Abstract
There is increasing evidence of cardiac involvement post-SARS-CoV-2 infections in symptomatic as well as in oligo- and asymptomatic athletes. This study aimed to characterize the possible early effects of SARS-CoV-2 infections on myocardial morphology and cardiopulmonary function in athletes. Eight male elite handball players (27 ± 3.5 y) with past SARS-CoV-2 infection were compared with four uninfected teammates (22 ± 2.6 y). Infected athletes were examined 19 ± 7 days after the first positive PCR test. Echocardiographic assessment of the global longitudinal strain under resting conditions was not significantly changed (− 17.7% vs. − 18.1%). However, magnetic resonance imaging showed minor signs of acute inflammation/oedema in all infected athletes (T2-mapping: + 4.1 ms, p = 0.034) without reaching the Lake-Louis criteria. Spiroergometric analysis showed a significant reduction in VO2max (− 292 ml/min, − 7.0%), oxygen pulse (− 2.4 ml/beat, − 10.4%), and respiratory minute volume (VE) (− 18.9 l/min, − 13.8%) in athletes with a history of SARS-CoV2 infection (p < 0.05, respectively). The parameters were unchanged in the uninfected teammates. SARS-CoV2 infection caused impairment of cardiopulmonary performance during physical effort in elite athletes. It seems reasonable to screen athletes after SARS-CoV2 infection with spiroergometry to identify performance limitations and to guide the return to competition.
Highlights
There is increasing evidence of cardiac involvement post-SARS-CoV-2 infections in symptomatic as well as in oligo- and asymptomatic athletes
The global coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) affected all age groups, including young and physically active individuals
We evaluated parameters of spiroergometry, as well as echocardiography and magnetic resonance imaging (MRI)
Summary
There is increasing evidence of cardiac involvement post-SARS-CoV-2 infections in symptomatic as well as in oligo- and asymptomatic athletes. This study aimed to characterize the possible early effects of SARS-CoV-2 infections on myocardial morphology and cardiopulmonary function in athletes. Outbreaks in professional teams represent a potential risk for all athletes involved To this date, a validated screening strategy for myocardial effects of SARS-CoV-2 in elite athletes is missing. The study aims to characterize the possible cardiac involvement of a SARS-CoV-2 infection in athletes. For this purpose, we evaluated parameters of spiroergometry, as well as echocardiography and magnetic resonance imaging (MRI). Clinical parameter N Age,y Weight, kg Height, cm Time from the positive COVID-19 test result to clinical tests, d Clinical symptoms No symptoms, No Headache, No Rhinitis, No No sense of taste and/or smell, No Chest pain, No Breathing problems, No Sore throat, cough, sniffles, No Listlessness, No Aching limbs, No ECG-abnormalities rest, No ECG-abnormalities exercise, No Echocardiographic measurements Global longitudinal strain (GLS), % Pericardial effusion, No Cardiac MRI measurements (left ventricular) Ejection fraction, % End-diastolic volume index, ml/m2 End-systolic volume index, ml/m2 Stroke volume index, ml/m2 Native T1 value, ms (reference: 1250 ms) Base Middle Apex Number of segments above reference Native T2 value, ms (reference: 45 ms) Base Middle Apex Number of segments above reference Late gadolinium enhancement present, No
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