Why is COVID-19 causing heart inflammation, or myocarditis, in athletes? Experts weigh in.

Researchers are learning more about the long-term effects of COVID-19 every day, and one aspect that keeps coming up is that athletes struggle with potentially serious heart disease after the virus emerges.
University of Florida star striker Keyontae Johnson, who collapsed during a game on the basketball court on Dec. 12, was reportedly diagnosed with myocarditis, a form of heart infection that has been repeatedly linked to COVID-19 that he was suffering from during the game suffered summer.
University of Florida star striker Keyontae Johnson, seen here December 21, collapsed during a game on the basketball court earlier this month - reportedly the result of COVID-19-related myocarditis. And he's not the only athlete who has experienced this medical problem. (Mary Holt / Icon Sportswire via Getty Images)
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But Johnson is far from the only athlete struggling with heart infections after the coronavirus. In August Georgia state quarterback Mikele Colasurdo announced on Twitter that he would not be able to play football this season after he was "diagnosed with heart disease due to my COVID-19 infection." Red Sox pitcher Eduardo Rodriguez also struggled with myocarditis after getting the virus. So did the University of Miami defense against Al Blades.
What is myocarditis?
Myocarditis is inflammation of the heart muscle known as the myocardium, according to the Mayo Clinic. The condition can affect your heart muscle and electrical system, making it less able to pump. As a result, "patients may struggle with fast or abnormal heart rhythms called arrhythmias," says Dr. Thomas Russo, professor and chief of infectious diseases at Buffalo University in New York, told Yahoo Life.
Myocarditis is usually caused by viral infections. "It's more common with some viruses than others," says Dr. Richard Watkins, an infectious disease physician and professor of medicine at Northeast Ohio Medical University, told Yahoo Life. He names coxsackievirus (which can cause hand, foot and mouth disease) as more common culprits, influenza and HIV less.
The symptoms of myocarditis, according to the Mayo Clinic, are as follows: chest pain, fatigue, shortness of breath, and rapid heart rate (arrhythmias).
Myocarditis can be serious, Russo says, adding, "You can have a stroke or heart attack and die." But in many cases, the condition will improve on its own and people can recover completely - they just often have to go without competitive sport for up to six months, says Russo. However, in some situations, medication and even a mechanical heart pump might be required, the Mayo Clinic says.
But what is the connection between myocarditis and COVID-19?
That connection is currently unclear, says Watkins.
It may simply be that COVID-19 is just another virus that causes inflammation, says infectious disease expert Dr. Amesh A. Adalja, senior scientist at the Johns Hopkins Center for Health Security, told Yahoo Life. "It's an inflammatory response focused on the heart that occurs with many different viruses, and COVID-19 is one of them," he says.
However, Russo points out that this may be more common with COVID-19 than many people believe.
A study published in JAMA Cardiology in July performed cardiac MRIs in 100 patients who had recently recovered from COVID-19, and 60 of whom had myocarditis. Even more frightening, the inflammation was independent of pre-existing conditions, the severity of COVID-19, and their general disease progression.
"This is something we as medical professionals really worry about," says Russo. "Most people try to get COVID when they live or die, but the reality is that it's far more complicated than that."
Russo points out that "virtually any organ in the body can be affected by COVID-19," including the heart, lungs, brain and kidneys. And myocarditis as a persistent side effect could be a result of it.
Why high-level athletes were diagnosed with myocarditis may simply be because they are being monitored a little more closely than others. "High-performance athletes often have a lot of tests done, and that can lead to myocarditis," says Adalja. Athletes may also notice symptoms more because they put stress on their bodies regularly, Russo says.
This can happen to non-athletes as well, says Dr. Jason Womack, director of sports medicine at Rutgers Robert Wood Johnson Medical School and team doctor at Rutgers Athletics, told Yahoo Life. "If someone had COVID-19 and later developed symptoms such as exercise intolerance or chest pain with activity, those would be reasons to seek heart counseling," he warns.
Overall, however, Russo says: "We don't fully understand who gets myocarditis from COVID-19, how great the risk and how great the damage is."
Russo urges people with COVID-19 to be aware of the risk of myocarditis, noting, "Anyone could potentially be at risk for these types of complications."
For the latest coronavirus news and updates, please visit https://news.yahoo.com/coronavirus. According to experts, people over 60 and those with compromised immune systems remain at the greatest risk. If you have any questions, please see the CDC and WHO resource guides.
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