The main takeaway from a Penn State doctor's report on COVID-19's link to myocarditis is more uncertainty
Did Penn State’s longtime athletic doctor really assert that approximately one-third of all Big Ten athletes who have tested positive for COVID-19 have myocarditis, a potentially damaging, or even deadly, inflammation of the muscles around the heart?
Not exactly.
That very conclusion went viral Thursday after a Centre Daily Times story printed some of Dr. Wayne Sebastianelli’s comments from early this week. On Monday he appeared before the State College (Pennsylvania) Area Board of School Directors, who are debating the safety of high school sports and other activities.
Sebastianelli was brought in for his expertise, especially since Penn State was part of the Big Ten’s decision to cancel fall sports, including football.
Somewhere in the translation between Zoom meeting and social media however, a lot of nuance and perspective was lost and Sebastianelli's comments became a political football to be batted around.
“When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles [are] inflamed,” Sebastianelli said on the Zoom meeting. “And we really just don’t know what to do with it right now. It’s still very early in the infection. Some of that has led to the Pac-12’s and the Big Ten’s decision to sort of put a hiatus on what’s happening.”
Sebastianelli also explained, “You could have a very high-level athlete who’s got a very superior VO2 max and cardiac output who gets infected with COVID and can drop his or her VO2 max and cardiac output just by 10 percent, and that could make them go from elite status to average status,” Sebastianelli said. “We don’t know that. 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.”
Both of those quotes are accurate.
However, during other parts of Sebastianelli’s hour-plus appearance, he made it clear that the Big Ten has not run a “cardiac MRI” on every athlete that has tested positive for COVID.
Doing so would be challenging, since it requires sophisticated equipment (it can’t even be performed in the State College area, for example) and is very time consuming (analyzing one MRI can take over an hour).
However, some Big Ten athletes did receive cardiac MRIs. How many? Why were they chosen? Sebastianelli didn’t say. He hasn’t yet returned a call for further clarification from Yahoo Sports.
Among that group, however, about one-third did have inflamed heart muscles, he said.
How that percentage would project across all entire Big Ten athletes is unknown. Were these athletes singled out because they were displaying other issues, and thus aren’t a representative sample of the league?
Moreover, while Sebastianelli said he is concerned about the long-term impact, he also noted that many other specialists, including some at the Mayo Clinic, aren’t.
“[They] feel this is a finding that is incidental and may not warrant any further investigation or concern,” Sebastianelli said. “And they’ll let somebody compete again in 30 days or more of their viral infection, [if it] has cleared and their heart has displayed normal activity based on their level of competition.”
He further acknowledged that any virus, such as influenza, can cause inflammations in the body, including around the heart. However, he said he wasn’t aware of any major study of how the flu compares to COVID. He figures one will be conducted this winter.
The debate over whether college football being played has been heated – while the Big Ten and Pac-12, among other leagues, have postponed the season, the ACC, Big 12 and SEC are still planning on playing later this month. It’s even political, with both Joe Biden and Donald Trump weighing in on the issue via comments or commercials.
Sebastianelli’s comments were seized upon by all sides of the argument, however his full perspective was far more middle of the road. He was very honest in his uncertainty, which he reiterated is his No. 1 concern.
“We really don’t have any long-term studies,” Sebastianelli said. “The virus has only been around six months in the sense [of] what our exposure has been. So we don’t know.
“There have been some athletes who have struggled to get reconditioned again,” he continued. “Fortunately not here [at Penn State] but through our networking and communication with other athletic trainers at other universities you hear about athletes who just struggle. Whether that is a short-term effect [of] 30 days, 60 days, 90 days or something that changes their VO2 max permanently, I just can’t answer that.”
During the school board meeting he tried to express that not enough is known to rule anything out.
“I'm not saying you cancel sports, I'm saying it has to be respected,” Sebastianelli said. “We really want to study this further to understand what is happening with the student athlete.”
The board members thanked Sebastianelli for his honest and reasonable perspective. How can you fault an expert for acknowledging what they don’t know?
That might not be good for viral outrage, but that’s how it really played out.
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