Objectives
We sought to explore the spectrum of cardiac abnormalities in student-athletes who returned to university campus in July 2020 with an uncomplicated Coronavirus disease 2019 (COVID-19).
Background
There is limited information regarding cardiovascular involvement in young individuals with mild or asymptomatic COVID-19.
Methods
Screening echocardiograms were performed in 54 consecutive student-athletes (mean age: 19 years, 85% males) who tested positive on reverse transcription–polymerase chain reaction nasal swab testing of the upper respiratory tract or IgG antibodies against SARS-CoV-2. A sequential cardiac magnetic resonance (CMR) imaging was performed in 48 (89%) subjects.
Results
A total of 16 (30%) athletes were asymptomatic while 36 (66%) and 2 (4%) reported mild and moderate COVID-19 related symptoms, respectively. For the 48 athletes completing both imaging studies, abnormal findings were identified in 27 (56.3%) individuals. This included 19 (39.5%) showing pericardial late enhancements with associated pericardial effusion. Of the individuals with pericardial enhancements, 6 (12.5%) had reduced global longitudinal strain (GLS) and/or an increased native T1. One patient showed myocardial enhancement and reduced left ventricular ejection fraction or reduced GLS with or without increased native T1 were also identified in additional 7 (14.6%) individuals. Native T2 were normal in all subjects and no specific imaging features of myocardial inflammation were identified. Hierarchical clustering of LV regional strain identified three unique myopericardial phenotypes that showed significant association with the CMR findings (P=0.03).
Conclusion
Over one in three previously healthy college-athletes recovering from COVID-19 infection showed imaging features of a resolving pericardial inflammation. Although subtle changes in myocardial structure and function were identified, no athlete showed specific imaging features to suggest an ongoing myocarditis. Further studies are needed to understand the clinical implications and long-term evolution of these abnormalities in uncomplicated COVID-19.
Background
There is a lack of contemporary data on cardiogenic shock (CS) in‐hospital mortality trends.
Methods and Results
Patients with CS admitted January 1, 2004 to December 31, 2018, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in‐hospital mortality among the overall population and selected subgroups. Among a total of 563 949 644 hospitalizations during the period from January 1, 2004, to December 30, 2018, 1 254 358 (0.2%) were attributed to CS. There has been a steady increase in hospitalizations attributed to CS from 122 per 100 000 hospitalizations in 2004 to 408 per 100 000 hospitalizations in 2018 (
P
trend
<0.001). This was associated with a steady decline in the adjusted trends of in‐hospital mortality during the study period in the overall population (from 49% in 2004 to 37% in 2018;
P
trend
<0.001), among patients with acute myocardial infarction CS (from 43% in 2004 to 34% in 2018;
P
trend
<0.001), and among patients with non–acute myocardial infarction CS (from 52% in 2004 to 37% in 2018;
P
trend
<0.001). Consistent trends of reduced mortality were seen among women, men, different racial/ethnic groups, different US regions, and different hospital sizes, regardless of the hospital teaching status.
Conclusions
Hospitalizations attributed to CS have tripled in the period from January 2004 to December 2018. However, there has been a slow decline in CS in‐hospital mortality during the studied period. Further studies are necessary to determine if the recent adoption of treatment algorithms in treating patients with CS will further impact in‐hospital mortality.
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