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Rasmusen HK, Aarøe M, Madsen CV, Gudmundsdottir HL, Mertz KH, Mikkelsen AD, Dall CH, Brushøj C, Andersen JL, Vall-Lamora MHD, Bovin A, Magnusson SP, Thune JJ, Pecini R, Pedersen L. The COVID-19 in athletes (COVA) study: a national study on cardio-pulmonary involvement of SARS-CoV-2 infection among elite athletes. Eur Clin Respir J 2023; 10:2149919. [PMCID: PMC9744211 DOI: 10.1080/20018525.2022.2149919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background COVID-19 can cause cardiopulmonary involvement. Physical activity and cardiac complications can worsen prognosis, while pulmonary complications can reduce performance. Aims To determine the prevalence and clinical implications of SARS-CoV-2 cardiopulmonary involvement in elite athletes. Methods An observational study between 1 July 2020 and 30 June 2021 with the assessment of coronary biomarkers, electrocardiogram, echocardiography, Holter-monitoring, spirometry, and chest X-ray in Danish elite athletes showed that PCR-tested positive for SARS-CoV-2. The cohort consisted of male football players screened weekly (cohort I) and elite athletes on an international level only tested if they had symptoms, were near-contact, or participated in international competitions (cohort II). All athletes were categorized into two groups based on symptoms and duration of COVID-19: Group 1 had no cardiopulmonary symptoms and duration ≤7 days, and; Group 2 had cardiopulmonary symptoms or disease duration >7 days. Results In total 121 athletes who tested positive for SARS-CoV-2 were investigated. Cardiac involvement was identified in 2/121 (2%) and pulmonary involvement in 15/121 (12%) participants. In group 1, 87 (72%), no athletes presented with signs of cardiac involvement, and 8 (7%) were diagnosed with radiological COVID-19-related findings or obstructive lung function. In group 2, 34 (28%), two had myocarditis (6%), and 8 (24%) were diagnosed with radiological COVID-19-related findings or obstructive lung function. Conclusions These clinically-driven data show no signs of cardiac involvement among athletes who tested positive for SARS-CoV-2 infection without cardiopulmonary symptoms and duration <7 days. Athletes with cardiopulmonary symptoms or prolonged duration of COVID-19 display, exercise-limiting cardiopulmonary involvement.
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Affiliation(s)
- Hanne Kruuse Rasmusen
- Department of Cardiology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark,CONTACT Hanne Kruuse Rasmusen Clinic of Sports Cardiology, Department of Cardiology, University of Copenhagen Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Building 67, DK-2200Copenhagen, Denmark
| | - Mikkel Aarøe
- Department of Cardiology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Christoffer Valdorff Madsen
- Department of Cardiology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Kenneth Hudlebusch Mertz
- Institute of Sports medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Astrid Duus Mikkelsen
- Department of Cardiology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Christian Have Dall
- Department of Cardiology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Christoffer Brushøj
- Institute of Sports medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jesper Løvind Andersen
- Institute of Sports medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Ann Bovin
- Department of Cardiology, Vejle Hospital, Part of Lillebaelt Hospital, Vejle, Denmark
| | - S. Peter Magnusson
- Institute of Sports medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jens Jakob Thune
- Department of Cardiology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Redi Pecini
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Lars Pedersen
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Kofoed KF, Kelbæk H, Hansen PR, Torp-Pedersen C, Høfsten D, Kløvgaard L, Holmvang L, Helqvist S, Jørgensen E, Galatius S, Pedersen F, Bang L, Saunamaki K, Clemmensen P, Linde JJ, Heitmann M, Wendelboe Nielsen O, Raymond IE, Kristiansen OP, Svendsen IH, Bech J, Dominguez Vall-Lamora MH, Kragelund C, Hansen TF, Dahlgaard Hove J, Jørgensen T, Fornitz GG, Steffensen R, Jurlander B, Abdulla J, Lyngbæk S, Elming H, Therkelsen SK, Abildgaard U, Jensen JS, Gislason G, Køber LV, Engstrøm T. Early Versus Standard Care Invasive Examination and Treatment of Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. Circulation 2018; 138:2741-2750. [DOI: 10.1161/circulationaha.118.037152] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Klaus F. Kofoed
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Henning Kelbæk
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark (H.K., H.E., S.K.T.)
| | - Peter Riis Hansen
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Dan Høfsten
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Lene Kløvgaard
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Lene Holmvang
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Steffen Helqvist
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Erik Jørgensen
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Søren Galatius
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Frants Pedersen
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Lia Bang
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Kari Saunamaki
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Peter Clemmensen
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Jesper J. Linde
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Merete Heitmann
- Department of Cardiology, Bispebjerg and Frederiksberg Hospitals (M.H., O.W.N., I.E.R., O.P.K., I.H.S., M.H.D.V.-L.), University of Copenhagen, Denmark
| | - Olav Wendelboe Nielsen
- Department of Cardiology, Bispebjerg and Frederiksberg Hospitals (M.H., O.W.N., I.E.R., O.P.K., I.H.S., M.H.D.V.-L.), University of Copenhagen, Denmark
| | - Ilan E. Raymond
- Department of Cardiology, Bispebjerg and Frederiksberg Hospitals (M.H., O.W.N., I.E.R., O.P.K., I.H.S., M.H.D.V.-L.), University of Copenhagen, Denmark
| | - Ole Peter Kristiansen
- Department of Cardiology, Bispebjerg and Frederiksberg Hospitals (M.H., O.W.N., I.E.R., O.P.K., I.H.S., M.H.D.V.-L.), University of Copenhagen, Denmark
| | - Ida Hastrup Svendsen
- Department of Cardiology, Bispebjerg and Frederiksberg Hospitals (M.H., O.W.N., I.E.R., O.P.K., I.H.S., M.H.D.V.-L.), University of Copenhagen, Denmark
| | - Jan Bech
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Maria Helena Dominguez Vall-Lamora
- Department of Cardiology, Bispebjerg and Frederiksberg Hospitals (M.H., O.W.N., I.E.R., O.P.K., I.H.S., M.H.D.V.-L.), University of Copenhagen, Denmark
| | - Charlotte Kragelund
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Thomas Fritz Hansen
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Jens Dahlgaard Hove
- Department of Cardiology, Hvidovre and Amager Hospitals (J.D.H., T.J., G.G.F.), University of Copenhagen, Denmark
| | - Tem Jørgensen
- Department of Cardiology, Hvidovre and Amager Hospitals (J.D.H., T.J., G.G.F.), University of Copenhagen, Denmark
| | - Gitte G. Fornitz
- Department of Cardiology, Hvidovre and Amager Hospitals (J.D.H., T.J., G.G.F.), University of Copenhagen, Denmark
| | - Rolf Steffensen
- Department of Cardiology, Hillerød Hospital (R.S., B.J.), University of Copenhagen, Denmark
| | - Birgit Jurlander
- Department of Cardiology, Hillerød Hospital (R.S., B.J.), University of Copenhagen, Denmark
| | - Jawdat Abdulla
- Department of Cardiology, Glostrup Hospital (J.A., S.L.), University of Copenhagen, Denmark
| | - Stig Lyngbæk
- Department of Cardiology, Glostrup Hospital (J.A., S.L.), University of Copenhagen, Denmark
| | - Hanne Elming
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark (H.K., H.E., S.K.T.)
| | | | - Ulrik Abildgaard
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Jan Skov Jensen
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Gunnar Gislason
- Department of Cardiology, Herlev and Gentofte Hospitals (P.R.H., C.T.-P., S.G., J.B., C.K., T.F.H., U.A., J.S.J., G.G.), University of Copenhagen, Denmark
| | - Lars V. Køber
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
| | - Thomas Engstrøm
- Department of Cardiology, The Heart Centre, Rigshospitalet (K.F.K., D.H., L.K., L.H., S.H., E.J., F.P., L.B., K.S., P.C., J.J.L., L.V.K., T.E.), University of Copenhagen, Denmark
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