Abstract
This review aims to elucidate the myocarditis incidence in SARS-CoV-2-positive
athletes and to evaluate different screening approaches to derive sports
cardiological recommendations after SARS-CoV-2 infection. The overall incidence
of athletes (age span 17–35 years, 70% male) with myocarditis
after SARS-CoV-2 infection was 1.2%, with a high variation between
studies (which contrasts an incidence of 4.2% in 40 studies within the
general population). Studies that used conventional screening based on symptoms,
electrocardiogram, echocardiography, and cardiac troponin – only
followed by cardiac magnetic resonance imaging in case of abnormal findings
– reported lower myocarditis incidences (0.5%, 20/3978).
On the other hand, advanced screening that included cardiac magnetic resonance
imaging within the primary screening reported higher incidences (2.4%,
52/2160). The sensitivity of advanced screening seems to be 4.8 times
higher in comparison to conventional screening. However, we recommend
prioritization of conventional screening, as the economical load of advanced
screening for all athletes is high and the incidence of myocarditis in
SARS-CoV-2-positive athletes and the risk of adverse outcomes seems low. Future
research will be important to analyze the long-term effects of myocarditis after
infection with SARS-CoV-2 in athletes for risk stratification to optimally guide
a safe return to sport.
Key words
return to sport - COVID-19 - CMR - review
