The discovery of athletes developing myocarditis after battling a COVID-19 infection previously forced several professional and collegiate sports leagues to cancel their major events and seasons. But latest scientific data on the pathogenesis of the coronavirus disease has shed light on how the incidence of heart inflammation among athletes was lower than first thought.

New Guidance

The American College of Cardiology (ACC) released new guidelines for athletes who battled COVID-19 on Tuesday, after two years of research. The new guidance contained a cohesive plan for athletes and weekend warriors attempting to return to their intensive routines and activities.

Based on the new guidelines, asymptomatic athletes are encouraged to abstain from training for three days to ensure that they won’t develop symptoms. Athletes with mild but non-cardiopulmonary symptoms should wait for the symptoms to resolve before returning to their exercise training.

Meanwhile, athletes with cardiopulmonary symptoms, such as chest pain, palpitations, and syncope, are strongly recommended to defer exercise training for three to six months. They should also complete self-isolation, wait for their symptoms to go away, and subject themselves to cardiac testing for further evaluation.

Experts said re-introduction of exercise to athletes who survived COVID-19 should be gradual. They should start with small and less intense exercise before increasing frequency, duration, and intensity. This would help their bodies adapt to the changes in their routines brought about by the infection.

Future Directions

The ACC said that the guidelines are still subject to change, especially when further understanding of the cardiovascular effects of COVID-19 becomes available. There is a need to continue studying the effects of SARS-CoV-2 in athletes to determine how long recovery takes after the symptoms disappear. Moreover, it is crucial to find the risks and benefits of exercise resumption for athletes after an infection.

Early in the pandemic, doctors were doing “very rigorous testing searching for myocarditis,” believing that the incidence of the condition “was going to be much higher,” Cleveland Clinic Sports Cardiology Center co-director Dr. Tamanna Singh, who was not involved in the new guidance, told ABC News.

Thanks to further research on the matter, scientists were able to determine that the rate of myocarditis development in athletes was “very low” at around “0.6 to 0.7%.” Despite this, University of Michigan cardiologist and echocardiographer Dr. Nicole Bhave, a co-chair on the committee that worked on the new guidance, said patients with COVID myocarditis must receive proper treatment because though the complication may be rare, it could get serious fast.