New study aims to determine the prevalence of COVID-related heart inflammation among elite athletes

An innovative study at Duke Health aims to determine the prevalence of COVID-related heart inflammation among top-level athletes and establish the symptoms and clinical features to ensure they receive timely and accurate diagnoses.

Heart inflammation, called myocarditis, can arise from COVID infections, and can cause chest pain, heart palpitations and shortness of breath. In severe cases, it can cause permanent damage. Numerous college and professional athletes have tested positive for COVID, adding heightened urgency to research on the cardiovascular effects of the infection.

The Duke-led study is an outgrowth of the Hearts of Athletes study that was launched to establish a better understanding of how hearts are altered by high-level athletic activities. With the new focus on COVID, the study will enroll 300 NCAA, professional and Olympic athletes around the country - 200 who have had COVID and 100 who have not - to undergo heart tests and participate in ongoing monitoring via a health app.

Even before COVID, we did not have enough information about how the hearts of elite athletes might be different than other healthy people. Now with COVID and its potential impact on the heart, it's more important than ever to understand whether athletes face unique risks or greater protections based on their cardiovascular features."

Manesh Patel, M.D., study lead, chief of cardiology, Duke University Medical School

The Hearts of Athletes study is funded by The Joel Cornette Foundation, which was established by the family of former Division 1 basketball player Joel Cornette after he died unexpectedly in his mid-30s from an undiagnosed heart condition. The Cornette Foundation supports research into heart disease among athletes and selected Duke as the analytic center for the Hearts of Athletes study.

The study will be available to top athletes from across the U.S. through the Hearts of Athletes app -- built on Deloitte's ConvergeHEALTH MyPath for Clinical cloud-based digital platform -- downloaded to their mobile devices.

Both COVID-positive and -negative study participants will undergo standard heart workups -- including an echocardiogram followed by a cardiac MRI -- at a medical facility where they live. Athletes who have received COVID vaccinations will also be eligible. Their de-identified cardiac images will then be sent to the Duke Heart Center for a blinded analysis. Those who have abnormalities will undergo additional observation and treatment.

Participants will also complete a daily health survey for a month, noting COVID symptoms and other health information, via the app.

The study will determine the rate of COVID-related myocardial involvement among athletes, as well as the symptoms and clinical features associated with the condition. Additionally, the data and images of the athletes' hearts will be archived for additional research that could inform medical care and treatment.

"This study will help us better understand how COVID affects the hearts of athletes and, more importantly, how playing sports affects the heart more broadly," Patel said. "Athletes need to know if they have heart conditions that put them at risk - this is information that is empowering. We need to be able to identify those conditions and weigh the impact."