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Study finds cardiac problems in pro athletes who battled COVID-19 are RARE

Heart inflammation is uncommon in pro athletes who've had mostly mild COVID-19 and most don't need to be sidelined, according to a study conducted by major professional sports leagues.

The results are not definitive, outside experts say, and more independent research is needed. But the study published Thursday in JAMA Cardiology is the largest to examine the potential problem. The coronavirus can cause inflammation in many organs, including the heart.

The research involved professional athletes who play football, hockey, soccer, baseball and men's and women's basketball. All tested positive for COVID-19 before October and were given guideline-recommended heart tests, nearly 800 total. 

Red Sox pitcher Eduardo Rodriguez (right) jokes with teammates on February 26 at the team's spring training facility in Fort Myers, Florida after missing the 2020 season due to COVID-19

None had severe COVID-19 and 40 percent had few or no symptoms - what might be expected from a group of healthy elite athletes with an average age of 25. Severe COVID-19 is more common in older people and those with chronic health conditions.

Almost 4 percent had abnormal results on heart tests done after they recovered but subsequent MRI exams found heart inflammation in less than 1 percent of the athletes. These five athletes all had COVID-19 symptoms. Whether their heart problems were caused by the virus is unknown although the researchers think that is likely.

They were sidelined for about three months and returned to play without any problems, said Dr. Mathew Martinez of Morristown Medical Center in New Jersey. He's the study's lead author and team cardiologist for football's New York Jets.

Dr. Mathew Martinez of Morristown Medical Center in New Jersey is the study's lead author and team cardiologist for the Jets

Some athletes have suffered considerably with coronavirus. Buffalo Bills tight end Tommy Sweeney, Jaguars running back Ryquell Armstead, and Boston Red Sox pitcher Eduardo Rodriguez missed all or some their 2020 seasons after contracting coronavirus. 

Sweeney suffered from an enlarged heart, the Bills announced in November, while Armstead was hospitalized twice while battling complications from coronavirus. 

Meanwhile, Orlando Magic center Mo Bamba is only just starting to return to form after battling effects of coronavirus for several months. 

Two previous smaller studies in college athletes recovering from the virus suggested heart inflammation might be more common. The question is of key interest to athletes, who put extra stress on their hearts during play, and undetected heart inflammation has been linked with sudden death.

The Jaguars' Ryquell Armstead was hospitalized twice while battling COVID-19 complications

Yankees slugger Clint Frazier wears a mask as he steps to the plate for a game in September

Whether mild COVID-19 can cause heart damage 'is the million-dollar question,' said Dr. Richard Kovacs, co-founder of the American College of Cardiology's Sports & Exercise Council. And whether severe COVID-19 symptoms increase the chances of having fleeting or long-lasting heart damage 'is part of the puzzle,' he said.

Bills tight end Tommy Sweeney (pictured) is suffering from an inflamed heart - a condition that is believed to have resulted from COVID-19, according to head coach Sean McDermott

Kovacs said the study has several weaknesses. Testing was done at centers affiliated or selected by each team, and results were interpreted by team-affiliated cardiologists, increasing the chances of bias. More rigorous research would have had standardized testing done at a central location and more objective specialists interpret the results, he said.

Also, many of the athletes had no previous imaging exams to compare the results with, so there is no way to know for certain if abnormalities found during the study were related to the virus.

'There is clearly more work to do but I think it is very helpful additional evidence," said Dr. Donald Lloyd-Jones, president-elect of the American Heart Association.

Dr. Dial Hewlett, a member of a COVID-19 task force at the National Medical Association, which represents Black physicians, said the study 'is extremely timely.' Hewlett is a deputy health commissioner for New York's Westchester County and advises high schools and colleges on when to allow young athletes to return to play after COVID-19 infections.

'I'm grateful that we are starting to get some data to help guide us in some of our decisions,' Hewlett said.

The Myocarditis Foundation in August reported that while myocarditis is a rare cardiovascular disease, it has been reported in patients diagnosed with COVID-19. It is a condition caused by the body's immune system's response to infection and can lead to shortness of breath, chest pain and heart palpitations. The foundation recommends athletes abstain from participating in competitive sports for a minimum of three months before being re-examined. However, more recent studies have found that heart inflammation may not be a major issue for professional athletes who suffered mild to moderate COVID-19 symptoms during their infection 

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