Objective:

Myocarditis can be associated with Covidinfection and is one of the most common risk factor for sudden cardiac death in athletes. However athletes do not have any risk factors for developing severe course  of Covid infection. Evaluating the risk for cardiac events we worked up the effect of a past COVID-19 infection check-up on the cardiovascular and respiratory system in professional, semi-professional and recreational athletes.

Method:

41 athletes presented to our institution for a sportcardiologic check-up after Covid infection before return to sport. History, physical examination, 12 lead ECG, laboratory tests  (cardiac troponin,  NT-proBNP), spiroergometry, spirometry, echocardiography and bioimpedance measurement were obtained.

Results

41 athletes (age 25,8 ± 4,6; 93% males) were examined. 26  (63 %) were soccerplayer, 10 were  basketball players (25 %) and 5 were performing different sports (12%). 90% of the athletes were vaccinated against COVID-19 (12% 1 vaccination, 68% 2 vaccination, 10% booster with third vaccination). Mean weight was 80, 6 ±12,3 kg, and muscle mass were 40,6 ±6,5 kg. Four athletes (10%) had comorbidities including experienced myocarditis six years ago, arterial  hypertension, glutensensitiv enteropathy. 6 athletes complained about prolonged reconvalescence, no athletes showed abnormal ECG or echo. All laboratory tests were negative.

The mean maximum O2 uptake was 45,0 ± 5,7 ml/kg/min, FeV1/VC was 96 ±11 l, anaerobic threshold was 139 ± 24 bpm.

However, in four athletes (10%) during spiroergometry a decrease in the O2 saturation to minimal 73 % occurred. All four athletes were complaining of prolonged reconvalescence. Pneumonic work up showed no disorders on chest X-ray, in the mechanical ventilation or spirometry.

Conclusion

No significant cardiac abnormalities could be observed after Covid infection in our cohort. Interestingly in four athletes a significant decline of the O2 saturation could be observed.  Further work up and data will show whether this status is reversible and might give some insights  the mechanisms of the reduced oxygen diffusion capacity in these athletes.