Cardiac Magnetic Resonance changes in athletes in the post-COVID era: A literature review
DOI:
https://doi.org/10.33448/rsd-v12i9.43242Keywords:
Post-Acute COVID-19 Syndrome; Athletes; Mycarditis.Abstract
Introduction: COVID-syndrome presents itself as a post-systemic state with symptoms and the development of possible late sequelae after the acute disease state has subsided. Among these sequelae, cardiac magnetic resonance imaging (CMR) findings are associated with the potential outcomes in previously infected patients. The athletic population deserves a careful look at all events involved in the physio-metabolic process that can culminate in sudden cardiac death. Purpose: To evaluate the prevalence of CMR changes in athletes previously infected with SARS-CoV-2. Methods: Systematic literature review with analytical studies found in PubMed, LILACS, and CENTRAL databases of previous athletes tested for SARS-CoV-2 by CMR testing. Results and review: From six studies selected, most of them reported athletes in CMR, as late gadolinium enhancement, and T2-weighted abnormalities, which showed the presence of subclinical or clinical forms of myocarditis, with a prevalence of variation of 0.12 to 2.3% in relation to the population. In addition, CMR was responsible for diagnosing cases in which there were neither clinical nor strongly suggestive changes to indicate screening for myocarditis. Conclusion: Myocarditis disease is part of the study group of diseases associated with the post-COVID syndrome and, despite the low prevalence, further research is needed to outline the best strategy that is capable of identifying and diagnosing myocarditis, even after mild and moderate cases.
References
Brito, D., Meester, S., Yanamala, N., Patel, H. B., Balcik, B. J., Casaclang-Verzosa, G., Seetharam, K., Riveros, D., Beto, R. J. 2nd, Balla, S., Monseau, A. J., Sengupta, P. P. et al. (2021). High Prevalence of Pericardial Involvement in College Student Athletes Recovering From COVID-19. Division of Cardiology. 14(3): 541-555. https://doi.org/10.1016/j.jcmg.2020.10.023
Casasco, M., Iellamo, F., Scorcu, M., Parisi, A., Tavcar, I., Brugin, E., Martini, B., Fossati, C., Pigozzi, F. et al. (2022). Return to Play after SARS-CoV-2 Infection in Competitive Athletes of Distinct Sport Disciplines in Italy: A FMSI (Italian Federation of Sports Medicine) Study. J Cardiovasc Dev Dis, 15;9(2): 59. https://doi.org/10.3390/jcdd9020059.
Clerkin, K. J., Fried, J. A., Raikhelkar, J., Sayer, G., Griffin, J. M. Masoumi, A. et al. (2020). COVID-19 and cardiovascular disease. Circulation, 141(20), 1648-1655. https://doi.org/10.1161/CIRCULATIONAHA.120.046941
Colangelo, L., Volpe, A., Toso, E., Magnano, M., Matta, M., Vignati, C., Marchini, A., Semperboni, L., Stefanini, L., Harmonica, F. et al. (2022). Incidence and Clinical Relevance of COVID-19 in a Population of Competitive Young and Elite Football Players: A Retrospective Observational Study. Sports Med Open, 15;8(1):54. https://doi.org/10.1186 /s40798-022-00442-x.
Daniels, C. J., Rajpal, S., Greenshields, J. T. et al. (2021). Prevalence of Clinical and Subclinical Myocarditis in Competitive Athletes With Recent SARS-CoV-2 Infection: Results From the Big Ten COVID-19 Cardiac Registry. JAMA Cardiol. https://doi.org/10.1001/jamacardio. 2021.2065.
Driggin, E., Madhavan, M. V., Bikdeli, B., Chuich, T., Laracy, J., Biondi-Zoccai, G., & Parikh, S. A. et al. (2020). Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. Journal of the American College of cardiology, 75(18), 2352-2371. https://doi.org/10.1016/j.jacc.2020.03.031.
Goldstein, D. S. et al. (2020). The extended autonomic system, dyshomeostasis, and COVID-19. Clin Auton Res. 30(4): 299–315. https://doi.org/10.1007/s10286-020-00714-0.
Eichhorn, C., Bière, L., Schnell, F., Schmied, C., Wilhelm, M., Kwong, R. Y. et al. (2020). Myocarditis in Athletes Is a Challenge. Cardiovascular Imaging, 13(2 Pt 1):494-507. https://doi.org/10.1016/j.jcmg.2019.01.039
Fontes-Pereira, A. (2023). Revisão Sistemática da Literatura. Rio de Janeiro: Aldo Fontes-Pereira Ghorayeb N, Stein R, Daher DJ, Silveira AD da Ritt LEF. et al. (2019) The Brazilian Society of Cardiology and Brazilian Society of Exercise and Sports Medicine Updated Guidelines for Sports and Exercise Cardiology. Brazilian Archives of Cardiology, 112(3):326-368. https://doi.org/ 10.5935/abc.20190048
Perillo Filho, M., Francisco, R. C., Garcia, T. G, Teixeira, M. F., Bassaneze, B., Albuquerque, L. C. A., Alô, R. O. B., Colombo, C., & Ghorayeb, N. (2020). Esporte em Tempos de Covid-19: Alerta ao Coração. Arquivos Brasileiros De Cardiologia, 115(3), 303–307. https://doi.org/10.36660/abc.20200652
Guan, W., Ni, Z., Hu, Y., Liang, W., Ou, C., He, J. et al. (2019). Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med, 382:1708-1720. https://doi.org/10.1056/NEJMoa2002032
Kawaguchi, L. Y. A., Nascimento, A. C. P., Lima, M. S., Frigo, L., Paula Júnior, A. R. Tierra-Criollo, C. J., & Lopes-Martins, R. A. B. et al (2007). Characterization of heart rate variability and baroreflex sensitivity in sedentary individuals and male athletes. Brazilian Journal of Sports Medicine, 13(4), 231-236. https://dx.doi.org/10.1590/S1517-869220.0.0.04
Martinez, M. W., Tucker, A. M., Bloom, O. J., Green, G., DiFiori, J. P., Solomon, G., Phelan, D., Kim, J. H., Meeuwisse, W., Sills, A. K., Rowe, D., Bogoch, I. I., Smith, P. T., Baggish, A. L., Putukian, M., Engel, D. J. et al. (2021). Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systematic Return-to-Play Cardiac Screening. JAMA Cardiol, 1;6(7):745-752. https://doi.org/ 10.1001/jamacardio.2021.0565.
Matsushita, K., Marchandot, B., Jesel, L., Ohlmann, P., & Morel, O. et al. (2020). Impact of COVID-19 on the cardiovascular system: a review. Clin Med, 9(5): 1407. https://doi.org/ 10.3390/jcm9051407
Maron, B. J., Udelson, J. E., Bonow, R. O., Nishimura, R. A., Ackerman, M. J., Estes III, N. M., & Maron, M. S. et al. (2015). Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis: a scientific statement from the American Heart Association and American College of Cardiology. Circulation, 132(22), e273-e280. https://doi.org/10.1161/CIR.0000000000000239
Petek, B. J., Moulson, N., Baggish, A. L For the ORCCA Investigators. et al. (2022). Prevalence and clinical implications of persistent or exertional cardiopulmonary symptoms following SARS-CoV-2 infection in 3597 collegiate athletes: a study from the Outcomes Registry for Cardiac Conditions in Athletes (ORCCA). British Journal of Sports Medicine, 56(16): 913-918. https://doi.org/ 10.1136/bjsports-2021-104644
Phelan, D., Kim, J. H., Chung, E. H. et al. (2020). A Game Plan for the Resumption of Sport and Exercise After Coronavirus Disease 2019 (COVID-19) Infection. JAMA Cardiol, 5(10):1085–1086. Doi:10.1001/jamacardio.2020.2136
Porzionato, A., Emmi, A., Barbon, S., Boscolo-Berto, R., Stecco, C., Stocco, E., Macchi, V., De Caro, R. et al. (2020). Sympathetic activation: a potential link between comorbidities and COVID-19. FEBS J, 287(17): 3681-3688. https://doi.org/10.1111/febs.15481.
Starekova, J., Bluemke, D. A., Bradham, W. S., Eckhardt, L. L., Grist, T. M., Kusmirek, J. E., Purtell, C. S., Schiebler, M. L., Reeder, S. B. et al. (2021). Evaluation for Myocarditis in Competitive Student Athletes Recovering From Coronavirus Disease 2019 With Cardiac Magnetic Resonance Imaging. Cardiol JAMA, 1;6(8):945-950. https://doi.org/10.1001/jamacardio.2020.7444
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Antonio da Silva Menezes Junior; Vinícius Araújo Barbosa; Tiago de Almeida Laranjeira; Pedro de Alcantara Torquette D’Dalarponio; Mariana Bassoli Felix Dutra; João Marcos Palmeira Ferrato Gomes; Joaquim Ferreira Fernandes; Rebeca Coelho de Carvalho; Danielle Nibia Damião; Paulo Henrique Cardoso Amorim
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
