Risk of heart damage from COVID-19 weighed in on Big Ten’s decision to cancel fall sports

Joey Kaufman
Pitcher Eduardo Rodriguez of the Boston Red Sox was ruled out for the entire 2020 season due to heart inflammation caused by COVID-19.

Two weeks ago, the mother of an Indiana University football player posted a message on Facebook that grabbed the attention of administrators throughout the Big Ten.

It detailed the serious side effects of COVID-19, including “14 days of hell” caused by breathing issues, and further described “possible heart issues” that doctors had seen in her son, Brady Feeney, a freshman offensive lineman.

“Bottom line, even if your son’s schools do everything right to protect them,” Deborah Rucker wrote, “they CAN’T PROTECT THEM!!”

As the Big Ten reached a decision to cancel its fall sports season, including football, because of the coronavirus pandemic, the cardiac complications experienced by Feeney, along with other reported cases of the heart issue myocarditis in athletes, took hold as a considerable factor.

“Any time you’re talking about the heart with anyone, but especially a young person, you have to be concerned,” conference commissioner Kevin Warren said in an interview on the Big Ten Network following the league’s announcement.

NCAA chief medical officer Brian Hainline said last week that he had been aware of at least 12 coronavirus-related cases of myocarditis inflammation of the heart muscle across all member schools.

Myocarditis is triggered by viral infections and poses particular challenges for athletes, even those in their late teens and 20s, cardiologists say.

Left undiagnosed and untreated, it can cause heart damage and sudden cardiac arrest.

Dr. Jonathan Kim, the chief of sports cardiology at Emory University, recommends a minimum of three months of limited exercise for those diagnosed with the condition.

“If you are engaging in high physical activity, that could precipitate dangerous heart rhythms,” Kim said.

The recovery time for myocarditis makes it a potentially season-ending illness for athletes.

The most prominent example of myocarditis this summer has been in major league baseball, where Eduardo Rodriguez, a 27-year-old pitcher for the Boston Red Sox, was sidelined for the 2020 season while dealing with the ailment after a bout with COVID-19.

Due to the prevalence, Dr. Colleen Kraft, an infectious disease expert at Emory and member of the NCAA’s COVID-19 advisory panel, warned that schools were “playing with fire” by staging sports.

While the Big Ten called off fall sports, followed soon thereafter by the Pac 12, the other major conferences are forging ahead with plans to play this fall.

“I think one case of myocarditis in an athlete is too many,” Kraft said. “I don’t want to see stories of athletes who can no longer play and that had promising careers simply because somebody didn’t protect themselves.”

Researchers are still examining the link between the coronavirus and myocarditis.

In some studies, heart complications have been found in 20% of patients who are hospitalized with COVID-19 that’s far more pervasive than with infections from other viruses, including the flu or common cold. According to Kim, only about 1% of hospitalized patients from those other viral infections see cardiac issues arise.

“This virus seems to have a greater affinity for the heart,” said Dr. Curt Daniels, director of the Ohio State University Wexner Medical Center’s adolescent and adult congenital heart disease program.

But how often does myocarditis appear in all people who test positive for COVID-19, including those who are not admitted to the hospital or do not show symptoms? It’s unknown.

So, too, is the long-term severity of the heart inflammation triggered by the coronavirus.

“We obviously don’t know because it hasn’t been around long enough,” Daniels said. “It could be very mild and go away in everybody and have no long-term effects. Or there could be longer-term effects where the inflammation in the heart turns into scar tissue and can be a risk for arrhythmias.”

The level of uncertainty involving the effects from the virus weighed on Warren, the Big Ten’s first-year commissioner, and other administrators.

It was a point he raised frequently during last week’s televised interview.

“You’re in this unknown territory of, ‘Well, if we don’t know, then let’s let everybody play,’” Daniels said. “There’s obviously some potential value to that; since we don’t know, let’s let everybody play.

“But it appears that the risk is significant enough, from what we know, that since we don’t know (everything), then everybody’s sort of swayed toward safety. That’s been the impression I get from everybody since we don’t know, we’re going to move toward safety, as opposed to: We don’t know, let’s see what happens.”

Daniels believes more research is needed on heart problems stemming from COVID-19. That included monitoring a wider range of athletes who are found to be positive for the virus, resulting from increased and more accurate testing.

He also stressed a need to better determine when it is safe for those found to have myocarditis, or similar heart issues, to resume athletic training. There is little to no room for error.

Earlier this month, Michael Ojo, a 27-year-old former Florida State basketball player who had previously tested positive for COVID-19, died of a heart attack while working out in Serbia.

Sorting out some of the uncertainty is a critical step as the Big Ten considers staging a football season early next year, along with restarting other winter and spring sports.

“We’ve got to figure something out,” Daniels said, “because we’re going to be doing the same dance three months from now, four months from now, and the spring’s going to come up and it’s going to be the same thing.”