Ohio State study: 15% of "recovered/recovering" COVID athletes have myocarditis on MRI
Key passage quoted below.
"Four of the athletes -- about 15% -- had signs of inflammation to the heart muscle. However, experts caution these results don't necessarily mean athletes who have recovered from COVID-19 are in grave danger.
The MRI findings described in the study are only one factor in a very complex process of diagnosing serious heart problems such as myocarditis. Doctors also use blood tests, symptoms and echocardiograms to guide their decisions. And in the study of these 26 college athletes, every one of these other findings were normal with the exception of mild viral symptoms in some athletes.
As pressure mounts to resume college athletics, all eyes are on the experts with one simple question: How will we know when it's safe for competitive athletes to return to sports?
"The athletes [in the study] had already recovered or had no symptoms," said Dr. Eugene Chung, a cardiac electrophysiologist at University of Michigan and author of A Game Plan for the Resumption of Sport and Exercise After Coronavirus Disease 2019 (COVID-19) Infection, also published in JAMA Cardiology earlier this year.
"But with those MRI findings and the uncertainty about what they mean, at this time, I would recommend at least three months of exercise limitation," said Dr. Chung, who was not involved in the Ohio State study."
September 11th, 2020 at 3:00 PM ^
Dave Yost will sue the "MRI findings."
September 11th, 2020 at 3:05 PM ^
Sorry, saw this part and stopped: "Four of the athletes -- about 15% -- had signs of inflammation to the heart muscle. However, experts caution these results don't necessarily mean athletes who have recovered from COVID-19 are in grave danger."
You cannot extrapolate to a population as large as "athletes" (i.e. millions of people) from the observation of 26 people. No, no, no. This is part of the reason why jackasses are calling this virus a "hoax." I know, the medical community is doing its best and little data points help. And the media wants to get stories out that are helpful to people (and yes, get clicks). But this is frustrating...
September 11th, 2020 at 3:18 PM ^
Also because similar studies are using MRI findings of highly dubious nature to classify things myocarditis outside of the typical clinical algorithm. See the fake JAMA article earlier this year.
September 11th, 2020 at 3:20 PM ^
Great observation. We as a society need to stop watching and listening to all the "fake news" outlets regardless of political agenda. It seems everyone has an angle. Maybe the "dawn of the internet" has caused this false reporting as click bait from even the most reputable sources.
Even if the report is correct, is the condition linked to some other condition the athlete has (STDs come to mind). Then if there is a link, is there any long-term damage? Then any statistics will need to stand up to peer review scrutiny; which will take months or even years.
September 11th, 2020 at 3:24 PM ^
Even if the report is correct, is the condition linked to some other condition the athlete has (STDs come to mind).
You can't be serious.
September 11th, 2020 at 4:59 PM ^
He is and don’t call them “Shirley”.
September 11th, 2020 at 5:46 PM ^
What? HAHAHAHAHAHHAHAHAHAHAH
September 11th, 2020 at 3:21 PM ^
The authors stated conclusion was that mri could be used as a tool for risk stratification.
not that this should be used to guide policy
September 11th, 2020 at 3:41 PM ^
I know, I actually did read it. I think I am more mad at your headline than the article itself. ;-)
September 11th, 2020 at 4:45 PM ^
If that helps distract you from the content, more power to you
September 11th, 2020 at 8:32 PM ^
No science can prove anything in a couple months starting from nothing. If that is your standard, nothing will be proven re: covid. Yet it is here.
4 (or 8) out of 26 case reports is something that merits further study. (Remember that 1 person with a weird reaction paused a vaccine trial). I hope to hell they play football, but anybody that has any signs of this needs to be shut down.
September 11th, 2020 at 10:24 PM ^
Correct! An "N" of 26 is not a viable number for a scientific finding on something like COVID. Also, one always has to ask "What is the end result of these athletes that have myocarditis?". Do they have any issues with this or is it just a medical finding that in the long run means little to nothing.
September 11th, 2020 at 3:05 PM ^
If I'm reading this excerpt correctly, then the title of this post is wrong. The MRIs showed signs of inflammation, but since all the other tests were normal, then no actual diagnosis was given.
Also, shout out to Dr. Chung for suggesting the three month exercise limitation period. That seems like a super convenient length of time to restrict the exercise of the OSU players.
September 11th, 2020 at 3:25 PM ^
-itis
[ˈīdəs]
SUFFIX
-
forming names of inflammatory diseases.
"Of 26 competitive athletes, 4 (15%) had CMR findings suggestive of myocarditis" is the direct quote from the article
September 11th, 2020 at 3:37 PM ^
Yes, but in medicine, you don't diagnose because of cringey internet semantics arguments. This is because treatment algorithms flow from clinical diagnoses. Context matters, but stripping of context is a great way to get ignorant people to panic
September 11th, 2020 at 3:49 PM ^
Well, you can get nitpicky about the way I worded a headline, or you can look at the very relevant data that shows that what should be healthy hearts are showing abnormalities on imaging, similar to every other paper on Covid and cardiac mri to date
September 11th, 2020 at 4:13 PM ^
You can't actually look at the data because they didn't release any data or methods. I'm not getting nit picky, though. This is literally the crux of the issue that I'm talking about. If you haven't read or understood the other 'myocarditis' papers (all of which have the same issues and two of which were retracted/corrected post headlines) I can't help you.
September 11th, 2020 at 4:37 PM ^
What "data" do you want to look at?
This is a small sample size case series of imaging findings. Imaging studies are interpreted by radiologists and cardiologists, and their summarized findings are in the paper. Its a pretty cut and dry case series and there's nothing you can really scrutinize unless you don't trust the interpretations of the physicians themselves
September 11th, 2020 at 4:44 PM ^
I'd like to look at their findings (noticed you skipped methodology). I understand that the study is largely useless because it is low powered, but they're trying to pump a similar stupid narrative that has been pushed in the pages of other articles. Again, if you're not familiar with the diagnostic techniques being used here and why they shouldn't be compared to myocarditis, as it is typically diagnosed, I can't help you. I mean, I could, but I spent a lot of time on here explaining this issue to stupid people a few days ago, and I don't care to repeat myself.
September 11th, 2020 at 4:48 PM ^
The findings are in table 2 of the paper
The methodology is just interpreting a cardiac MRI as they do with any other patient who comes in for a cardiac MRI.
Almost all are objective imaging values, some are subjective (particularly the pattern of enhancement), but subjectivity is an inherent limitation of all imaging research. I trust at a hospital like Ohio State, their interpretations are correct
you'll never see the MRIs themselves other than selected images, because of HIPAA
September 11th, 2020 at 5:00 PM ^
>but subjectivity is an inherent limitation of all imaging research.
Really opens it up to the question of why all the myocarditis is being found via imaging and none of it can be confirmed via blood testing. Not a hard question to answer, most likely.
https://twitter.com/venkmurthy/status/1304447000272924672
If you want specific, high-quality analysis from a UMich cardiologist at CVC, read this. If you don't have much clinical training, it won't help much, but the main takeaways are as follows. No control. Confounders include study group consisting only of highly trained athletes (known prevalence of late gadolinium enhancement within range found in study). Apparently eyeballing edge cases @ 1% cutoff criteria for RVEF. All cases are very subtle.
"What I am concerned about is the notion that even among people with no symptoms, there is raging, "carnage" of the heart muscle cells, with long term implications of a "wave" of heart disease/failure. As of yet there is no data to support such talk, IMO." - Dr. Murthy
September 11th, 2020 at 5:56 PM ^
Welp, another rabbit hole to delve into. Yay.
I don't agree with you much at all, and sometimes think you're a raging lunatic, but this post was solid. You provided some real info. I don't know enough on the topic to say anything intelligent, but I will read up on it.
September 11th, 2020 at 6:39 PM ^
I appreciate the begrudged compliment
Good on ya
September 11th, 2020 at 6:11 PM ^
Research report after research report comes out about myocarditis risk related to COVID and all your responses are why each report has one flaw or another. Yours is solely an agenda driven argument that is void of scientific integrity. Come back when you have the study that says athletes do not get myocarditis from covid and there is no risk?
September 11th, 2020 at 6:41 PM ^
> all your responses are why each report has one flaw or another.
Correct. That used to be called science
September 11th, 2020 at 8:24 PM ^
That is not science. That is politics
There is more than enough data where your nit picking tactics put your political agenda above science. At this point the burden of proof is on you to provide the irrefutable (your requirement) study to prove the counter argument.
If you were approaching a burning building for the first time in history would you tell your fire fighters to jump into the fire because there is no perfect study to prove jumping into fire is not safe? Of course not. The burden of proof is on those, like you, who want to risk lives not same them.
September 11th, 2020 at 6:34 PM ^
There is no 100% specific “test” for myocarditis
there is a “test” that shows what a normal heart looks like, with imaging criteria for a radiologic diagnosis of myocarditis . That is what this article addresses
if you disagree with the known Body of literature behind cardiac mri and what constitutes “normal” and “abnormal”, then I don’t know what else to say
September 11th, 2020 at 6:41 PM ^
I'll just take this substanceless parting shot as an admission of failure on your part
September 11th, 2020 at 5:00 PM ^
Your posts are nonsensical and you don't know what you are talking about. If you do a cardiac MRI and see signs of inflammation, that is a potential problem. There are now multiple reports of this in mildly or minimally symptomatic patients. The answer is, as it has been for the past six months, we simply don't know the answer. In the absence of knowing whether you are potentially exposing people to permanent cardiomyopathy, the prudent thing is to not put those people at unnecessary risk.
September 11th, 2020 at 5:02 PM ^
Username checks out.Your risk stratification capabilities are lacking
September 11th, 2020 at 8:24 PM ^
Most common cause of myocarditis is Adenovirus. Sounds scary. Shouldn't we be doing something about this terrifying virus since it has been the chief contributor to myocarditis? The children aren't safe until we eradicate Adenovirus.
September 11th, 2020 at 6:18 PM ^
Chung is probably pals with Sebastianelli at PSU ... throwing more chum in the water for their "be afraid - be very afraid" cohorts that need daily reminders that the world is overdue to end
September 11th, 2020 at 7:13 PM ^
He is a Harvard educated, University of Michigan Professor. I will take his opinion over yours any day.
September 11th, 2020 at 7:42 PM ^
I'l raise you a UMich Cardiologist, Dr. Murthy, saying he's full of shit. Oh boy!
September 11th, 2020 at 3:05 PM ^
yet 75% of them tested positive for stds, not believed to be Covid-19 related
September 11th, 2020 at 3:12 PM ^
Sir Yacht was the source.
September 11th, 2020 at 3:15 PM ^
how many times do we have to teach you this lesson, old man?
September 11th, 2020 at 5:50 PM ^
Oh, I love the young people . . .
September 11th, 2020 at 3:15 PM ^
Does this indicate the percentage of athletes who did not have Covid who had signs of inflammation in the heart muscle? It seems hard to get a handle on this unless we have a control group to compare to.
September 11th, 2020 at 3:21 PM ^
Exactly why is there still pressure to play now that we all know Trump never believed it was a hoax?
Dude is a super-spreading liar.
I still don't believe there will ever be much of a college football season. Disappointed but it is what it is given the stae of CV in the US.
September 12th, 2020 at 4:40 PM ^
COVID conspiracy theories aren’t really logically consistent they’re more of a feeling the world is out to get you (or isn’t in this case) and in America feelings matter more than facts
September 11th, 2020 at 3:29 PM ^
Uncertainty is what we must live with for now. Despite the bloviators, there are few easy and no obvious answers.
September 11th, 2020 at 3:43 PM ^
Too much noise. I quit paying much attention a while back. I’ll be enjoying football tomorrow and will be rooting for the Miami Hurricanes this season because, wtf.
September 11th, 2020 at 3:48 PM ^
They looked competent last night at least.
September 11th, 2020 at 3:51 PM ^
Just a different U of M with more 2 Live Crew.
September 11th, 2020 at 6:13 PM ^
I will be watching for Duke to upset ND... about same percentage chance malarkey has quoted here within
September 11th, 2020 at 3:47 PM ^
3 months of exercise limitation?
That would definitely suggest something more than what most teams are doing now.
September 11th, 2020 at 3:48 PM ^
Point to this info is that the medical community will err on the safe side. With this even a possibility, it is not likely that there will be enough votes to play any time soon. Then there is the no practice of Wisconsin and other schools who are not going to vote to begin the season when they would have a disadvantage having not been in pads the same amount of time as other schools.
OSU can loose the hope of any CFP.
September 11th, 2020 at 4:41 PM ^
26 person sample size is almost statistically irrelavant. 80% of people in A2 are think OSU sucks.
September 11th, 2020 at 4:43 PM ^
Yes, but when you combine multiple similar studies of 25-100 patients showing similar findings (known as a "meta-analysis"), you can reach statistical relevance.
Don't worry, that's coming next and you will tell us then why that Doesn’t matter either unless it supports your feelings