Debate Swirls Around Myocarditis Figures In Athletes With COVID-19

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. 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:

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:

  1. Community prevalence: travel between campuses and on commercial aircraft is a major risk for teams and campuses
  2. 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.
  3. 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.

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Tim Liebhold
16 days ago

Whether it’s 35, 25, 15 or 5% it really doesn’t matter. I was hospitalized for 5 days in 2012 for with Viral Myocarditis. It is a serious condition, and WILL end up killing of these student athletes if it is not taken seriously. I’m convinced that my strong heart from swimming (even 4 years after retirement, and only swimming masters occasionally) saved my life. Somebody is not going to be so lucky. We’ve already lost 180,000 lives and counting, and if even 1 college athlete loses their life from a known condition it will be too many.

doconc
Reply to  Tim Liebhold
16 days ago

Tim: in all likelihood your virus was an influenza type, common and usually routine. sometimes unusual complications occur. I know someone who got parkinsons and cardiomyopathy from flu at age 38. rare things can happen.

We don’t quarantine the world from rare events. we can’t prevent influenza death either

meeeee
Reply to  doconc
16 days ago

Chad Carvin had viral cardiomyopathy back in the 1990’s and recovered from it. Any virus can cause it. The question is whether SARS-CoV-2 is more likely to cause it. If we really knew the number it would be an easy call. Part of me suspects that football players might be at greater risk because many are often obese (linemen). Swimmers are not. Their risk would be if they kept swimming while infected as that puts them at more risk. We tell our patients to not exercise if they have a viral infection because of this reason. The problem is that >95% of cases in the young are completely asymptomatic. The ‘if even 1 college athlete loses their life ….it will… Read more »

HeadTimer
Reply to  doconc
16 days ago

What a crappy response to a valid concern from someone who suffered from the very affliction the article is referencing.

CA_LAWYER
Reply to  HeadTimer
16 days ago

HeadTimer, just because someone suffered from the affliction doesn’t make them an expert on the topic or mean that someone can’t elaborate on the topic.

HeadTimer
Reply to  CA_LAWYER
16 days ago

IMO to invalidate his very valid concern and personal experience is not cool and more than a little insensitive. If you have personal experience with something like this, you have way more knowledge than most of us.

Swimmom
Reply to  doconc
16 days ago

That is completely untrue 100% the data supports his statement

Kate
Reply to  Tim Liebhold
16 days ago

Endocarditis can be triggered from any bacterial or viral infection – even a common cold.

This hysteria needs to stop.

JeahBrah
Reply to  Kate
16 days ago

Endocarditis is a different disease, and is almost always caused by bacteria or fungus, not viruses or colds.

Last edited 16 days ago by JeahBrah
Swimmom
Reply to  Kate
16 days ago

Not at this rate not even close

CA_LAWYER
Reply to  Kate
16 days ago

Agree, people you have the Internet at your finger tips. Look up something for once and you’ll see there are a large number of causes for endocarditis.
https://www.mayoclinic.org/diseases-conditions/endocarditis/symptoms-causes/syc-20352576

Ol' Longhorn
Reply to  CA_LAWYER
16 days ago

Endocarditis is not myocarditis. Contract law isn’t constitutional law. Apples aren’t oranges.

Irish Ringer
Reply to  Ol' Longhorn
15 days ago

Looking at the thread I don’t think the lawyer turned it to endocarditis from myocarditis, but was rather responding to the thread above. None the less, it seemed to have wandered a bit.

Last edited 15 days ago by Irish Ringer
CA_LAWYER
Reply to  Ol' Longhorn
15 days ago

A bedpan is different than a toilet too, but you would still have to clean both when tending to your patients.

Anonymous
Reply to  Tim Liebhold
13 days ago

My D1 athlete had mild covid 19 in July. No myocarditis. Hoping for as many as possible to be the same.

HISWIMCOACH
16 days ago

https://t.co/nEyTV3UXVY?amp=1

U of Kansas 546 cases. said. “We know of no cases associated with our entry testing efforts where individuals have required care beyond their physician’s office, including no known hospitalizations.”

HISWIMCOACH
Reply to  HISWIMCOACH
16 days ago

The Ohio State U: ZERO reported C19 hospitalizations with 882 student “C19 PCR+ tests” [‘Ohio State reports 882 student coronavirus cases’

PVSFree
Reply to  HISWIMCOACH
16 days ago

I’m not a medical professional, but from my understanding myocarditis is one of those things that’s hard to detect unless you’re looking for it. Like the article said, in the Ohio State study (15% had myocarditis), the athletes had mild or no symptoms

HISWIMCOACH
Reply to  PVSFree
16 days ago

Much is unknown about myocarditis. My prediction is that much like how the “experts” were saying kids with Covid were going to get Kawasaki waaaaay back in May this story will soon be forgotten about. Or like the story that young healthy people were getting strokes due to Covid back in April.

Team apocalypse is getting desperate. Can’t wait to see what they pull out next.

Last edited 16 days ago by HISWIMCOACH
JP input is too short
Reply to  HISWIMCOACH
16 days ago

That you don’t hear about things in the news anymore doesn’t mean they don’t exist.

Steve Nolan
Reply to  HISWIMCOACH
16 days ago

1,000 people are still dying every day in the US. Like you say about myocarditis, much is also unknown about Covid-19. Maybe in a year, everyone who got it just has their eyeballs fall out. I dunno! It sure as hell seems like a better idea to maybe try to do as much as we can to prevent people from getting it at all, versus just hoping that everyone that does get it’ll be just fine as long as they don’t die. What about the long-haulers? People that still have symptoms months after the virus has presumably left their system? A lot of those folks are in their 30s, idk why a college athlete in their 20s might not end… Read more »

Edison Didn’t Invent the Lightbulb
Reply to  Steve Nolan
16 days ago
CA_LAWYER
Reply to  Steve Nolan
16 days ago

The key to that whole diatribe….”I dunno”

Awsi Dooger
Reply to  HISWIMCOACH
16 days ago

Team Ignorance remains unblemished. Never correct one time. But it is hilarious every time I wander over here. I know exactly what the hand-carry types will be spewing. They are totally incapable of anything except desperately hanging out at the right wing deflective sources and then scampering like good little minions. An estimate today is 400,000 United States deaths by the end of the year including 3000 per day. It also indicated that number could be reduced by 122,000 deaths if all Americans would simply wear masks. Which, or course, they will not, since right wingers brainstormed that a migrant caravan trudging from Central America was deadly but coronavirus a mere hoax. Subsequently they have wrapped themselves in so much… Read more »

Rookie
Reply to  Awsi Dooger
16 days ago

So the IMHE Model that you’re citing has US deaths increasing by a factor of 2.3X to 410,000 by year end. It also has global deaths increasing from 623K to 2.81 million by year end, or a rate of increase near 4.5X. That’s basically double the projected US rate of increase. The IMHE Model is partly responsible for causing Governor Cuomo to freak out in April and order nursing homes to take in Covid patients, which needlessly added thousands to NY’s deaths tolls.

HISWIMCOACH
Reply to  Rookie
16 days ago

What you said is correct. I’d like to clarify, it’s the Bill Gates funded IMHE (not a doctor or a scientist by the way)

Corn Pop
Reply to  Rookie
15 days ago

What do you suggest we do/ did with ppl with Covid19 ?

Hank Monroe
Reply to  Awsi Dooger
16 days ago

Back with the “right winger” rhetoric?

You can find research that supports both over counting and under counting of the virus, but to come on here and continually throw out your right winger rant and #45 disparagement is weak.

HeadTimer
Reply to  HISWIMCOACH
16 days ago

So the doctors aren’t “experts” but you are? Do you have an MD?

HISWIMCOACH
Reply to  HeadTimer
16 days ago

I have a brain. And am allowed to have an opinion. My opinion is that these doctors running IMHE are bought and sold.

Is your only argument that I’m not an expert or would you like to cite why you think their model is good? That sound like healthier discourse than telling me I’m not an MD which I already know.

Ol' Longhorn
Reply to  HISWIMCOACH
16 days ago

So did the Scarecrow in Wizard of Oz.

PsychoDad
Reply to  HISWIMCOACH
16 days ago

You forgot to mention Soros too.

Hank Monroe
Reply to  HeadTimer
16 days ago

In the medical community there isn’t a 100% agreement on any of this and can easily find MD’s that support both sides of this argument.

swimmomfl
Reply to  HISWIMCOACH
16 days ago

Seriously, HISWIMCOACH, if you think this is all a hoax you are just, well… stupid. We are living this “hoax” on a daily basis with a high level, 22 year old, peak conditioned athlete. Ask the long haulers what the virus is like. Our other daughter, who also had the stupid thing, is gonna get tested for the cardiac stuff as well… why? Because 15% is way too high to risk it, and a smart return to play protocol under these conditions warrants being cautious and thorough. People like you just p*** me off. The effects of this virus are real. People may not be dying at the rate that you think justifies the concern, but try walking a few… Read more »

jvog88
Reply to  HISWIMCOACH
15 days ago

Ah, I knew you’d be here. I think everyone knows your views at this point. Maybe give it a rest, or try commenting on swimming next time.

CA_LAWYER
Reply to  HISWIMCOACH
16 days ago

If an 80 year old woman, who happens to be the leader of the house, is safe enough getting her hair done I think these college kids will be alright.

Edison Didn’t Invent the Lightbulb
16 days ago

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.

M Palota

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.

About Jared Anderson

Jared Anderson

Jared Anderson swam for nearly twenty years. Then, Jared Anderson stopped swimming and started writing about swimming. He's not sick of swimming yet. Swimming might be sick of him, though. Jared was a YMCA and high school swimmer in northern Minnesota, and spent his college years swimming breaststroke and occasionally pretending …

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