Elite athletes safely return to top-level sports after COVID-19: No issues found in more than 2 years of follow-up

Heart problems after a COVID infection are a serious concern for both elite athletes and recreational athletes alike. A study from Amsterdam UMC, published in Heart, offers some reassuring news.

"We examined over 250 elite athletes and found that those who had contracted COVID-19 did not experience severe heart issues that impacted their careers," says Juliette van Hattum, a Ph.D. candidate in sports cardiology at Amsterdam UMC.

The study specifically focused on elite athletes, a group that could be particularly susceptible to heart issues, particularly heart inflammation, post-COVID-19 due to their intense physical activity.

"We wanted to know if COVID-19 posed a risk to this group, who push their bodies and hearts to the limit," says Harald Jorstad, a sports cardiologist at Amsterdam UMC.

Of the 259 athletes followed in the study, spread across sports as diverse as cycling and water polo, 123 had contracted COVID-19. They were initially assessed around four months after their infection and followed for an average of 27 months. While some athletes who had had COVID-19 did show a slightly elevated resting heart rate, there were no significant differences in overall heart function. Crucially, they also found no increase in ventricular arrythmias or sudden cardiac deaths.

"Interestingly, four of the athletes did show clear peri-myocardial involvement due to their COVID-19 infection. But the good news is that even these athletes were able to continue their professional careers and remain competitive at the highest levels without further heart issues," adds van Hattum. The finding of four athletes—around 3%—with heart involvements echoes other studies that show heart inflammation as a symptom of a COVID-19 infection.

Jorstad concludes, "Our study should be reassuring for athletes and about the impact of COVID-19 on the heart. Based on what we've seen, heart involvement is rare and the risks appear to be minimal, even for those returning to intensive sports activities."