Methods of non-invasive electrocardiology in the detection of myocardial damage after COVID-19 (SARS-CoV-2) infection in young elite athletes

Abstract

The impact of the new coronavirus infection (SARS-CoV-2) on the state of the cardiovascular system in minor athletes is uncertain. The “golden” standard for their detection is cardiac magnetic resonance imaging with gadolinium contrast. However, mass screening of athletes using magnetic resonance imaging has not shown any advantage over conducting research according to indications. An analysis of the results of an in-depth medical examination of 1505 young athletes, members of youth teams of the Russian Federation, who were examined at the Center for Syncope and Cardiac Arrhythmias from September 1, 2021 to June 31, 2022, was carried out. 236 athletes (15.7%) suffered SARS-CoV-2 infection for the 6 months preceding the in-depth medical examination. Stage I of the examination included examination, electrocardiography, echocardiography, and bicycle ergometry. 22 athletes (9.3%) required a more in-depth examination due to the identified changes in the first stage (stage II). It included Holter monitoring with assessment of heart rate turbulence, microvolt alternation of the T wave and heart rate variability, and high-resolution electrocardiography. Seven athletes (32%), with changes identified at this stage, were sent for magnetic resonance imaging (stage III). Based on its results, myopericarditis was diagnosed in 4 cases (1.7% of 236), and the necessary treatment and observation were prescribed. Conclusion. There is a low (less than 2%) involvement of myocardial damage in young elite athletes who have had SARS-CoV-2 infection. Additional methods of non-invasive electrocardiology, such as high-resolution electrocardiography, Holter monitoring with assessment of heart rate variability, heart rate turbulence and microvolt alternation of the T wave, make it possible to determine indications for cardiac magnetic resonance imaging.