Penn State doctor says 30-35% of Big Ten athletes positive for COVID-19 had myocarditis symptoms

Cases of myocarditis, an inflammation of the heart muscle, appear to be prevalent among Big Ten athletes, said Penn State's director of athletic medicine, impacting roughly one-third of all athletes who have tested positive for the coronavirus.

Wayne Sebastianelli, who is also the team doctor for Penn State football, said Monday during a meeting of the State College Area School District board of directors that cardiac scans of Big Ten athletes who contracted COVID-19 showed "30 to roughly 35 percent of their heart muscles" indicated symptoms of myocarditis.

"And we really just don’t know what to do with it right now," he said. "It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening."

Myocarditis, which can be fatal, was a driver behind the Big Ten's decision to postpone the coming season with the possibility to return this winter or spring. 

"There is simply too much we do not know about the virus, recovery from infection, and longer-term effects," Big Ten Commissioner Kevin Warren wrote last month. "While the data on cardiomyopathy is preliminary and incomplete, the uncertain risk was unacceptable at this time."

The possibility of widespread instances of myocarditis may impact the conference's thinking at a time when Big Ten presidents and chancellors have come under pressure to reconsider last month's decision, particularly as three other Power Five leagues move ahead as scheduled with the start of their seasons this month.

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Penn State and the Big Ten did not respond to USA TODAY Sports' requests for comment.

Many cardiologists, "some high-level," Sebastianelli said, would come to the conclusion that the high percentage of myocarditis cases are incidental and “may not warrant any further investigation or any further sort of concern.”

For example, a report conducted in Germany in late July and used by the Big Ten to inform last month's decision has since come under increased scrutiny.

"I think it’s important to know what’s reliable and what’s not and I think there are numerous issues with this paper and frankly it’s inconsistent with some of the higher quality data that’s out there in the pathology literature," Michigan associate professor of cardiovascular medicine and radiology Venk Murty told the Detroit Free Press.

Only one of the 26 programs that responded to survey questions conducted by ESPN on the potential heart-related conditions caused by COVID-19 reported having an athlete who developed heart issues. But the school, Oregon State, said the issue was not myocarditis.

According to the Mayo Clinic, "In many cases, myocarditis improves on its own or with treatment, leading to a complete recovery."

Even in mild cases, however, the clinic suggests that "persons should avoid competitive sports for at least three to six months."

Inflammation can lead to "electrical malaise," Sebastianelli said, potentially causing arrhythmia, or an irregular heart rhythm. 

"What has been seen across some of the schools is that some of the athletes affected haven’t really recovered their full pulmonary function," he said. "They just don’t train as hard as they normally can.

"We don’t know how long that’s going to last. What we have seen is when people have been studied with cardiac MRI scans — symptomatic and asymptomatic COVID infections — is a level of inflammation in cardiac muscle that just is alarming.”

In an email to the Centre Daily Times, which first reported his remarks, Sebastianelli said he had "no direct conversation" on the number of myocarditis cases with Penn State President Eric Barron, "but needless to say we all have concerns for the health and safety of every (Penn State) student-athlete, as well as those at every level of competition; this is a public health issue.”