The incidence of post-COVID-19 cardiac compromise is not well known. The eventual cardiac repercussions on a return to high-performance sport are unclear. A prospective observational study with evaluation by physical examination, electrocardiogram, Doppler echocardiogram and cardiac magnetic resonance imaging (CMR) was carried out in international level professional soccer players recovering from COVID-19 who had the disease asymptomatic or with mild symptoms. Four-month follow-up with participation in national and international competitions. Twenty-four soccer players were included, age 27.13 years (between 20 and 36). Nine (37.5%) had asymptomatic disease and 15 (62.5%) had mild symptoms. No athletes required hospitalization. Physical, electrocardiographic, and echocardiographic examinations did not reveal heart disease. CMRs showed ventricular thicknesses and volumes consistent with high-performance athletes. In T1, T2 and fat saturation signals, no fat infiltration or signs of edema were observed. No late enhancement after gadolinium injection. They began their training between 12 and 14 days after diagnosis. Eleven (45.8%) participated between 4 and 6 international matches of Libertadores de América International Cup. The remaining 13 completed high intensity training sessions and participated in local league competitions. At 4 months after diagnosis, none of the soccer players developed cardiac events and training and competitions were well tolerated. These findings suggest low cardiovascular impact of COVID 19 and excellent tolerance to early post-COVID high intensity exercise of young athletes recovering from the disease with no or mild symptoms.
La incidencia de compromiso cardíaco post COVID-19 en pacientes que cursaron la enfermedad asintomáticos o con síntomas leves no es bien conocida. Tampoco están claras las eventuales repercusiones cardíacas en el regreso al deporte de alto rendimiento. Se realizó un estudio observacional prospectivo con evaluación mediante electrocardiograma, ecocardiograma Doppler y resonancia magnética cardiaca (RMC) a hombres futbolistas profesionales de nivel internacional que habían cursado COVID-19 asintomáticos o con síntomas leves; seguimiento 4 meses con participación en competencias nacionales e internacionales. Se incluyeron 24 futbolistas, edad media 27, (20-36). Nueve (37.5%) cursaron la enfermedad asintomáticos y 15 (62.5%) con síntomas leves. Los exámenes físicos, electro y ecocardiográficos no evidenciaron cardiopatía. Las RMCs mostraron espesores y volúmenes ventriculares acordes a deportistas de alto rendimiento. En las señales de T1, T2 y saturación grasa no se observó infiltración grasa ni signos de edema; sin realce tardío post inyección de gadolinio. Comenzaron sus entrenamientos entre 12 y 14 días post diagnóstico. Once (45.8%) participaron entre 4 y 6 encuentros internacionales de la Copa Libertadores de América. Los restantes 13 cumplieron con entrenamientos de alta intensidad y participaron en competencias de liga local. A 4 meses del diagnóstico ninguno de los futbolistas desarrolló eventos cardíacos y los entrenamientos y competencias fueron bien tolerados. Estos hallazgos sugieren la escasa repercusión cardiovascular de COVID-19 y la excelente tolerancia al ejercicio de alta intensidad realizado en forma precoz post COVID de deportistas jóvenes que cursaron la enfermedad asintomáticos o con síntomas leves.
Keywords: COVID-19; athlete; cardiac magnetic resonance; soccer player.