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Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis

Author

Listed:
  • Gloria Modica

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
    These authors contributed equally to this work.)

  • Massimiliano Bianco

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
    These authors contributed equally to this work.)

  • Fabrizio Sollazzo

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Emanuela Di Murro

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Riccardo Monti

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Michela Cammarano

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Lorenzo Morra

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Francesco Maria Nifosì

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Salvatore Francesco Gervasi

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy
    The author has passed away.)

  • Ester Manes Gravina

    (Department of Geriatrics, Neurosciences, Orthopaedics and Head and Neck, Università Cattolica del Sacro Cuore-Fondazione Policlinico ‘Agostino Gemelli’ IRCCS, 00168 Rome, Italy)

  • Paolo Zeppilli

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

  • Vincenzo Palmieri

    (Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy)

Abstract

Background: To assess the event rates of myocarditis detected by Cardiac Magnetic Resonance (CMR) in athletes who recovered from COVID-19. Methods: A systematic literature search was performed to identify studies reporting abnormal CMR findings in athletes who recovered from COVID-19. Secondary analyses were performed considering increased serum high sensitivity troponin (hs-Tn) levels and electrocardiographic (ECG) and echocardiographic (ECHO) abnormalities. Results: In total, 7988 athletes from 15 studies were included in the analysis. The pooled event rate of myocarditis was 1% (CI 1–2%), reaching 4% in the sub-group analysis. In addition, heterogeneity was observed (I2 43.8%). The pooled event rates of elevated serum hs-Tn levels, abnormal ECG and ECHO findings were 2% (CI 1–5%), 3% (CI 1–10%) and 2% (CI 1–6%), respectively. ECG, ECHO and serum hs-Tn level abnormalities did not show any correlation with myocarditis. Conclusions: The prevalence of COVID-19-related myocarditis in the athletic population ranges from 1 to 4%. Even if the event rate is quite low, current screening protocols are helpful tools for a safe return to play to properly address CMR studies. Trial registration: the study protocol was registered in the PROSPERO database (registration number: CRD42022300819).

Suggested Citation

  • Gloria Modica & Massimiliano Bianco & Fabrizio Sollazzo & Emanuela Di Murro & Riccardo Monti & Michela Cammarano & Lorenzo Morra & Francesco Maria Nifosì & Salvatore Francesco Gervasi & Ester Manes Gr, 2022. "Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(7), pages 1-12, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:4279-:d:786328
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    Cited by:

    1. Valerio Flavio Corona & Maria Rosaria Gualano & Maria Francesca Rossi & Angelica Valz Gris & Carlotta Amantea & Umberto Moscato & Walter Ricciardi, 2022. "Psychological and Mental Sequelae in Elite Athletes with Previous SARS-CoV-2 Infection: A Systematic Review," IJERPH, MDPI, vol. 19(24), pages 1-7, December.

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