PSU Doctor Clarifies Comments on Myocarditis % in B1G Athletes

Submitted by JR's Flow on September 3rd, 2020 at 6:55 PM

I know there is a post on the original story already, but didn't want this important update to go unnoticed under 120 comments.

I am not posting this to dis-value the issue of myocarditis, but we all know how important accurate info has been throughout the pandemic. 

Link:

https://twitter.com/BonaguraESPN/status/1301644428025540608?s=20

bronxblue

September 3rd, 2020 at 9:51 PM ^

So wait, are we arguing that there aren't long-term health dangers from COVID-19 or just that this 35% number was wrong?  Because I've not seen much evidence that myocarditis isn't exasperated by a COVID-19 infection and that can cause medium-term, at least, health issues for people of all ages.

TrueBlue2003

September 4th, 2020 at 2:28 AM ^

There's no evidence whatsoever that covid causes worse medium term health issues than any number of other virus that we don't give a crap about.  That's mostly because we don't know the extent of what those viruses do because, well, we don't give a crap.  Also, we probably haven't even reached medium term with covid.  So it's still unknown.  But almost certainly isn't worse for asymptomatic people.  Maybe, but probably not!

That's where are.

MRunner73

September 4th, 2020 at 10:03 AM ^

Exactly my point as we're only 6 to 7 months into to this COVID pandemic. We need to wait, perhaps another year and see how and if any long term effects are real or not. Also, people recover at different rates so even if myocarditis is a real issue for some student athletes, some can overcome this while other may not.

Malarkey

September 3rd, 2020 at 7:51 PM ^

I mean, does this change the fact that an unusually high rate of big ten and other athletes were diagnosed with myocarditis over the offseason, including multiple football players who can’t play this season? For instanced the IU lineman and Georgia state QB?

 

1 doctor spouting an incorrect number shouldnt change that, but I would be curious to know the actual number in the study he reports

TrueBlue2003

September 3rd, 2020 at 8:07 PM ^

Well, it's the difference between literally unbelievably, astronomically high and just maybe high (but we don't even know if it's high because, again, we've never given asymptomatic people cardiac MRI after viral infections everrrrrr).

The fact that it was caught in the  IU lineman and Georgia State QB should arguably reassure people about playing.  We are now screening for this when we never would have in the past.  Sure, a higher % of players might have to sit out for it (let's say 4% vs what might be 1% in a regular year), but that probably means fewer players would play with heart inflammation than ever before.  For teams that are able to screen for it of course.  And only they should be playing, not high schools.  But there's no reason not to let those teams with the resources to screen for this play football.

TrueBlue2003

September 3rd, 2020 at 9:32 PM ^

Yeah, I mean, the moderate concern wasn't made up. But at the same time, the German study with a biased sample that turned up some 60% of people with inflammation was also getting too much play.  That (and the fact an IU lineman's mother went off on facebook) spooked the presidents, probably way too much.

All I've seen over and over and over from real cardiologists (like the ones handling MLS, MLB, etc) is that it's something serious enough to screen for, but if you do, you're good to play.

BananaRepublic

September 3rd, 2020 at 8:32 PM ^

Now that the scare headline has been debunked we can deal with this. I'll redirect back to all my questions about the parameters used to define myocarditis from the previous thread and whether or not there was clinical correlation. I'll also note that neither Georgia State nor the QB released any details as to what the mysterious heart condition was. Linking i"t" to covid in a single case is just as specious as trying to do it on a broader scale without proper controls. Myocarditis is not all that uncommon, but now will forever carry the baggage of "linked to covid" which is fairly meaningless as the literature currently describes.

 

Further, we have every NFL player who has tested positive being tested for myocarditis (reported as all negative today) and 26/26 other P5 schools who responded to inquiry reported 0 cases of myocarditis as well. From what I can gather, the study being talked about here is out of Ohio State. Another MRI study, this showed 15% rate of myocarditis among athletes testing positive. If it's similar to the JAMA study, problematic. But there's no additional info available other than the blurb in NYT, it is still pre publication. 

the fume

September 3rd, 2020 at 10:02 PM ^

The issue going forward is going to be the usage of cardiac MRI. It's not usually what is used because it often costs a couple grand. The question is going to be if this tests results are real or if it is essentially too sensitive compared to typical myocarditis numbers/guidelines.

The OSU study used it, the German study used it, but I doubt the NFL or any other universities have. You're going to get massively different numbers depending on how you test.

BananaRepublic

September 4th, 2020 at 11:31 AM ^

This is definitely the problem (potentially with these studies). Think of myocarditis as a broad spectrum of things that just mean "inflammation of heart muscle". We've been measuring this a certain way for a long time by pre screening for clinical significance and then drilling down with imaging and blood tests with cutoffs and detection limits that are typically far less sensitive thatn what is being used here. We're likely finding very mild cases of heart inflammation and then throwing them in the big bucket of myocarditis which is understood to mean a certain, more serious thing in the context of how it is typically discovered. It's sloppy at best, disingenuous at worst. I think a mix of both after having seen some of the major pubs and their subsequent corrections

bronxblue

September 3rd, 2020 at 10:09 PM ^

Is myocarditis really "not all that uncommon"?  The highest number I've seen is 9% of the population, and that was based on a sampling of autopsies.  Most other papers seem to paint it as closer to 2-3% of the population, slightly higher amongst younger people.  But that doesn't strike me as a condition that is plaguing the masses to a significant degree.

I'd also say the the survey you're referencing has some key limitations.  Only 26 out of 65 teams responded to the survey per ESPN and only 10 filled out the whole thing, which feels pretty limiting in terms of extracting value.  

I agree that the report was wrong and it's good they clarified, but I feel like a lot of people (including in this thread) are weaponizing this incorrect statement as proof there's nothing to worry about when that is definitely not true.

NittanyFan

September 3rd, 2020 at 7:05 PM ^

LOL, that didn't take long.  Dr. Sebastianelli fails again (I mentioned in the other thread I don't trust him at all, as regards another incident in his life).

DTOW

September 3rd, 2020 at 7:20 PM ^

I can't comment on what the "lower rate" is but the NFL and NFLPA confirmed zero cases of myocarditis.  Also mentions their protocol requires all players with confirmed cases are required to go through additional screening for heart problems before they're allowed back on the field.  So basically, the NFL and NFLPA are actively looking for players with myocarditis and haven't found any.

https://twitter.com/JohnKryk/status/1301630019819667457

I sure hope the Big Ten Presidents revisit their decision.  Going from 35% to 0% seems like a massive change to the calculus.  Its also another black eye on the conference and how they've handled this whole thing. 

Originally, I was leaning in the camp of not playing and giving the Presidents the benefit of the doubt but at this point I'm starting to get worried that ego is getting in the way of good leadership and the Presidents would rather ignore new information rather than admit that they may have made a hasty decision with bad information.  Woof.  What an absolute mess this has become.

mwolverine1

September 3rd, 2020 at 7:50 PM ^

I believe the Big 12 is also requiring heart screenings to return to activities after a Covid positive test result. 

If myocarditis isn't a big concern, I would say that's 1 criterion down to return to play. We will also need accurate and available rapid testing and stability in Covid rates on campuses.

BatmanUMfan

September 3rd, 2020 at 8:07 PM ^

My son is a college freshman at a major Texas university recently diagnosed with Covid-19. Fortunately, he has had no symptoms. He went to a party almost 2 weeks ago and nearly everyone at the party has been diagnosed with COVID-19 and none of these young men have had any symptoms. The data has consistently shown that college students demonstrate little to no serious issues from COVID-19. This is whether they play football or not.
He has been placed away from his roommate a separate floor with our other students that have been confirmed positive for COVID-19. he is currently in isolation for the next 10 - 14 days.
Apparently, there’s been many cases on campus and most of the cases are asymptomatic. classes are continuing online as well as in person.
I am also a physician. The myocarditis data presented previously seemed to be flawed to me. I practice in such a way that if things don’t make sense to me, I always verify and reconfirm them. A lot of physicians don’t use common sense ,unfortunately, in medicine anymore.My point is that classes are continuing and football will be played soon in Texas as well as all the southern states.
I am hoping that the Big Ten revisits their decision to postpone football season and begins the season shortly. At this point, I agree with the post above and previously from extra melanin.

Unfortunately, this viewpoint seems to be constantly under attack on this blog. I wish everyone would use a little bit more common sense and not attack each other for different opinions.



 

 

 

SFBlue

September 3rd, 2020 at 10:20 PM ^

Godspeed your son's recovery. I don't think there is enough data or study to determine whether playing college football is a good or bad idea; the virus and its effects are too new. As I've said before I think reasonable minds can disagree. If the South does it safely, so will the B1G/PAC12 either in January, November, or perhaps before that. 

JR's Flow

September 3rd, 2020 at 7:18 PM ^

I tried to find this before posting, but struck out. It is unclear if B1G athletes were even the group being studied and not just athletes in the test group. 

 

The only thing I have to go off of is that 26 Power 5 answered a survey about potential heart issues as a result of COVID-19, and Oregon St was the only school with one student with a heart-related issue, but it was not myocarditis. Link: https://www.espn.com/college-sports/story/_/id/29745712/nearly-half-power-5-disclose-covid-19-test-data

bronxblue

September 3rd, 2020 at 9:46 PM ^

Counter-point would be that 25 schools didn't answer the survey or provide any information about the state of their athletes and the positive rate.  And yes, if you ave nothing negative to report you're more likely to respond to a survey than if you have less-than-ideal numbers to show.  In fact, only 10 of the 65 schools answered all of the questions in the survey.  So I'm not sure we can take a heck of a lot away from a voluntary survey in which less than 20% of respondents completed the whole thing.

 

the fume

September 3rd, 2020 at 10:11 PM ^

If it's close to 15%, and the methods are consistent, I can't imagine it not being significant.

Google tells me 10-20 per 100,000 people, tho it's severely under-diagnosed.

I'm sure cardiologists have somewhat of an idea of how much inflammation shows up normally in a cardiac MRI, and I'm sure some are part of the peer review process.

BornInAA

September 3rd, 2020 at 7:13 PM ^

No way, doctors at Universities are completely infallible.

You know, like Dr. Anderson and Dr. Nassar.

So because of Covid agendas, any Dr. that states anything everybody runs with it.

LewisBullox

September 3rd, 2020 at 7:25 PM ^

Stuff like this is infuriating because it literally only erodes peoples' trust in medicine, science and data. The age of information is ruining everything. Too much noise.

drjaws

September 3rd, 2020 at 8:04 PM ^

Stuff like this in infuriating because it shows the utter inability, or refusal, of many many people to think critically when presented with information.  Sounds real?  Believe and defend, with vitriol if necessary.  
 

The problem isn’t what got out.  It’s with how people will eat up and believe random shit and defend it like their well-being is at stake.