What is myocarditis? And should ACC football players be worried about it?
Penn State’s director of athletic medicine made national news Thursday for alarming comments on the link between the novel coronavirus and the heart condition myocarditis, which he later corrected.
According to the Centre Daily Times, Dr. Wayne Sebastianelli told a local school board Monday that “30 to roughly 35 percent” of Big Ten athletes who tested positive for COVID-19 had myocarditis, an inflammation of heart muscles that can lead to fatal cardiac arrest during exercise/exertion.
“And we really just don’t know what to do with it right now,” Sebastianelli told the State College Area School District board of directors, according to the paper. “It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening.”
By late Thursday, Penn State Health issued a statement correcting Sebastianelli’s previous comments, which he had confirmed to the paper. He was recalling “initial preliminary data that had been verbally shared by a colleague on a forthcoming study, which unbeknownst to him at the time had been published at a lower rate” of close to 15 percent, the statement said.
The non-profit Myocarditis Foundation defines the condition as “a rare but potentially devastating” one that is “most commonly caused by viruses.” There are around 75 deaths per year in athletes between 13 and 25 years old, the foundation said, and myocarditis causes around 6 percent of those deaths.
Dr. Eugene Chung, the chair of the American College of Cardiology’s Sports and Exercise Council, told the News & Observer last month that coronavirus has been connected to myocarditis since COVID-19 may cause heart arrhythmias. Those arrhythmias affect heart muscles through inflammation — which can lead to myocarditis — and through blood clotting, which elevates the risk of heart attacks.
“If someone has COVID-19, but doesn’t have symptoms, we still want to ask the questions” Chung told the N&O. “And depending on exposure and depending on symptoms, we want to do a cardiac evaluation because (COVID-19) does seem to have the ability to affect the heart and not cause symptoms.”
He added: “And while the numbers we have seen are small, there have been some reports of inflammation picked up in the heart with cardiac MRI, even in the absence of symptoms. So that is definitely a concern.”
Chung’s comments line up with the study Sebastianelli referenced, albeit incorrectly. The research from Dr. Curt Daniels, the director of sports cardiology at Ohio State, said those cardiac MRIs found myocarditis in around 15 percent of athletes who’d tested positive for COVID-19. Almost all of those athletes showed mild symptoms or no symptoms, Daniels told the New York Times.
The preliminary findings of Daniels’ three-month study were presented to Big Ten and Pac 12 leaders in early August, before both leagues postponed their seasons for football and all other fall sports. In an Aug. 11 statement, Big Ten commissioner Kevin Warren said it “became abundantly clear that there was too much uncertainty regarding potential medical risks” to allow fall competition.
Boston Red Sox ace Eduardo Rodriguez, 27, was diagnosed with myocarditis in late July after battling the coronavirus earlier in the summer. He will miss the entire 2020 season, and the Red Sox believed the condition was a result of Rodriguez contracting COVID-19, ESPN reported. Rodriguez said in late July his doctors told him 10 to 20 percent of people diagnosed with COVID-19 have also been diagnosed with myocarditis.
There haven’t been any cases of myocarditis in COVID-19 positive student-athletes at Penn State, the school said in its Thursday statement issued to ESPN. It added Sebastianelli “apologize(s) for any confusion” caused by his Monday comments.
This story was originally published September 3, 2020 at 10:06 PM with the headline "What is myocarditis? And should ACC football players be worried about it?."