Myocarditis and potential heart damage caused by COVID may be biggest challenge to resuscitating college sports

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A small but growing body of evidence shows that COVID-19 can damage the heart, sometimes fatally, even in a previously healthy young athlete.

This frightening fact is shrouded in so many unknowns that even expert medical groups can offer only limited guidance. That’s why collegiate athletic conferences, professional sports leagues, and high school teams are debating what to do. The Big Ten Conference’s debate ended with a decision to err on the side of caution.

Here are some of the questions medical and sports authorities are grappling with.

What is myocarditis? Myocarditis is inflammation of the heart muscle, or myocardium, usually triggered by infection with a virus, including germs that cause the common cold. The inflammation is generally mild and goes away with rest. But it can also cause temporary or permanent heart problems, notably abnormal rhythms, progressive heart failure, even sudden cardiac death.

How does the coronavirus damage the heart? The exact mechanisms are unclear, but studies suggest an immune system overreaction or an autoimmune response (a self-destructive attack on healthy tissue), or both.

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In a nutshell, the plan recommends that athletes with asymptomatic, mild, or moderate COVID-19 be monitored for heart problems and swear off exercise for at least two weeks. Players who need hospitalization and develop myocarditis that does not resolve should follow existing guidelines for athletes with cardiovascular abnormalities.

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