通过体检职业运动员,结论是新冠对心脏影响不大

来源: N. 2021-03-04 09:34:22 [] [博客] [旧帖] [给我悄悄话] 本文已被阅读: 次 (8709 bytes)

看原文,自己总结吧。(又,感冒什么的,也能引发心肌炎的。)

https://www.wsj.com/articles/covid-heart-complications-myocarditis-exercise-study-sports-11614871544?mod=hp_lead_pos12 

A New Study of Athletes’ Hearts After Covid Shows Encouraging Results

Sports leagues initially feared that testing positive for Covid-19 would lead to heart damage. The first comprehensive study—on hundreds of pro athletes—suggests that is rare.

 
 
 
 

The scary question that leagues like the NBA, NFL and MLB  faced as they returned to play over the past year was how prevalent heart damage would be among players who tested positive for Covid-19. They now have an encouraging answer: It’s rare. 

A new study on the topic in JAMA Cardiology is based on the screening of 789 professional athletes who tested positive for Covid-19 between May and October in Major League Baseball, Major League Soccer, the National Hockey League, National Football League, and the men’s and women’s National Basketball Association. 

The paper shows that 0.6% of those athletes ultimately had findings suggestive of inflammatory heart disease. Five athletes were held out of competition because of their cardiac results. Three had myocarditis, which is heart inflammation, and two had pericarditis, which is swelling of the tissue that surrounds the heart. All had had moderate cases of Covid.

The findings suggest that long-term heart complications in non-severe Covid cases are unlikely—and that sports leagues are still likely to continue with cardiac screenings during the pandemic. 

 

“There was a lot of fear over the spring and summer over myocarditis in athletes,” said Dr. David Engel, an associate professor of medicine at Columbia University Irving Medical Center and one of the paper’s authors. “It helps to answer a lot of the uncertainty that was circulating around the medical community about the prevalence of myocarditis for athletes or general population for people who had asymptomatic or mild forms of Covid.” 

That initial fear in the early days of the pandemic was based primarily on images coming from hospitalized patients. Researchers suspected their hearts might look different from those of the many people who recovered from the virus at home. But they had no way of knowing for sure. 

It was a difficult problem to clinically analyze because the various forms of heart screenings required to study this phenomenon can be both expensive and taxing on healthcare systems. The professional sports leagues, with tens of billions of dollars on the line, helped provide the solution. 

They didn’t just test athletes for Covid-19. They also tested their hearts.  

 

The study’s conclusion is that screenings—troponin blood tests, electrocardiograms and resting echocardiograms—are effective if costly tools to intercept rare possibilities that could carry a terrible price. Five professional athletes having cardiac incidents on courts, fields and rinks would have been a catastrophe. Instead, those five athletes were asked to sit out for months after their screenings detected potential health issues. 

No athletes in the study were identified, but some have identified themselves as sitting out for heart-related issues. Boston Red Sox pitcher Eduardo Rodriguez, for example, missed the 2020 season and has said a screening showed he had myocarditis.    

“The messages of the study are that safe return to sport is possible on an organizational level if systematic and careful screening is performed,” said Dr. Engel, who has worked with the NBA on cardiac screenings for years. 

The prevalence answer comes after cardiologists have reassured the rest of the population that, in general, they do not need to fear hidden inflammation when returning to exercise after asymptomatic, mild or even moderate cases of the virus. 

This is because recreational athletes typically don’t exert themselves under the same pressure as professionals, and more reliably respond to warning signs such as difficulty breathing, dizziness or feeling faint, said Christopher Newton-Cheh, a cardiologist at Massachusetts General Hospital.

“Professional athletes are more vulnerable because they have a lot of incentives to really push themselves,” said Dr. Newton-Cheh. “I think they require a bit more guidance and caution…they’re more likely to be redlining it than a recreational athlete.”

He advises that weekend warriors who weren’t hospitalized for the virus can return to exercise once 10 days have passed and Covid symptoms are gone, with the possible exception of loss of taste or smell—as long as they are able to go slowly, ramp up, recognize that they will not immediately be back to their pre-Covid condition, and follow up on what they find.

People who are struggling to perform normal activities, or had a moderately severe case and are over 65 or have a history of cardiovascular disease, should have screenings before returning to exercise, Dr. Newton-Cheh said. Dr. Engel said that for people who experience significant symptoms, such as shortness of breath or chest pains, screenings are “absolutely necessary.”

 

所有跟帖: 

indeed good news. -Smart- 给 Smart 发送悄悄话 (0 bytes) () 03/04/2021 postreply 10:03:03

FDA的调整 -蓝调- 给 蓝调 发送悄悄话 蓝调 的博客首页 (209 bytes) () 03/04/2021 postreply 13:04:28

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