Table 1.
Case Series Evaluating the Prevalence of Myocarditis, Other Myocardial Involvement, and Pericardial Involvement in Athletes Following SARS-CoV-2 Infection∗
| Case Series | Competition Level | Sample Size | CMR Strategy | Age, Mean or Median Years | Sex, % Female | Symptomatic, n (%) | Myocarditis or Pericarditis, n (%) | Additional Observations |
|---|---|---|---|---|---|---|---|---|
| Rajpal et al223 (Online September 11, 2020) | Collegiate | 26 | All athletes | 20 | 42% | 12 (46%) | Myocarditis: 4 (15%) Pericarditis: 0 (0%) |
LGE: 12 (46%) Pericardial effusion: 2 (8%) |
| Brito et al74 (Online November 4, 2020) | Collegiate | 54 | Symptomatic athletes and those with an abnormal ECG and/or echocardiogram (N = 48, 89%) | 19 | 15% | 38 (70%) | Myocarditis: 0 (0%) Pericarditis: 19 (40%) |
Any CMR abnormality: 27 (56%) |
| Vago et al226 (Online December 16, 2020) | Professional | 12 | All athletes | 23 | 83% | 10 (83%) | Myocarditis: 0 (0%) Pericarditis: 0 (0%) |
NA |
| Clark et al224 (Online December 17, 2020) | Collegiate | 59 with COVID-19 60 athlete controls 27 healthy controls |
All subjects | 20 25 30 |
63% | 46 (78%) | Myocarditis: 2 (3%) Pericarditis: 1 (2%) |
RV insertion point LGE: 13 (22%) with COVID-19, 10 (24%) of 41 athlete controls evaluated with gadolinium, 0 (0%) healthy controls |
| Starekova et al73 (Online January 14, 2021) | Collegiate | 145 | All athletes | 20 | 26% | 111 (77%) | Myocarditis: 2 (1%) Pericarditis: 0 (0%) |
RV insertion point LGE: 38 (26%) Mid-myocardial LGE: 2 (1%) |
| Malek et al227 (Online January 20, 2021) |
Professional | 26 | All athletes | 24 | 81% | 20 (77%) | Myocarditis: 0 (0%) Pericarditis: 1 (4%) |
Any CMR abnormality: 5 (19%), includes 1 mid-myocardial LGE (4%) |
| Hendrickson et al228 (Online May 11, 2021) | Collegiate | 137 | Selective (based on abnormal triad testing, N = 5, 4%) | 20 | 32% | 112 (82%) | Myocarditis: 0 (0%) Pericarditis: 0 (0%) |
Abnormal ECG: 0 (0%) Abnormal cTn: 4 (3%) Abnormal echocardiogram: 4 (3%) Any CMR abnormality (of those tested): 0 (0%) |
| Hwang et al229 (Online June 24, 2021) | Collegiate | 55 | Selective (based on abnormal triad testing, N = 8, 15%) | NA | NA | 38 (69%) | Myocarditis: 0 (0%) Pericarditis: 1 (2%) |
Abnormal ECG: 3 (5%) Abnormal cTn: 1 (2%) Abnormal echocardiogram: 6 (11%) Any CMR abnormality (of 8 tested): 2 (25%) |
CMR = cardiac magnetic resonance imaging; cTn = cardiac troponin; ECG = electrocardiogram; LGE = late gadolinium enhancement; NA = not available; RV = right ventricle.
∗
Studies included standard triad testing (ECG, cTn, and echocardiogram) or standard triad testing along with mandated CMR.