Claims that COVID-19 results in high rates of myocarditis have been quickly clarified by a US doctor after triggering a wave of both concern and scepticism from other clinicians.
The assertion was made by Penn State university sports physician Dr Wayne Sebastianelli, who told a media outlet that myocarditis had been seen on MRI scans of 30-35% of university athletes who tested positive for COVID-19.
The claim was shared on social media by high profile physicians, with many saying it confirmed other reports of the long term adverse inflammatory effects of COVID-19 infection on organ systems beyond the respiratory tract.
Cardiologist Dr Eric Topol, Director of the Scripps Research Translational Institute, said the finding was the latest in a growing body of evidence that COVID-19 is a “heart virus” causing a distinctive pattern of cardiac abnormalities.
Today we learned ~1/3 Big Ten athletes who were #COVID19 + had abnormal heart MRIs, consistent w/ myocarditis, even those without symptoms. If anyone still is questioning whether this virus attacks the heart, it’s denialism. https://t.co/8qGJDhjlpk
— Eric Topol (@EricTopol) September 3, 2020
He pointed to previous reports of cardiac abnormalities in young athletes with COVID-19 and a paper in the European Heart Journal that reported cardiac abnormalities in about half of patients with COVID-19 undergoing echocardiography.
A German report, published in JAMA Cardiology, found cardiac involvement in 78% of COVID-19 patients and ongoing myocardial inflammation in 60%, independent of preexisting conditions, severity and overall course of the acute illness,
But the claims were also met with strong criticism from other cardiologists who described them as “implausible” and said there was little data to support a unique cardiac impact of the COVID-19 virus.
The online discussion quickly descended into counter-accusations of ‘alarmism’ vs ‘denialism’ over the cardiac effects of COVID-19
Unfortunately, it is deja vu all over again. I last tossed down the physician’s RED FLAG & cried FOUL on this #COVID19 #myocarditis issue on August 11th and now forced to do it again. There is no way that 30-35% of #Athletes with COVID19 have myocarditis.
— Michael J. Ackerman MD,PhD (@MJAckermanMDPhD) September 3, 2020
The debate took another dramatic turn when Dr Sebastianelli clarified his comments, saying he had been misled by preliminary data communicated to him by a colleague and the actual rate of myocarditis was perhaps around 15%.
He apologised for the confusion and acknowledged that “many cardiologists feel this is a finding that is incidental and may not warrant any further investigation or concern.”
A spokesperson for Penn State said there had been no cases of myocarditis among university athletes
Prof Francois Balloux, director of the UCL Genetics Institute described the claims of a unique COVID-19 cardiac effects as absurd and said any severe infection would have long term adverse effect on the heart.
Other cardiologists agreed, saying there was no evidence of a pattern of COVID-19 related cardiac abnormalities in their patients, and that effects on cardiac cells seen in the laboratory did not necessarily translate into the real world.
To date, the cardiac pathology we have observed in our experience has been, at most, minimal, and nothing unexpected or different for otherwise critically ill patients. Sars-CoV2 is an infectious pulmonary disease, not a cardiac disease. https://t.co/WpcdjSBcdV
— Andy McCullough (@DrAMcCullough) April 7, 2020
However Dr Topol maintained that there were many other credible reports of a long term effect of COVID-19 related inflammatory on the cardiovascular system.