Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis

To assess the event rates of myocarditis detected by Cardiac Magnetic Resonance (CMR) in athletes who recovered from COVID-19. A systematic literature search was performed to identify studies reporting abnormal CMR findings in athletes who recovered from COVID-19. Secondary analyses were performed c...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-04, Vol.19 (7), p.4279
Main Authors: Modica, Gloria, Bianco, Massimiliano, Sollazzo, Fabrizio, Di Murro, Emanuela, Monti, Riccardo, Cammarano, Michela, Morra, Lorenzo, Nifosì, Francesco Maria, Gervasi, Salvatore Francesco, Manes Gravina, Ester, Zeppilli, Paolo, Palmieri, Vincenzo
Format: Article
Language:English
Subjects:
Abnormalities
Asymptomatic
Athletes
Bias
Calcium-binding protein
Cardiac arrhythmia
Coronaviruses
COVID-19
COVID-19 - epidemiology
Disease transmission
Electrocardiography
Exercise
Heart diseases
Heterogeneity
Humans
Infections
Magnetic Resonance Imaging
Meta-analysis
Myocarditis
Myocarditis - diagnostic imaging
Myocarditis - epidemiology
Patients
Pneumonia
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Systematic Review
Troponin
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Summary:To assess the event rates of myocarditis detected by Cardiac Magnetic Resonance (CMR) in athletes who recovered from COVID-19. A systematic literature search was performed to identify studies reporting abnormal CMR findings in athletes who recovered from COVID-19. Secondary analyses were performed considering increased serum high sensitivity troponin (hs-Tn) levels and electrocardiographic (ECG) and echocardiographic (ECHO) abnormalities. In total, 7988 athletes from 15 studies were included in the analysis. The pooled event rate of myocarditis was 1% (CI 1-2%), reaching 4% in the sub-group analysis. In addition, heterogeneity was observed (I2 43.8%). The pooled event rates of elevated serum hs-Tn levels, abnormal ECG and ECHO findings were 2% (CI 1-5%), 3% (CI 1-10%) and 2% (CI 1-6%), respectively. ECG, ECHO and serum hs-Tn level abnormalities did not show any correlation with myocarditis. The prevalence of COVID-19-related myocarditis in the athletic population ranges from 1 to 4%. Even if the event rate is quite low, current screening protocols are helpful tools for a safe return to play to properly address CMR studies. the study protocol was registered in the PROSPERO database (registration number: CRD42022300819).
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph19074279