Heart issues linked to COVID-19 a big concern in athletics

COVID-19 and its link to the heart issue myocarditis has become a frequent point of discussion in recent weeks, as the leaders of college sports leagues decide whether or not to hold competitions this fall.

Dr. Colleen Kraft, a fellow with the Infectious Diseases Society of America, did not mince words Thursday during an NCAA briefing on the virus.

“I think we are playing with fire,” said Kraft, a member of the NCAA’s COVID-19 advisory panel. “I think one case of myocarditis in an athlete is too many.”

Having college sports during a pandemic is a challenging venture, especially in a country where there are more than 50,000 people being infected with COVID-19 daily. The issue of myocarditis just drills down another level. These aren’t faceless people, one case out of a thousand, potentially asymptomatic. These are athletes who were infected and, in turn, developed inflammation of their heart muscle.

The story of Indiana offensive lineman Brady Feeney, who was sidelined as medical personnel monitored a potential heart abnormality stemming from COVID-19, has since been mentioned as a cautionary tale by leaders of the Mid-American and Pac-12 conferences. NCAA chief medical officer Brian Hainline said Thursday he knows of a dozen cases of myocarditis, specifically, among NCAA student-athletes, and the NCAA has just updated guidance for institutions on how to screen for the condition.

“This has been around for a long time, and it’s here with COVID-19, and we are taking it seriously,” Hainline said. “The guidance you’ll see today is even more rigid in terms of the processes that must happen after a student-athlete, who is even asymptomatic, tests positive. It’s based not on our recommendations solely, but the recommendations of the leading sports cardiologists in the country.”

This isn’t a new issue, per se. Hainline remembers 30 years ago when he was attending a conference and received specific guidance to not allow tennis athletes to train with flu- or cold-like symptoms, because they could develop myocarditis. In 2006, Northwestern football coach Randy Walker died from heart damage inflicted by a virus.

But with the backdrop of COVID-19, an incredibly contagious, novel virus that has killed more than 166,000 people in the U.S., there are renewed worries about what myocarditis means for the safety of athletes.

In young people, the condition seems relatively rare, according to Dr. Mohan Shenoy, a cardiologist with IU Health Southern Indiana Physicians. But that doesn’t mean college athletes are immune. And it could be deadly.

“If it’s a very severe infection of the cardiac muscle that goes on for a prolonged period of time, it is very uncommon, but it is possible to have permanent damage,” Shenoy said. “And in very, very rare circumstances — and I want to emphasize very, very rare, because I’ve only seen it twice in my career — the heart muscle can basically rupture and you can die instantly. But that’s super-duper rare.”

The concern for medical professionals is that they are still learning about the short- and long-term effects of COVID-19. At first, the virus was primarily linked with the pulmonary system because the immune response it triggers, the “cytokine storm,” inflames the lungs and fills them fluid and debris. But it’s now understood that the virus seems to attack blood vessels, or the vascular system.

It not only gives patients a hard time breathing, dropping oxygen levels and straining the heart. Sometimes, COVID-19 patients suffer from blood clots, leading to heart attacks or strokes. Sometimes, an infection not only inflames the heart muscle but the lining of the heart itself.

Every day, doctors are learning more. Shenoy recalled an email exchange with docs just a few days ago, about the best screening method for COVID-related heart issues. Tests measuring troponin in the blood, a protein that is elevated any time there is heart damage, seems to work best.

“When the surge hit us in April, we had no playbook,” Shenoy said. “We took a blank book and started writing our own playbook. Now that we are a few months into this, we know what to do, what works.”

Again, Shenoy doesn’t believe there is an outsized risk of myocarditis in athletes. Just as many young, healthy people can be asymptomatic, most will not develop heart issues. And if they do, most patients will heal quickly, while a minority will need several weeks or months to recover.

But that reality underscores why the task of communicating the pandemic’s seriousness has been so difficult. Younger people assume COVID-19 won’t hurt them badly.

“I understand why it’s hard for people … it’s not like you do something and it affects you,” Shenoy said. “But if I were to play basketball with a set of friends, I could basically go home and take it to my family. What doesn’t affect me can affect other people. Playing basketball can affect other people. It’s a very hard concept to connect to.

“And there’s a huge human and social cost to losing all these patients. As a frontline physician, it gives you a different perspective. … So do we have to take this seriously? Of course, yes. And extremely so.”

The split between Power 5 conferences that have halted fall sports, the Big Ten and Pac-12, and the ones that are still going ahead, the SEC, ACC, and Big 12, has raised more questions about the appropriate level of caution.

The latter three are trusting in their testing capabilities, believing they can limit infections and possible aftereffects. The other two seemed swayed by the unknown, which includes myocarditis, as well as infection rates nationally and on campus when the fall semester soon starts.

Dr. Carlos del Rio, a fellow at the Infectious Diseases Society of America, and another member of the NCAA’s COVID-19 advisory panel, turned the conversation from whether to shut down sports. In his opinion, the issue is still whether the U.S. can vanquish the pandemic.

People need to wear masks, wash their hands, and socially distance. Then sporting events can happen, no question.

“We have a serious problem,” del Rio said. “I feel like the Titanic. We have hit the iceberg, and we are trying to make decisions about what time we should have the band play.”

Hainline, asked about the prospects for spring sports, echoed del Rio’s sentiment.

“It’s not just about testing. It’s about where are we as a country and where are we as humanity in making decisions for one another so that we get through this pandemic together,” Hainline said. “It’s not just about the fall and spring, it’s more importantly where are we as human beings taking care of one another. And I don’t know where we’ll be in the spring. But where we are today is exceptionally disappointing.”

29 comments

  1. Randy Walker, Northwestern’s head coach dying of heart disease from a virus in 2006. That’s a reach. We all remember the ‘great plague of ’06’…..Anyone with a medical title next to their name feels compelled to enter the fray with some kind of ‘justfiable’ reason to shut down not only conference sports,..but the WORLD. They cite undercounting death tolls. It’s the other way. The financial payoff is much higher than if someone actually died of something else, but listed as Covid. So far, the mortality rate is about 47% off ALL REPORTED DEATHS from people on their last legs in nursing homes. A guy in his thirties, I think in Florida, was listed as a ‘Covid-19 Death’. He was killed in a traffic mishap,…while on his MOTORCYCLE. Sorry folks. IU, like other woke destinations of ‘higher education’ is siding with fear and politics. McRobbie, the other President’s, AD’s and of course the new Commissioner have guaranteed at least one positive,….the football team will complete the season without a loss. The Huan -flu is very contagious…but no more lethal to young people than seasonal influenza and pneumonia. Look at the 3 major conferences that have packed it in for the fall,…Big East (basketball) east coast liberals, PAC 12 west coast liberals and BIG 10 urban east/central. Then there’s the south. The decision to shut the fall sports season will have negative effects that will have long, long lasting ramifications, and not just financially. How many ‘verbal commits’ to B10 schools are rethinking about switching to the B12, ACC or SEC? If I were a 3+ star kid,…I would have to consider my options,…wouldn’t you?

    1. I’m sure Jon can provide support for the Randy Walker statement since that’s a new cause of death and not something that was ever reported, to my knowledge.

          1. No problem. And yes, definitely scary. And I probably should have added the context about the widow’s recent statement just so people weren’t confused. My apologies.

  2. It’s amazing that so many people have now become instant experts in virology, immunology, public health, and epidemiology.
    I personally do not claim to have such expertise.
    Here’s a quote from somebody who actually makes his living at it.
    “Dr. Carlos del Rio, an infectious disease specialist at Emory University and a member of the NCAA advisory panel, said this about fall sports in a video conference Thursday:“I feel like the Titanic. We have hit the iceberg, and we’re trying to make decisions of what time we should have the band play.”
    Said del Rio: “What’s important right now is we need to control this virus. Not having fall sports this year, in controlling this virus, would be to me the No. 1 priority.”
    He may very well be wrong, but to yell at the Big10 right now is misplaced, in my humble opinion.
    Nobody has a totally clear understanding of where this virus is heading.
    Nobody.

  3. with the number of infections nationwide and the number of deaths close to 169,000; I doubt that “Fan-driven ” college basketball will happen this year as well. These other conferences that are open ( if you think they are going to limit fan attendance, that is a joke) Dallas Cowboys set down “rules” for tailgating . if you have to have rules for that in both college and pro football then contolling the virus and making people safe is the farthest thing from your thoughts. restricting human behavior as to make an environment safe for the majority isnt the leading thought.

  4. So big time sports is an recognizable danger but filling college campuses with residing students will be benign. Ya, I get it. Logic at its pinnacle use.

  5. Four days prior to the Feeney story breaking and his mom going to twitter…
    Posted on a Scoop thread titled ‘Promising early reviews on IU’s Lander
    July 29, 2020’ :

    Harvard for Hillbillies says:
    July 29, 2020 at 3:22 pm

    A pandemic possesses “it factor.” “It” should be keeping these kids at home right now. They don’t make 3 million/year. Their health and the health of their families is not guaranteed by gigantic earnings, stock holdings and life insurance policies. We don’t even have certainty of the long term effects of contracting this virus. Studies using MRI’s have shown major inflammation of the heart long after all major symptoms have dissipated.

    The horrific possible side effect was known ….If Feeney’s mom had not come forward, would any of us had ever known. I haven’t searched for verification, but I believe I heard a report that up to 10 players from the conference may have also been experiencing myocarditis and it wasn’t being publicly disclosed. Absolutely shameful… I wouldn’t trust a single source on testing or health clearances coming from any of the 3 asinine conferences attempting to go forward.
    There are already questions concerning testing transparency and testing frequency coming out of Florida State. Reports of players not feeling confident in what they are being told.
    I would also be ashamed to have any twitter quote from a superstar player in the ACC picked up and retweeted by the Fumbler in Chief.

  6. I would also be curious to how Covid could affect the functioning of an enlarged heart….Any of you remember the tragic story of former Hoosier, Jason Collier? It was never known until after his death that Jason Collier had an enlarged heart.
    Supposedly, he had rather abnormal EKG’s while on the Atlanta Hawks, but they didn’t do further testing. It wasn’t until after his fatal heart attack that an autopsy discovered a severely enlarged heart.

    Disclosure (old personal tale and I have no medical expertise to back it up)…My childhood dentist (avid swimmer) once told me many top swimmers can have enlarged hearts. His personal opinion was that such enlargements can reduce life expectancy. My interpretation was that grueling training regiments can contribute to an enlarged heart muscle…beyond a genetic component.
    Jason Collier’s heart was almost 1.5 times the size of a normal heart consistent with his size/weight.

  7. COLLIER, Jason Jeffrey 28, of Cumming, Georgia died unexpectedly October 15, 2005, in Cumming, Georgia. He was born September 8, 1977, in Springfield, Ohio, the son of Jeffrey R. and Joyce A. Collier and was a 1996 graduate of Catholic Central High School and a member of the 1996 State Championship team. He also was the 1996 Mr. Basketball for the State of Ohio, a McDonald All-American, and a Naismith Award Winner as one of the top six basketball players in the nation in 1996. Jason attended Indiana University and was a business management graduate of the Georgia Institute of Technology (Georgia Tech), where at both schools he played basketball. He played three years with the Houston Rockets NBA team and was presently in his third year with the Atlanta Hawks. In his younger years, Jason was also a nationally ranked swimmer and holds several records yet today.

    https://www.legacy.com/obituaries/springfield/obituary.aspx?n=jason-collier&pid=15428515&fhid=5368

    1. Hypertrophic cardiomyopathy, the disease that resulted in the sudden deaths of basketball players Jason Collier, Hank Gathers, Pete Maravich and Reggie Lewis, as well as USA volleyball star Flo Hyman, (among others), is congenital and not a byproduct of competitive swimming. Athletics, however, can somewhat mask what is very typically an asymptomatic ailment that can nonetheless lead to sudden death. The lack of any symptoms, however, means that cardiac testing that would identify such a condition is often not done. If there is a common trait among sufferers, it is far more common in taller people, many of who tend to be athletes.

      1. And most importantly, Walker’s condition, and others mentioned, were not results of this or any other transmittable disease.

        1. And the myocarditis may appear to be a very small percentage because some of the infected athletes (or even general population) have not, thankfully, put their possibly inflamed heart muscle through enough strain to cause cardiac arrest. They recover…or will recover (hopefully without scarring upon the heart muscle) eventually. There have been many anecdotal stories of people having subnormal recovery from exercise and shortness of breath weeks after a mild illness thought to be Covid. That seems very atypical to any prolonged side effect of getting the flu and other colds long after a virus has subsided. Could the shortness of breath be due to inflammation of the heart?

          And at least 10 BigTen players diagnosed with myocarditis seems pretty alarming considering how it’s normally very rare.

  8. Pistol Pete….Dressed up as him for a Halloween many years ago. Wore his LSU number, a Don Post skull mask and carried a silver toy pistol. My wife was expecting . She dressed up as a basketball goal…Made a cardboard backboard and I hollowed out a cheap rubber basketball and double-faced tape the outer skin of the ball to her shirt/lower abdomen.

    Wasn’t it a pick-up game at a playground when he suffered his heart attack?

    My childhood dentist was quite the character….I guess I really shouldn’t trust his definitive claim that competitive swimmers would have higher chances of dying earlier than normal life expectancy because of enlarged hearts. He would drill out my cavities without the use of Novocain….You would claw your fingers into the arms of the chair and sweat bullets while listening to the high pitched squealing of his whistling drill…..waiting for him to strike a nerve. “Just let me know when you feel something,” he’d say. My blood pressure goes through the roof to this day with any dentist visit. The terror forever lingers and awaits the sound of the drill.
    He had a nice home only a few blocks from my parents home in Chesterton. He actually had a totally enclosed swimming pool…in a sort of contemporary ranch style home.
    Wish I could share the advice he would give me when I told him I had a new girlfriend….but it’s probably not appropriate for the very friendly streets of Scoop
    Anyway, BearDown, I’ll defer to your medical expertise. I’ll defer to your expertise on pandemics. I’ll defer to your expertise on all things. I’ll defer to your expertise on the appropriate place to use “whom.” I’ll defer to the way you just kissed Jon Blau’s ass, too. I’ll defer to all of your slippery, slimy and snidely ways.
    I’m just here so I won’t get fined.

    Just a final note to the SEC, ACC and Big 12. Halloween is for fun…and so is football. I remember a neighborhood I tried to take my kid trick-or-treating when she was only a toddler. Some people (my guess is Jesus freaks) had roped off their street/cul-de-sac to ban Halloween for some religious objections….Wonder if Dabo Swinney is one of those extreme “activists” and bans Halloween while marching his kids to their possible Covid heart inflammation death (mask not included).
    It’s all in god’s hands….

    1. Harvard,

      I do believe this is the first salient point I have ever seen you make, “It’s all in god’s hands….”

      1. THINK!!!!!! Welcome back. Missed you, brother. Hope you are staying healthy and all your family is well.

        Anyone watch Bill Maher? He had Colin Cowherd on his show last night. Cowherd thinks all of college football will be shut down by the end of next week. A lot of discussion on the size of linemen and the heart issues….

          1. ^^^My apologies…That wasn’t the full segment with Cowherd. You’ll have to choose a clip with the entire show to see the full discussion. When they discussed heavy linemen, they didn’t specifically mention myocarditis (my mistake). Cowherd did have some interesting thoughts on distinctions between college athletes (with no financial claim/stake to put their health risk on the line) and pro athletes going forward amid the Covid environment.

      2. Just to tantalize your tastebuds….If football is in god’s hands, then leave Halloween in god’s hands. Allow god to be the ultimate judge if we have crossed from serving god to thinking we’re god. Leave football alone because it’s fun entertainment and everything can have an element of recklessness bordering on defiance of better judgment? Leave Halloween alone and stop using god to stomp out fun, judge others and promote yourself. Can’t I have a little defiance?

        If Swinney believes it’s in god’s hands, then shuddup about “god” and let god do his job from the big broadcast booth in the clouds.

  9. For whom the bell tolls…? Correction to Line 1:

    Pistol Pete….Dressed up as him for a Halloween [party] many years ago.

    BearDown- Try this first drill demonstrated by ‘Pistol.’

    You all have a good Friday night…..

  10. Pistol Pete the Second Amendment of the NBA. Though times and eras in professional sports were never perfect…the Pistol represented a time when professional sports did have a standard or level of integrity…that long ago came to an end with money and all things related define that loss of integrity…Almost all integrity has been confiscated and hijacked in professional sports. 1988 since his passing yesterday to yesteryear to what is now 32 years a time gone by.

  11. Nicely done, t.

    Add a guy like Bob “Butterbean” Love….#10

    I sort of think the NBA is akin to the movie industry…..In movies, the biggest event is the Academy Awards. In the NBA, the biggest event is Draft Night. Movies are now just a shotgun distribution of mostly garbage. NBA is also just a shotgun distribution of mostly garbage. As the years have gone by, both fields of entertainers are at a point of being so self-engrossed that the overall 2 hours of product on the court or on the screen is a disjointed narcissistic endeavor of hyped vomit.
    Bottom Line: Our hunger can no longer discern. We eat just to eat. We have no tastebuds. Prepackaged and prepared meals ….Prepackaged sports. We carelessly gamble our intestines with every meal served. We carelessly gamble away dollars to find purpose in watching sports void of character or meaning.
    Place the outrage where it belongs. We created the end result. We are mass consumers of all things…with a lost ability to discern any differences. We seek the cheapest price while ultimately being overcharged for terrible products. Throwaway society consumed appearing to have more than the guy next door.

  12. I had Covid- didn’t seem too bad at the time. But since then, my heart rate and pulse skyrocket randomly for no apparent reason. It’s a real thing. I don’t know if it’s temporary or the new normal. I also get out of breath easily after being in perfect health before Covid. I had pain in my chest while sick but I thought it was from the coughing. I never thought I could have a heart attack from a flu. The worst part is that none of the doctors have any answers- they just throw around greek terms for things they don’t really know or understand yet. Another weird thing- my body temp is now 94 degrees. I was 98.6 like clockwork before Covid and now 94- again, the doctors have no answers.

  13. Exactly what I’ve been hearing, 123. Lingering shortness of breath. Talk to many who think they may have had the virus (but were never tested because it was mild symptoms) and have the same shortness of breath issues now.

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