Importance The utility of cardiac magnetic resonance imaging (MRI) as a screening tool for myocarditis in competitive student athletes returning to training after recovering from coronavirus disease 2019 (COVID-19) infection is unknown.

Objective To describe the prevalence and severity of cardiac MRI findings of myocarditis in a population of competitive student athletes recovering from COVID-19.

Design, Setting, and Participants In this case series, an electronic health record search was performed at our institution (University of Wisconsin) to identify all competitive athletes (a consecutive sample) recovering from COVID-19, who underwent gadolinium-enhanced cardiac MRI between January 1, 2020, and November 29, 2020. The MRI findings were reviewed by 2 radiologists experienced in cardiac imaging, using the updated Lake Louise criteria. Serum markers of myocardial injury and inflammation (troponin-I, B-type natriuretic peptide, C-reactive protein, and erythrocyte sedimentation rate), an electrocardiogram, transthoracic echocardiography, and relevant clinical data were obtained.

Exposures COVID-19 infection, confirmed using reverse transcription–polymerase chain reaction testing.

Main Outcomes and Measures Prevalence and severity of MRI findings consistent with myocarditis among young competitive athletes recovering from COVID-19.

Results A total of 145 competitive student athletes (108 male and 37 female individuals; mean age, 20 years; range, 17-23 years) recovering from COVID-19 were included. Most patients had mild (71 [49.0%]) or moderate (40 [27.6%]) symptoms during the acute infection or were asymptomatic (24 [16.6%]). Symptoms were not specified or documented in 10 patients (6.9%). No patients required hospitalization. Cardiac MRIs were performed a median of 15 days (range, 11-194 days) after patients tested positive for COVID-19. Two patients had MRI findings consistent with myocarditis (1.4% [95% CI, 0.4%-4.9%]). Of these, 1 patient had marked nonischemic late gadolinium enhancement and T2-weighted signal abnormalities over multiple segments, along with an abnormal serum troponin-I level; the second patient had 1-cm nonischemic mild late gadolinium enhancement and mild T2-weighted signal abnormalities, with normal laboratory values.

Conclusions and Relevance In this case series study, based on MRI findings, there was a low prevalence of myocarditis (1.4%) among student athletes recovering from COVID-19 with no or mild to moderate symptoms. Thus, the utility of cardiac MRI as a screening tool for myocarditis in this patient population is questionable.

重要性 心脏磁共振成像 (MRI) 作为心肌炎筛查工具的实用性尚不清楚。

目的 描述从 COVID-19 康复的竞技学生运动员群体中心肌炎的心脏 MRI 表现的患病率和严重程度。

设计、设置和参与者 在这个案例系列中，我们在我们的机构（威斯康星大学）进行了电子健康记录搜索，以识别所有从 COVID-19 中恢复的竞技运动员（连续样本），他们在2020 年 1 月 1 日和 2020 年 11 月 29 日。MRI 结果由 2 位在心脏成像方面经验丰富的放射科医生使用更新的路易斯湖标准进行了审查。获得心肌损伤和炎症的血清标志物（肌钙蛋白-I、B型利钠肽、C反应蛋白和红细胞沉降率）、心电图、经胸超声心动图和相关临床资料。

暴露 COVID-19 感染，使用逆转录聚合酶链反应测试确认。

主要结果和措施 在从 COVID-19 康复的年轻竞技运动员中，与心肌炎一致的 MRI 发现的患病率和严重程度。

结果 共纳入从 COVID-19 中恢复的 145 名有竞争力的学生运动员（108 名男性和 37 名女性；平均年龄 20 岁；范围 17-23 岁）。大多数患者在急性感染期间有轻度（71 [49.0%]）或中度（40 [27.6%]）症状或无症状（24 [16.6%]）。10 名患者（6.9%）的症状没有具体说明或记录。没有患者需要住院。在患者 COVID-19 检测呈阳性后，心脏 MRI 的中位时间为 15 天（范围为 11-194 天）。两名患者的 MRI 结果与心肌炎一致（1.4% [95% CI，0.4%-4.9%]）。其中，1 例患者出现明显的非缺血性晚期钆增强和多个节段的 T2 加权信号异常，以及血清肌钙蛋白-I 水平异常；

结论和相关性 在本病例系列研究中，根据 MRI 发现，在从 COVID-19 康复的学生运动员中心肌炎的患病率较低（1.4%），没有或轻度至中度症状。因此，心脏 MRI 作为该患者人群心肌炎筛查工具的效用值得怀疑。