Athletes who test positive for the coronavirus – even if they’re asymptomatic – can show inflammation of heart muscles with unclear long-term effects. But a debate has raged this week on the specific levels of this inflammation, called myocarditis, and what it means for college athletics.
How Often Myocarditis Accompanies COVID-19
This week, a Penn State University doctor made headlines by referencing an older study on myocarditis. Speaking to the State College Area Board of School Directors, Penn State director of athletic medicine Dr. Wayne Sebastianelli said that among COVID-positive athletes, 30 to 35 percent showed inflammation of the heart muscles.
The school clarified his comments yesterday, saying Sebastianelli inadvertently referenced preliminary numbers that had been shared by a colleague. Unbeknownst to Sebastianelli, the rates were actually lower when the study was officially published. A New York Times story in August referenced a study from an Ohio State doctor with myocarditis rates in close to 15% of athletes who had the coronavirus. Almost all of the athletes with myocarditis had mild or no coronavirus symptoms.
Potential Effects To Athletes & Sports Seasons
As schools and sporting organizations grapple with major coronavirus decisions, one key argument has been that young and healthy individuals are at a lower risk of death from COVID-19. But the mystery of myocarditis throws some uncertainty on that idea.
“We really just don’t know what to do with it right now,” Sebastianelli told the Board. “It’s still very early in the infection.”
Sebastianelli said there’s no clear answer on how myocarditis could affect athletes long-term, or whether the cardiac inflammation could cause an athlete to drop from elite to just average, even if they have a mild or asymptomatic bout with the coronavirus.
“What we have seen is when people have been studied with cardiac MRI scans — symptomatic and asymptomatic COVID infections — is a level of inflammation in cardiac muscle that just is alarming,” Sebastianelli said.
That’s set off a debate between experts on how school sport decision-makers should proceed.
Mayo clinic genetic cardiologist Michael Ackerman has been a very public voice on the side of proceeding with sports. AL.com called him the doctor who ‘saved the college football season.’ After the Big Ten and Pac-12 had postponed fall sports, Ackerman advised the Big 12, easing concerns about myocarditis. The Big 12 ultimately ended up moving forward with its fall sports, leaving three of the Power-5 conferences still playing this fall.
Ackerman was quick to dispute the 30-35% numbers referenced by Sebastianelli this week, before the Penn State clarification. He tweeted yesterday highlighting the uncertainty over what we know about myocarditis:
I look forward to seeing the peer-reviewed publication. Equating a cardiac MRI finding, which is at best a Finding of Uncertain Significance (F.U.S.), to #Myocarditis in this setting is a FOUL (again). Making a ton of FUSS out of a F.U.S! Time to pick up the penalty flag.
— Michael J. Ackerman MD,PhD (@MJAckermanMDPhD) September 3, 2020
Meanwhile, MedPageToday’s Dr. Anthony Pearson wrote yesterday that the concerns about myocarditis are still valid. Pearson didn’t take a firm stance on whether college football should or shouldn’t happen, but said that “we need more data and more studies to know how important these early findings really are.”
Pearson also took aim squarely at Ackerman, arguing that decisions on sports should be made based on data, not on financial bases:
“Ideally, they should not be made on the basis of political or monetary calculations,” Pearson wrote. “Nor should one genetic cardiologist who happens to tweet what athletic directors want to hear (no matter his expertise with culinary and sports analogies) have an out-sized influence.”
(Ironically enough, Pearson identifies himself as a huge fan of Oklahoma Sooners football, while Ackerman says he’s not a football fan.)
Pac-12’s Listed Concerns
Myocarditis is important to the discussion because falls squarely under one of three main concerns the Pac-12 cited when it postponed all sports until January of 2021.
When the Pac-12 canceled its fall seasons, it published three major medical issues supporting that decision:
- Community prevalence: travel between campuses and on commercial aircraft is a major risk for teams and campuses
- Health outcomes related to COVID: the unknown health issues related to the coronavirus, including myocarditis. The Pac-12 said it didn’t have enough information to fully understand these short- and long-term outcomes.
- Testing capacity: the ability to test athletes more and receive results quicker is needed to prevent the spread of the virus.
The third point is already being somewhat addressed, as the Pac-12 came to an agreement with a testing manufacturer for rapid-result tests on all Pac-12 campuses.
I tested positive for Covid 5 weeks ago
Did the quarantine and had no issues outside of fatigue and loss of taste/smell. My symptoms were headaches, which were gone after 3 days. All other symptoms were gone after 3 days of quarantine.
After quarantine was done I attempted to run- I had been running 2-3 miles every other day in the summer. Now (after being cleared to go back out) I couldn’t make it half a mile without feeling like I had a 100 pound weight over my chest and heart. If I lay down after running it feels the same.
Coincidentally that pain is not there when I swim
I am not a conspiracy theorist and I believe in science. BUT how does Penn State’s HEAD doctor say in early September that 30-35% of covid-19+ athletes in the BIG also have myocarditis and then 3 days later PSU issues a statement clarifying that ZERO PSU athletes who have tested positive for covid-19 have or had myocarditis.
The PSU head doctor was recorded on youtube saying it = there was not a misunderstanding by the local news reporter.
What the heck is really going on?
This is all well and good but what is the My Pillow guy’s opinion?
There’s no debate…I went to PAC-12 championships at the end of February. No underlying conditions. Was sick soooo sick came home had a second wave with muscle pains so bad and chills. 2 months later still not feeling well CT showed enlarged heart, enlarged lymph-nodes and thyroid absent of any other condition! It’s not the flu! Many other parents and student athletes were sick there and after! So 10% 30% honestly until there is coordinated information nont related to politics it’s a stab in the datk!
So there is no debate. With so many asymptomatic cases and the inability to test frequently enough to quickly diagnose those who have it, do you think we should shut swimming down until we have more data regarding Covid and Myocarditis — and “long haul” Covid. The initial poster stipulated the “if it save one life” rule…is that where we are?
“There is no debate” is clearly wrong because this has been debated for months. I’m sure you are a nice lady and all, but you don’t have the influence to shut down the debate.
That’s just bunk. I don’t understand how you can read this article and suggest swimming can be done safely according to some of the standards being propagated on here. I suppose the larger schools and/or campuses with university hospitals might have the means to test frequently and diagnose the risks, but you start pushing this down the pyramid to smaller universities and club teams and it quickly becomes obvious that they don’t have the resources to diagnose the problem. Couple that with the fact so many Covid cases are asymptomatic, and you have the potential for a large group of undiagnosed swimmers in pools across the country with enlarged hearts. To suggest that swimming can be done safely suggests you… Read more »
You said hoax …. nobody else said the virus was a hoax.
Anyone who doesn’t agree with you is awful, got it.
Not related to politics is crucial!!!!
Oh debate is swirling eh? All this wonderful uncertainty. Everyone gets an opinion!
If only we had people that studied this who could debate and come to a general consensus over time on these things…
Today:
The University of Iowa today is reporting another 253 self-reported cases of COVID among students, bringing the total two weeks into the semester to 1,395. That is 253 new cases in two days. It reports three more employee cases for a total 19.
Pick percentage that will end up with Myocarditis and calculate how many 20 year olds will have problems. You still feel good about their chances?
100% ok with it.
yes, i’m ok with it. But that shouldn’t matter. Its really up to the 20 year old with a diagnosis that matters. Its a matter of individual liberty.
I’m just thankful it is now going through the schools. Not meaning to be harsh but the likelihood of any problems in the young is extremely small. If we can get 15-20% seropositive along with the 50-60% who have likely had it already the rate of infection will decrease dramatically (see NYC or Sweden). Keep the elderly and other at-risk individuals far away. Allowing infection rates to linger in the low to moderate rate only keeps the possibility of infection the elderly/at-risk for a longer period of time. Should just let them… Read more »
If your child has existing respiratory problems, would you feel comfortable sending them to college to “get together for a month without classes to party” and get infected?
Easy solution. Don’t send your child.
At 18+, they need to be able to make their own choices.
Most* 18+. There are still college students who are 17. Maya DiRado was 17 for most of her freshman year at Stanford; Kate Douglass was 17 for the first few months of her college career as well.
I’ll make note of that in my diary
Well that wasn’t your original question. As I’ve said, it’s individual choice and those at risk should protect themselves. The other 99% non elderly need to live life and produce for the good of everyone in the country
Ah, yes, famous Sweden with dead per million higher than USA. One thing is sure: you either shut it all down until vaccine is available, or keep it open and have a million dead and still ruined economy. There is no opening and re-opening. Just when we are getting it under control here in Texas (if you can call 4000 cases and 200 dead per day under control), stupid governor is thinking about reopening. Worked really well last time until we reached 13,000 cases per day.
US passed Sweden. They reached herd immunity.
Texas virus is burnt out almost.
But keep upholding that narrative.
Sweden is not even close to Herd Immunity
Given that a higher percentage of the US population has tested positive than Sweden (by my math, Americans have tested positive at 2.5x the rate), if Sweden is nearing heard immunity, then we should be there, right?
Then again, Sweden has always been a silly comparison to the United States. Swedes are naturally isolated – their population isn’t nearly as dense, they have fewer large cities, and a higher percentage of Swedes live alone than any other country on earth. One would suspect given their relative isolation, they would hit herd immunity at a relatively-lower infection rate, but I don’t know, 2.5x lower (and growing) seems like a lot.
The best conclusion is probably that “Sweden is not a good… Read more »
So we need to shut down swimming immediately?
I think keeping an eye on it and studying this issue further is the take away here
So shut down swimming until we’ve studied the issue and feel better about swimmers’ chances?
Yes. Shut it down. Drain all pools. Fine those who even think about swimming.
One could also ask if you are really a head timer considering you advocate for shutting down swim meets 🙂
This is nothing more than Coronabro propaganda…
Just about everyone’s numbers are suspect these days. It’s a shame draconian public policy decisions are based on some of the worst offenders.
Public policy should be determined by the concept of asymmetric risk.
If you’re not sure of the probabilities or potential consequences of an action- in this case, the potential for longterm damage due to exposure to a virus -then you’ve got to assume the worst until you know better.
It’s a simple idea, really, and it’s bizarre how it’s become so politicized.