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      Coronavirus Disease 2019 and the Athletic Heart : Emerging Perspectives on Pathology, Risks, and Return to Play

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          Abstract

          <p class="first" id="d5299225e176">Cardiac injury with attendant negative prognostic implications is common among patients hospitalized with coronavirus disease 2019 (COVID-19) infection. Whether cardiac injury, including myocarditis, also occurs with asymptomatic or mild-severity COVID-19 infection is uncertain. There is an ongoing concern about COVID-19-associated cardiac pathology among athletes because myocarditis is an important cause of sudden cardiac death during exercise. </p>

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Chaolin Huang, Yeming Wang, Xingwang Li … (2020)
          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China

            Shaobo Shi, Mu Qin, Bo Shen … (2020)
            Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. However, information on cardiac injury in patients affected by COVID-19 is limited.
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              Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)

              Tao Guo, Yongzhen Fan, Ming Chen … (2020)
              This case series study evaluates the association of underlying cardiovascular disease and myocardial injury on fatal outcomes in patients with coronavirus disease 2019 (COVID-19).
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                Author and article information

                Journal
                Title: JAMA Cardiology
                Abbreviated Title: JAMA Cardiol
                Publisher: American Medical Association (AMA)
                ISSN (Print): 2380-6583
                Publication date (Electronic): October 26 2020
                Affiliations
                [1 ]Emory University School of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia
                [2 ]Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas
                [3 ]The University of Texas Southwestern Medical Center, Dallas
                [4 ]Sanger Heart and Vascular Institute, Atrium Health, Charlotte, North Carolina
                [5 ]Sports Cardiology Center, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
                [6 ]Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
                [7 ]Michigan Medicine, University of Michigan, Ann Arbor
                [8 ]Hartford Hospital, Hartford, Connecticut
                [9 ]Cardiovascular Performance Program, Massachusetts General Hospital, Boston
                Article
                DOI: 10.1001/jamacardio.2020.5890
                PubMed ID: 33104154
                SO-VID: 27303638-ec0d-482f-9514-d76527a9f029
                Copyright © © 2020
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