Positive SARS-CoV-2 Diagnosis Has Modest Effects On Resting Indices Of Cardiac Conduction And Repolarization In Division-I NCAA Athletes

Abstract

PURPOSE: Positive diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may precipitate cardiac injury through alterations in ion channels and calcium handling. This, in turn, can be adversely cardiac conduction and/or repolarization. This study tested the hypothesis that SARS-CoV-2 infection alters indices of cardiac conduction and repolarization in Division-I NCAA athletes. METHODS: As part of preparticipation screening resting 12 lead electrocardiogram (ECG) measurements were performed (pre-SARS-CoV-2). Following a positive SARS-CoV-2 diagnosis, athletes completed the same ECG protocol. Ventricular rate, PR duration, QRS duration, QT interval duration, corrected QT interval, and the axis of the P-wave, QRS complex, and T-wave were evaluated. Data are presented as mean ± SD. RESULTS: Data were analyzed from 71 athletes (28 women; 83% White, 9% Black or African American, 7% Hispanic or Latino, and 1% Asian) from 15 different sports. On average there were 57 ± 25 days between the pre and to post COVID-19 testing. Seventy five percent of athletes reported common symptoms of infection including headache (60%), sore throat (54%), fatigue (48%), loss of taste and smell (48%), body aches (33%), cough (33%), fever (31%), shortness of breath (19%), nausea, vomiting, diarrhea (10%), chest pain (8%). The average duration of athletes experiencing symptoms was 5 ± 3 days. Following infection, resting ventricular rate increased 5 ± 12 bpm (pre: 60 ± 10 bpm; post: 65 ± 13 bpm, p < 0.01, d = 0.40). No differences were observed in the PR interval (pre: 146 ± 35 ms; post: 151 ± 16 ms, p = 0.30, d = 0.18) or QRS interval following COVID-19 (pre: 96 ± 10 ms; post: 95 ± 10 ms, p = 0.41, d = 0.13). QT interval decreased 15 ± 26 ms (pre: 409 ± 27 ms; post: 394 ± 32 ms, p < 0.01, d = 0.59), corrected QT interval also decreased 5 ± 14 ms (pre: 408 ± 20 ms; 403 ± 16 ms, p < 0.04, d = 0.32). P-axis increased 8 ± 18° (pre: 54 ± 20°; post: 63 ± 14°, p < 0.01, d = 0.45) following COVID-19. No differences between pre and post COVID-19 were observed in QRS-axis (pre: 82 ± 12°; post: 83 ± 12°, p = 0.15, d = 0.22) or T-axis (pre: 53 ± 18°; post: 55 ± 16°, p = 0.12, d = 0.24). CONCLUSIONS: Though preliminary, these data suggest a positive SARS-CoV-2 diagnosis has modest impact on indices of cardiac conduction and repolarization in NCAA division-I athletes.