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

Gloria Modica, Massimiliano Bianco, Fabrizio Sollazzo, Emanuela Di Murro, Riccardo Monti, Michela Cammarano, Lorenzo Morra, Francesco Maria Nifosì, Salvatore Francesco Gervasi, Ester Manes Gravina, Paolo Zeppilli and Vincenzo Palmieri
Additional contact information
Gloria Modica: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Massimiliano Bianco: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Fabrizio Sollazzo: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Emanuela Di Murro: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Riccardo Monti: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Michela Cammarano: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Lorenzo Morra: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Francesco Maria Nifosì: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Salvatore Francesco Gervasi: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Ester Manes Gravina: Department of Geriatrics, Neurosciences, Orthopaedics and Head and Neck, Università Cattolica del Sacro Cuore-Fondazione Policlinico ‘Agostino Gemelli’ IRCCS, 00168 Rome, Italy
Paolo Zeppilli: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
Vincenzo Palmieri: Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy

IJERPH, 2022, vol. 19, issue 7, 1-12

Abstract: Background: To assess the event rates of myocarditis detected by Cardiac Magnetic Resonance (CMR) in athletes who recovered from COVID-19. Methods: 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. Results: 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. Conclusions: 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. Trial registration: the study protocol was registered in the PROSPERO database (registration number: CRD42022300819).

Keywords: COVID-19; physical activity; myocarditis; athletes; cardiac magnetic resonance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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