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Bhatia, RT, Malhotra, A, MacLachlan, H, Gati, S, Marwaha, S, Chatrath, N, Fyyaz, S, Aleixo, H, Al-Turaihi, S, Babu, A, Basu, J, Catterson, P, Cooper, R, Daems, JJN, Dhutia, H, Ferrari, F, van Hattum, JC, Iqbal, Z, Kasiakogias, A, Kenny, A , Khanbhai, T, Khoury, S, Miles, C, Oxborough, D, Quazi, K, Rakhit, D, Sharma, A, Varnava, A, Tome Esteban, MT, Finocchiaro, G, Stein, R, Jorstad, HT, Papadakis, M and Sharma, S (2023) Prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players. Heart. ISSN 1355-6037
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Prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players.pdf - Accepted Version Available under License Creative Commons Attribution Non-commercial. Download (172kB) | Preview |
Abstract
Background and aim: The efficacy of pre-COVID-19 and post-COVID-19 infection 12-lead ECGs for identifying athletes with myopericarditis has never been reported. We aimed to assess the prevalence and significance of de-novo ECG changes following COVID-19 infection.
Methods: In this multicentre observational study, between March 2020 and May 2022, we evaluated consecutive athletes with COVID-19 infection. Athletes exhibiting de-novo ECG changes underwent cardiovascular magnetic resonance (CMR) scans. One club mandated CMR scans for all players (n=30) following COVID-19 infection, despite the absence of cardiac symptoms or de-novo ECG changes.
Results: 511 soccer players (median age 21 years, IQR 18-26 years) were included. 17 (3%) athletes demonstrated de-novo ECG changes, which included reduction in T-wave amplitude in the inferior and lateral leads (n=5), inferior leads (n=4) and lateral leads (n=4); inferior T-wave inversion (n=7); and ST-segment depression (n=2). 15 (88%) athletes with de-novo ECG changes revealed evidence of inflammatory cardiac sequelae. All 30 athletes who underwent a mandatory CMR scan had normal findings. Athletes revealing de-novo ECG changes had a higher prevalence of cardiac symptoms (71% vs 12%, p<0.0001) and longer median symptom duration (5 days, IQR 3-10) compared with athletes without de-novo ECG changes (2 days, IQR 1-3, p<0.001). Among athletes without cardiac symptoms, the additional yield of de-novo ECG changes to detect cardiac inflammation was 20%.
Conclusions: 3% of athletes demonstrated de-novo ECG changes post COVID-19 infection, of which 88% were diagnosed with cardiac inflammation. Most affected athletes exhibited cardiac symptoms; however, de-novo ECG changes contributed to a diagnosis of cardiac inflammation in 20% of athletes without cardiac symptoms.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Cardiomyopathies; Electrocardiography; Myocarditis; 1102 Cardiorespiratory Medicine and Haematology; 1103 Clinical Sciences; Cardiovascular System & Hematology |
| Subjects: | R Medicine > RC Internal medicine > RC1200 Sports Medicine G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports |
| Divisions: | Sport & Exercise Sciences |
| Publisher: | BMJ Publishing Group |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 17 May 2023 08:56 |
| Last Modified: | 17 May 2023 09:00 |
| DOI or ID number: | 10.1136/heartjnl-2022-322211 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/19256 |
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