When the Big Ten announced on Tuesday that it was shutting down its football teams for the 2020 season, it was widely reported that one reason was the appearance of myocarditis, an inflammation of the heart muscle that can be caused by a number of different viruses, including COVID-19.
Myocarditis can affect the heart’s ability to pump blood and maintain a healthy rhythm. If left untreated it can cause heart failure and sudden cardiac arrest according to the Mayo Clinic website.
CBSSports.com reported that as many as 15 Big Ten football players were left with myocarditis after being diagnosed with COVID-19. That fact, plus the impassioned Facebook posting by a mother of an Indiana player who was struggling with a COVID-related heart issue, was a significant factor that led to the timing of the Big Ten’s decision.
As expected, the Pac-12 followed the Big Ten in shutting down its football programs. That left the SEC, ACC, and Big 12 as the remaining Power Five schools that will attempt to start the 2020 season on time.
The question is, with this new element of the virus now a part of the medical narrative, can those three conferences get to the starting line?
More simply put: Will myocarditis and the challenges of diagnosing it force the final three Power Five conferences to drop out?
Not all doctors agree on how this will ultimately impact the conferences that still want to play football this season. Obviously, the medical people advising the Big Ten and Pac-12 felt it was serious enough to shut down football. While myocarditis is rare in the general population, a recent German study of 100 patients who had recovered from COVID-19 found cardiac involvement in 78 patients and ongoing heart inflammation in 60 patients.
While this is considered a small sample size, the study concluded: “These studies indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.”
Dr. Cameron Wolfe, an infection disease specialist at Duke, chairs the ACC’s Medical Advisory team. Earlier this week Wolfe said that after combing the data, he thought that football could be played safely. He said doctors have learned how to manage the risk.
“We believe we can mitigate it down to a level that makes everyone safe,” he told the Sports Business Journal. “Can we safely have two teams on the field? I would say yes. Will it be tough? Yes.”
Dr. Robert Hoff, a cardiologist in Atlanta, said that there is range of testing for myocarditis that can be done immediately when a player tests positive for COVID-19. There is a blood test, hsTroponin, which is widely used for measuring heart damage.
A negative finding on this blood test, “makes the diagnosis of acute myocarditis significantly less likely,” according to a May report in “Heart Rhythm,” the official journal of the Heart Rhythm Society.
There is also a Cardiac MRI, a very sensitive test that would reveal any heart issues.
“I foresee a protocol that if you’re an athlete and you tested positive for COVID, you would immediately test for myocarditis, which you can do in a number of ways,” said Hoff, a former golfer at Duke. “If it’s negative, they can go through their COVID protocols and get back on the field.
“But if it’s positive then you can’t let them exercise for a while. That’s it.”
Hoff said an athlete that tests positive for myocarditis must refrain from exercise from three to six months.
“There is still a lot that we don’t know,” said Hoff. “But I don’t think you have to throw the baby out with the bathwater.”
So in short, myocarditis can be diagnosed. But does its mere presence in the public dialog make a difficult decision for the ACC, SEC, and Big 12 even more difficult?
It was a game changer for the Big Ten and the Pac-12. Will it be a game changer for those conferences that still want to play?