Competitive Sports, the Coronavirus Disease 2019 Pandemic, and Big Ten Athletics

Role of cardiac magnetic resonance imaging in the diagnosis and management of COVID-19 related myocarditis: Clinical and imaging considerations

“…These tests provide little use in differentiating myocarditis from similarly presenting processes such as myocardial infarction or pulmonary embolus. If the aforementioned workup does not point towards a definitive diagnosis of myocarditis, CMRI may be indicated to provide direct tissue characterization, assess cardiac function indirectly based on the degree of inflammation present, and produce the confidence necessary to establish the diagnosis of myocarditis [42,44,45]. In addition, contrast-enhanced MRI may be a useful, noninvasive tool for long-term follow-up of patients with acute myocarditis and provide more accurate data on predicting outcome.…”

COVID-19 and the Athlete

“…The Big Ten Conference is setting up a cardiac registry from 14 schools that will report observational data but also incorporate control groups. Core laboratories in the areas of clinical/biomarkers, ECG, echocardiography, CMR, and epidemiology will independently review all cardiac evaluations ( 10 ). (Disclosure: Drs.…”

“…Future studies will ideally follow athletes longitudinally and incorporate controls groups that are healthy and have non-COVID-19–related infection. Until we have more data, a pragmatic approach that uses CMR on an individualized basis seems reasonable ( 8 , 10 ). Symptoms have been the starting triage point for expert-led RTP algorithms to date, but they can be subtle, minimized, or even denied when one is eager to return to play.…”

“…Future studies will ideally follow athletes longitudinally and incorporate controls groups that are healthy and have non-COVID-19–related infection. Until we have more data, a pragmatic approach that uses CMR on an individualized basis seems reasonable ( 8 , 10 ).…”

Calling an Audible

“…In this issue of Circulation: Cardiovascular Quality & Outcomes , we publish a Cardiovascular Perspective by the Big Ten Cardiac Registry Steering Committee (CRSC). 1 The article details a series of key recommendations made by this committee of conference administrators and physicians from diverse specialties including cardiology in light of the coronavirus disease 2019 (COVID-19) pandemic. It reviews the overall timeline of critical events that led initially to the cancelation of spring and fall sports as well as the recent decision by the Big Ten to allow football (and presumably other fall sports) to proceed.…”