With over 4.6 million deaths and 225 million reported cases, the COVID-19 (SARS-CoV-2) pandemic continues to negatively affect the lives of many worldwide.1 Athletes have been significantly affected, from cancellation of athletic events to unexpected cardiopulmonary complications despite optimal health. Cardiovascular function is paramount for athletes, and studies have demonstrated that severe cardiac complications can occur following SARS-CoV-2 infection, including myocarditis,2,3 myocardial injury (elevated troponin),4 heart failure, and arrhythmias.5 Due to a paucity of clinical data, the prevalence of cardiac pathology in athletes following SARS-CoV-2 infection is unknown. Three recent studies utilized cardiac magnetic resonance imaging (MRI) to evaluate subclinical pathology in competitive college athletes following asymptomatic to moderate COVID-19 illness confirmed by RT-PCR. Brito et al6 showed that of 48 athletes, 27 (56.3%) had MRI changes indicating cardiac involvement with unknown clinical significance. Of these athletes, approximately 19% were completely asymptomatic.6 Starekova et al7 reported 2 out of 145 (1.4%) competitive student athletes having MRI findings consistent with myocarditis. Clark et al8 reported myocarditis in 2 out of 59 athletes (3%), and pericarditis in 1 athlete.8 These cardiac complications can potentially contribute to sudden cardiac death and significant morbidity. Cardiac screening post-COVID infection in NCAA athletes is important. This article aims to understand the current guidelines for cardiac evaluation and provide recommendations based on patients seen at the Long Island Heart Rhythm Center, an electrophysiology/cardiology practice at the New York Institute of Technology College of Osteopathic Medicine in Old Westbury, New York.
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