Long COVID symptoms very rare among young, competitive athletes

BOSTON, Mass. — Lingering and unpredictable COVID-19 symptoms long after the illness is over continues to be a major point of concern. While modern medicine continues to work around the clock to better understand “long COVID” in all of its forms, a team from Massachusetts General Hospital and the University of Washington reports persistent COVID-related issues are very rare among college athletes.

Additionally, scientists conclude chest pain among young athletes returning to exercise post COVID recovery is similarly very rare. However, if a young athlete does experience such chest pain upon returning to training, researchers urge them to visit a doctor quickly.

“For the vast majority of athletes, this study shows that a return to play is possible without lingering COVID symptoms. But any new chest pain or cardiopulmonary symptom should be taken seriously,” says senior study author Jonathan Drezner, MD, director of the UW Medicine Center for Sports Cardiology, in a media release. “Even if initial cardiac testing is negative after a COVID-19 illness, chest pain while exerting yourself should be evaluated.”

The findings come from the Outcomes Registry for Cardiac Conditions in Athletes (ORCCA), which is a national database tracking COVID-19 cases among NCAA athletes. Put together and maintained by both MGH and UW Medicine, the purpose of ORCCA is to form a clearer understanding of COVID-19’s impact on collegiate athlete health.

1 in 100 athletes experience long COVID

All in all, study authors analyzed a dataset encompassing 3,597 male and female athletes from 44 colleges and universities, all of whom had recovered from a COVID-19 infection. Among that entire sample, only 1.2 percent dealt with any lingering COVID symptoms post-recovery. The team defined a “persistent symptom” as any health complaint lasting over three weeks from the initial COVID-19 illness or symptom onset.

Regarding the return to exercise and physical exertion specifically, four percent reported issues such as chest pain, fatigue, trouble breathing, or heart palpitations.

COVID-19 can be very detrimental to the heart and cardiovascular functioning. Scientists have found that the SARS-CoV-2 virus can even directly infect heart cells, causing dangerous inflammation called myocarditis. So, while it is rare, a young athlete experiencing any extra chest pain while returning to exercise post-COVID should consider undergoing a cardiac MRI (CMR).

Among the 24 included athletes who reported chest pain while exercising, study authors diagnosed probable or definite COVID-19 cardiac involvement in five of those cases (20.8%). However, among athletes reporting other lingering COVID exercise symptoms with no link to chest pain who underwent a CMR, the team found no cases of probable or definite COVID-19 cardiac involvement.

“This is useful information as we continue to see so many athletes – collegiate or otherwise – returning to sports,” adds study co-author Aaron Baggish, MD, director of the MGH Cardiovascular Performance Program. “While it’s heartening to see that the risk for persistent COVID symptoms in these athletes is low, we should keep monitoring players and checking in with them on how they’re feeling once they’re back in action.”

The study appears in the British Journal of Sports Medicine.