SARS-CoV2 infection: functional and morphological cardiopulmonary changes in elite handball players

Sci Rep. 2021 Sep 7;11(1):17798. doi: 10.1038/s41598-021-97120-x.

Abstract

There is increasing evidence of cardiac involvement post-SARS-CoV-2 infections in symptomatic as well as in oligo- and asymptomatic athletes. This study aimed to characterize the possible early effects of SARS-CoV-2 infections on myocardial morphology and cardiopulmonary function in athletes. Eight male elite handball players (27 ± 3.5 y) with past SARS-CoV-2 infection were compared with four uninfected teammates (22 ± 2.6 y). Infected athletes were examined 19 ± 7 days after the first positive PCR test. Echocardiographic assessment of the global longitudinal strain under resting conditions was not significantly changed (- 17.7% vs. - 18.1%). However, magnetic resonance imaging showed minor signs of acute inflammation/oedema in all infected athletes (T2-mapping: + 4.1 ms, p = 0.034) without reaching the Lake-Louis criteria. Spiroergometric analysis showed a significant reduction in VO2max (- 292 ml/min, - 7.0%), oxygen pulse (- 2.4 ml/beat, - 10.4%), and respiratory minute volume (VE) (- 18.9 l/min, - 13.8%) in athletes with a history of SARS-CoV2 infection (p < 0.05, respectively). The parameters were unchanged in the uninfected teammates. SARS-CoV2 infection caused impairment of cardiopulmonary performance during physical effort in elite athletes. It seems reasonable to screen athletes after SARS-CoV2 infection with spiroergometry to identify performance limitations and to guide the return to competition.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asymptomatic Infections
  • Athletes / statistics & numerical data*
  • Athletic Performance / physiology
  • Athletic Performance / statistics & numerical data*
  • COVID-19 / diagnosis
  • COVID-19 / physiopathology*
  • COVID-19 / virology
  • COVID-19 Nucleic Acid Testing / statistics & numerical data
  • Echocardiography / statistics & numerical data
  • Exercise Test / statistics & numerical data
  • Germany
  • Heart / diagnostic imaging
  • Heart / physiopathology*
  • Humans
  • Lung / diagnostic imaging
  • Lung / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • RNA, Viral / isolation & purification
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification
  • SARS-CoV-2 / pathogenicity
  • Spirometry / statistics & numerical data
  • Young Adult

Substances

  • RNA, Viral