Bohon, Jonathan P. Bonnet, Elizabeth Boyington, James E. Bray, Jenna Bryant, Jeffrey Bytomski, Sean Carnahan, Rachel Chamberlain, Samantha Charters, Nicholas Chill, Daniel E. Clark, Douglas Comeau, Laura Cook, Deanna Corey, Amy Costa, Marshall Crowther, Tarun Dalia, Craig Davidson, Kaitlin Davitt, Annabelle de St. Maurice, Peter N. Dean, Jeffrey M. Dendy, Katelyn DeZenzo, Courtney Dimitris, Jeanne Doperak, Calvin Duffaut, Craig Fafara, Katherine Fahy, Jason Ferderber, Megan Finn, Frank A. Fish, R. Warne Fitch, Angelo Galante, Todd Gerlt, Amy Gest, Carla Gilson, Jeffrey J. Goldberger, Joshua Goldman, Erich Groezinger, Jonathan R. Guin, Heather Halseth, Joshua M. Hare, Beth Harness, Nicolas Hatamiya, Julie Haylett, Neal Hazen, Sean G. Hughes, Yeun Hiroi, Amy Hockenbrock, Amanda Honsvall, Jennifer L. Hopp, Julia Howard, Samantha Huba, Mustafa Husaini, Lindsay Huston, Calvin Hwang, Laura Irvin, Val Gene Iven, Robert B. Jones, Donald Joyce, Kristine A. Karlson, Jeremy Kent, Christian F. Klein, Chris Klenck, Michele Kirk, Jordan Knight, Laura Knippa, Madeleine Knutson, Louis E. Kovacs, Yumi Kuscher, Andrea Kussman, Chrissy Landreth, Amy Leu, Dylan Lothian, Maureen H. Lowery, Andrew Lukjanczuk, John M. MacKnight, Lawrence M. Magee, Marja‐Liisa Magnuson, Aaron V. Mares, Anne Marquez, Grant McKinley, Scott Meester, Megan Meier, Pranav Mellacheruvu, Christopher O. Miles, Emily S. Miller, Hannah Miller, Raul D. Mitrani, Aaron J. Monseau, Benjamin Moorehead, Robert J. Myerburg, Greg Mytyk, Andrew Narver, Aurelia Nattiv, Laika Nur, Brooke E. Organ, Meredith Pendergast, Frank A. Pettrone, Jordan E. Pierce, Sourav Poddar, Diana Priestman, Ian Quinn, Fred Reifsteck, Morgan Restivo, James B. Robinson, Ryan Roe, Thomas Rosamond, Carrie Rubertino Shearer, Diego Riveros, Miguel Rueda, Takamasa Sakamoto, Brock Schnebel, Ankit B. Shah, Alan Shahtaji, Kevin Shannon, Polly Sheridan‐Young, Jonathon H. Soslow, Siobhan M. Statuta, Mark Stovak, Andrei Tarsici, Kenneth S. Taylor, Kim Terrell, Matt Thomason, Jason Tso, Daniel Vigil, Francis Wang, Jennifer Winningham, Susanna T. Zorn,

Cardiomyopathy and Myosin Studies

Background Initial protocols for return to play cardiac testing in young competitive athletes following SARS-CoV-2 infection recommended cardiac troponin (cTn) to screen for cardiac involvement. This study aimed to define the diagnostic yield of cTn in athletes undergoing cardiovascular testing following SARS-CoV-2 infection. Methods and Results This prospective, observational cohort study from ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) included collegiate athletes who underwent cTn testing as a component of return to play protocols following SARS-CoV-2 infection. The cTn values were stratified as undetectable, detectable but within normal limits, and abnormal (>99% percentile). The presence of probable or definite SARS-CoV-2 myocardial involvement was compared between those with normal versus abnormal cTn levels. A total of 3184/3685 (86%) athletes in the ORCCA database met the inclusion criteria for this study (age 20±1 years, 32% female athletes, 28% Black race). The median time from SARS-CoV-2 diagnosis to cTn testing was 13 days (interquartile range, 11, 18 days). The cTn levels were undetectable in 2942 athletes (92%), detectable but within normal limits in 210 athletes (7%), and abnormal in 32 athletes (1%). Of the 32 athletes with abnormal cTn testing, 19/32 (59%) underwent cardiac magnetic resonance imaging, 30/32 (94%) underwent transthoracic echocardiography, and 1/32 (3%) did not have cardiac imaging. One athlete with abnormal troponin met the criteria for definite or probable SARS-CoV-2 myocardial involvement. In the total cohort, 21/3184 (0.7%) had SARS-CoV-2 myocardial involvement, among whom 20/21 (95%) had normal troponin testing. Conclusions Abnormal cTn during routine return to play cardiac screening among competitive athletes following SARS-CoV-2 infection appears to have limited diagnostic utility.