CL_II_L: Clinical Medicine II. Lectures
Introduction:
The first research papers reported alarmingly high prevalence of COVID-19 related peri/myocardial involvement in the general population and soon became a focus of attention in athletes' population too.
Aims:
We aimed to create an post-COVID athletes' register to evaluate factors affecting safe return to play after COVID-19 infection.
Methods:
The athletes were first examined 2-4 weeks after the start of their infection. Our protocol comprised physical examination, 12 lead ECG, detailed blood testing and echocardiography. We performed additional examinations such as CT, CMR or Holter ECG as clinical findings necessitated.
Results:
We report the preliminary results of 240 athletes (141 males, avg. age 24,2±7,4 ys) of whom 202 are competitive athletes, 34% of them compete in their national team. Mean weekly training volume in the group was 11,3 hours.
The median symptomatic period was 5 days, the most common symptoms being smell and taste disturbance (58%) and headache (47%). Fever presented in 22% of the cases, cough and profound fatige was reported by 12%.
Ninety-five athletes were followed up on average 140 days after the initiation of their infection. Thirty-two percent of them reported persisting or recurring symptoms of which elevated resting heart rate and fatigue were the most common.
We had found elevated high sensitivity troponin T level in one asymptomatic athelte (17 ng/l, cut-off: 14) in whom a subsequently performed CMR excluded myocardial involvement.
Elevated D-dimer level was registered in 7 cases (5% of the samples) without evidence of ongoing thromboembolic event. CMR was performed in 61 cases based on symptoms or ECG alterations. We found no manifest pericarditis or myocarditis in either of the examined athletes.
Conclusion:
The low prevalence of post-COVID myocardial involvement in different athletes' groups may provide useful information for the optimisation of return to play protocols.
Funding:
Excellence Programme (2020-4.1.1.-TKP2020) of the Ministry for Innovation and Technology in Hungary, within the framework of the Therapeutic Development and Bioimaging thematic programmes of the Semmelweis University. This project was also supported by a grant from the National Research, Development and Innovation Office (NKFIH) of Hungary (K135076).
Semmelweis University, Doctoral School of Theoretical and Translational Medicine