Hurricanes’ doctor helps author major new study on athlete COVID heart complications

Amid all the bad news surrounding COVID-19 and sports, Josh Bloom was thrilled to finally be part of discovering what he believes to be some of the good news. The Carolina Hurricanes’ team physician was one of the authors of a study released Thursday that found an absence of serious heart issues in professional athletes diagnosed with COVID-19.

The NHL, NFL, NBA, WNBA, MLS and their players’ unions threw their support and data behind the study, which looked at the medical history of 789 athletes who had COVID, both symptomatic and asymptomatic. Of that group, 36 showed potential heart problems in diagnostic tests. Only five were found to be worth further investigation, and they were eventually able to return to action.

“You had to be cautious until you knew you couldn’t be,” Bloom said Friday. “Regarding this part of it, we’re pretty comfortable we don’t need to be.”

How Bloom got involved

So how did a community physician and team doctor end up with his name on a study authored by some of the biggest names in sports medicine, cardiology and infectious diseases?

Bloom also works out of Carolina Family Practice and Sports Medicine and the Carolina Sports Concussion Clinic in Cary. With his focus on brain injuries, he was the catalyst for his son’s football team at Apex Friendship to switch to contact-free practices in the fall of 2019.

Over the spring and summer, he saw that his athletic patients who either tested positive or had COVID antibodies, both symptomatic and asymptomatic, were passing cardiac screenings without any heart issues. Tapping his NHL connections, he reached out to the league’s chief medical officer, Winne Meeuwisse, to find out if the NHL was seeing the same thing. That conversation led to conversations across the professional leagues and unions, and the rapid expansion of an NBA/WNBA study already in progress.

“Honestly, I said as a clinician, ‘All this myocarditis, why are we not seeing it? Why are we not seeing cardiac arrests?’” Bloom said. “These are the things we were worried about with COVID.”

Initial fears

The potential for heart problems was one of the biggest fears and hurdles for sports’ return as the pandemic began, based on anecdotal hospital evidence with COVID-19 and an Ohio State study of a limited sample of athletes that found evidence of myocarditis, an inflammatory heart condition that often goes undiagnosed and can lead to heart attacks or other life-threatening complications.

Those fears were exacerbated when Florida’s Keyontae Johnson, who had contracted COVID-19 over the summer, collapsed during a game in December and was briefly placed in a medically induced coma. Johnson’s medical issues were not COVID-related, his family said, and the new study, published in JAMA Cardiology, should offer reassurance for athletes, Bloom said.

“This is really profound data for the rest of society as we make decisions about what a safe return to sports looks like at the youth level, in high school, across the board,” Bloom said. “I’m also involved in some of those decisions around here and this will help guide us.”

Fears of heart inflammation remain with COVID-19, but the study is an indication those complications are limited to patients who struggle with the disease, Bloom said. Most athletes aren’t in that group.

“It is the moderate to severe COVID cases that seem to be at significant risk,” Bloom said. “That’s a really important distinction. We’re not saying you don’t need to think about it, but you only need to think about it in patients who have a tough time with this, a hard clinical course. Our (study) population was obviously young and healthy and athletic. COVID’s a bad actor, but from a cardiac perspective it might not be radically different from other viral respiratory illnesses.”