Penn State doctor: 'Alarming' number of heart inflammation in athletes with COVID-19

Penn State doctor: 'Alarming' number of heart inflammation in athletes with COVID-19
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An "alarming" percentage of student athletes with COVID-19 are also developing heart inflammation known as myocarditis, according to a Penn State doctor, though he later clarified that the percentage is not as high as he initially said. 

Wayne Sebastianelli, Penn State’s director of athletic medicine, said during a board meeting Monday night that around 30 percent of student athletes with COVID-19 who were given cardiac MRI's were found to have heart inflammation. 

The comments were first reported by the Centre Daily Times and received a spike of attention on Thursday afternoon. 

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On Thursday evening, Penn State issued a statement saying that Sebastianelli was referring to "initial preliminary data that had been verbally shared by a colleague on a forthcoming study, which unbeknownst to him at the time had been published at a lower rate."

The statement pointed to a New York Times article in late August, reporting on a study showing around 15 percent of student athletes who had COVID-19 had myocarditis. 

While 15 percent is lower than 30 percent, the findings are still potentially concerning, though there is much that remains unknown.   

“What we have seen 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 in his initial comments. 

Sebastianelli said it is not clear to him or cardiologists who have been consulted exactly how concerning this finding is, and he suggested some cardiologists do not think it is a major problem.

But the findings mark a concerning unknown that illustrates that there are potential complications from the coronavirus that are not fully understood.

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The comments also come as President Trump has urged the Big 10, which has postponed its football season, to resume play. Trump earlier this week spoke to the conference’s commissioner about “immediately starting up” the season.

Sebastianelli said the unknowns around heart problems from the virus are part of the reason the conference decided to hold off on playing.

“We really just don’t know what to do with it right now, because it's still very early in the infection, so some of that has led to the Pac 12 and the Big Ten's decision to sort of put a hiatus on what’s happening because we really want to study this a little bit further and figure out what's going on with the student athlete,” he said.

Illustrating the potential risks, a former Florida State basketball player, Michael Ojo, reportedly died in Serbia from a heart attack after recovering from the coronavirus earlier this month.

Sebastianelli said myocarditis can become serious and even cause fatal heart problems, but it is unknown whether it will in these cases.

“There are many cardiologists, some very high level, at the Mayo Clinic, who feel like this is probably a finding that is incidental, and may not warrant any further investigation, or any further sort of concern,” Sebastianelli said. “And they'll let somebody really compete again within [30 days or so]."

But he said some athletes across the Big Ten have still not fully recovered from the coronavirus.

“Some of the athletes that have been infected haven't really recovered to their full pulmonary function,” he said. “They just don't train as hard as they normally can. Their tolerance has decreased, and so whether that's heart-related or lung-related, we really don't know yet and it's just another variable in change in performance that has to be reevaluated over time.”

Speaking before the clarifying statement was issued, Michael Ackerman, a cardiologist at the Mayo Clinic, said that while it is known that COVID-19 can cause myocarditis, he is skeptical that the frequency would be as high as 30 percent.

"That's a big number and it's a number that doesn't fit with the science, so I'm skeptical, but we have to see the strength of the evidence," he said.

He said that in autopsies of people who died from COVID-19, less than 15 percent have had myocarditis, and that is in a group of people with infections so bad they were fatal.

It is possible the inflammation or other changes to the heart detected in the cardiac MRIs of the Big 10 athletes are temporary changes that could also happen with other viruses like the flu, but that would otherwise go undetected because people with the flu do not typically get cardiac MRIs, he said. Overall, more study and a closer look at the evidence is needed in this instance, he said.

This story was updated at 7:31 to reflect the revised remarks.