Pandemic did not impact sudden cardiac arrest frequency in young athletes
Key takeaways:
- The incidence of sudden cardiac arrest/death among athletes did not change significantly during the COVID-19 pandemic.
- Survival of cardiac arrest was also not significantly different vs. the pre-pandemic years.
Despite early reports, there was no increase in rates of sudden cardiac arrest/death among athletes during the COVID-19 pandemic years vs. prior years, researchers reported.
During the pandemic years, there was one additional case of myocarditis-related sudden cardiac death among athletes compared with the prior 3 years, according to a research letter published in JAMA Network Open.
“The National Center for Catastrophic Sport Injury Research (NCCSIR) has used the same methodology to identify cases of sudden cardiac arrest/death in young competitive athletes across the U.S. for a decade,” Jonathan A. Drezner, MD, family medicine physician, director of the University of Washington (UW) Medicine Center for Sports Cardiology and co-chair of the UW Medicine Cardiovascular Wellness and Prevention Program, told Healio. “With no mandatory reporting system in the U.S., the multi-method approach for case ascertainment includes systematic search of traditional and social media, reporting from national and state athletic associations, and direct reporting to the NCCSIR. We were aware of the claims that sudden cardiac arrest/death had increased in young athletes during the pandemic. Thus, we believed we could scientifically compare the frequency of sudden cardiac arrest/death in the 3 years before and the first 3 years during the pandemic.”
Drezner, who is also editor-in-chief of the British Journal of Sports Medicine and team physician for the NFL’s Seattle Seahawks, the NWSL’s Seattle Reign and UW’s Huskies, and colleagues conducted a prospective cohort study using the NCCSIR database from 2017 to 2022.
Sudden cardiac arrest was defined as unexpected collapse in which CPR and/or defibrillation was provided and the individuals survived, and sudden cardiac death was defined as a sudden death from cardiac cause or structural normal heart with no other explanation and history consistent with cardiac-related death, according to the letter.
Sudden cardiac arrest amid COVID-19 pandemic
Overall, 387 competitive athletes from the youth, middle school, high school, club, college or professional sport levels who experienced sudden cardiac arrest/death during exercise, rest or sleep were identified (mean age, 17 years; 86% male; 40% Black). Most athletes with sudden cardiac arrest/death were high school level and 70% of events occurred during exercise.
Overall, 203 sudden cardiac arrests/deaths occurred during the 3 years before the pandemic era compared with 184 during the 3 years during the pandemic. The difference was not statistically significant (P = .33), according to the study.
“The results were not surprising. We had not noticed an uptick in cases through our surveillance,” Drezner said. “In addition, studies from early in the pandemic in college and professional athletes who tested positive for SARS-CoV-2 and subsequently underwent additional cardiac testing did not demonstrate a high frequency of myocardial involvement.”
Drezner noted that SARS-CoV-2 infection or vaccination status was not assessed for each athlete, only that the total annual frequency of sudden cardiac arrest/death did not increase.
Survival and cause of sudden cardiac death
Overall survival of sudden cardiac arrest was 50.9% and the proportion of sudden cardiac deaths was similar before compared with during the pandemic (52.2% before vs. 45.7% during; P = .2), according to the study.
Although cause of sudden cardiac death was determined in nearly three-quarters of athletes, myocarditis was only confirmed in three athletes before the pandemic and four during the pandemic.
“Sudden cardiac arrest is the leading cause of fatalities in young athletes during sports/exercise and caused by a variety of genetic, structural, electrical and acquired cardiac conditions,” Drezner told Healio. “CV safety in athletes remains an important priority, but the COVID-19 pandemic did not increase the frequency of sudden cardiac arrest/death.”
For more information:
Jonathan A. Drezner, MD, can be reached at 3800 Montlake Blvd. NE, Seattle, WA 98195.
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