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BERNSTEIN: Fear coronavirus, myocarditis relationship

Myocarditis proves a worthy threat toward the health of young people, and it is a possible effect of the coronavirus disease (COVID-19).
Photo by PxfuelMyocarditis proves a worthy threat toward the health of young people, and it is a possible effect of the coronavirus disease (COVID-19).

When I heard that coronavirus disease (COVID-19)-positive Big Ten Conference athletes were presenting with symptoms of myocarditis, I knew immediately that I would have to write an article about the thoughts bouncing around in my quarantine-fatigued brain. This is important. This is, if my first-hand experience has taught me anything, the beginning of a disaster.

To quickly update those of you who are unaware, the director of health sports medicine at Penn State University, Wayne Sebastianelli, recently reported that approximately 30 to 35 percent of athletes in the Big Ten who were infected with COVID-19, including mild or asymptomatic cases, developed symptoms of myocarditis. 

Sebastianelli recently clarified that the current data actually suggests a percentage lower than one-third, but he has nonetheless referred to the level of heart inflammation associated with COVID-19 as "alarming."

I, too, am alarmed. While I have never been infected with COVID-19, I have had a form of myocarditis. It was one of the worst experiences of my life, and it is one of the last things that a budding athlete, or any young person, should have to deal with. Let me paint a picture for you of what even a mild case of myocarditis can entail.

My first bout of heart inflammation occurred at the end of my sophomore year of high school. I was placed in an intensive care unit with excruciating chest pain, which radiated from the left side of my chest to my back and jaw, my heart inflammation enzymes were 170 times higher than normal. 

Leading up to my hospitalization, I experienced episodes of agony so intense that I found myself writhing on the floor, screaming to be sedated (I assure you, dear reader, that I am not one traditionally to writhe, and certainly not on such an undignified surface as the floor). I have talked with adults who have had similar heart inflammation experiences, and they have described the pain as the worst of their life. I share the sentiment.

My precise diagnosis was myopericarditis: a combination of direct heart muscle inflammation (myocarditis) and inflammation of the pericardial sac (pericarditis). I was fortunate in that, in my case, the pericarditis was more severe than the myocardial inflammation: I seem not to have suffered any significant scarring of the heart. 

My cardiologist prescribed a strict regimen of painkillers and barred me from any physical activity for six months, not that I could have exercised even if I wanted to. I was physically drained. When I finally returned to the gym, I had to hook myself up to an electrocardiography so my cardiologist could monitor me.

I will not chronicle the entirety of my second bout of myopericarditis this past winter, except to say that it did resurface, and that even now, although I exercise regularly, I constantly have to monitor my physical well-being and avoid overexertion. Keep in mind that, compared to more severe forms of myocarditis, my case seems to have been mild. Fulminant myocarditis, for example, has more than a 40 percent mortality rate in the first month of disease onset. 

Other forms of myocarditis can lead to fatal cardiac failure in more than one-fourth of patients within a decade of initial symptoms. As for those who survive their myocarditis experiences, many struggle with chronic heart problems which limit their physical ability and quality of life.

Some of you may read this and assume that the more serious consequences of myocarditis, like those of many other diseases, are less prevalent in young people. This is false. In fact, myocarditis affects people aged 20 to 40 more often than any other age group, and is "an important cause of death in children and young athletes," according to the National Organization for Rare Disorders.

At least one COVID-19 positive child, 11 years old, has already died as a direct result of myocarditis. Ossama Samuel, an associate professor at Mount Sinai Beth Israel hospital in New York, who has identified myocarditis in a number COVID-19 positive young adults (including those who had already recovered from the virus), said it is "extremely dangerous" for athletes to compete for at least three to six months following an episode of myocarditis.

The apparent link between myocarditis and COVID-19 is not something to be dismissed. Myocarditis could be the cause of up to seven percent of COVID-19-related deaths, according to Scientific American

So let me hammer my point home to my fellow college students: This is not a condition you want to have. If you are a young person, COVID-19-related myocarditis could threaten your life. If you are an athlete, a severe case of myocarditis has the potential to destroy your entire athletic career. Even the mild form from which I suffered was painful, nothing I have ever felt before, demoralizing and seriously disruptive to my physical fitness. 

If you refuse to fear what COVID-19 can do to you, please, at least fear myocarditis. 

Daniel Bernstein is a School of Arts and Sciences sophomore looking to major in cell biology and neuroscience and mathematics. His column, "Mind You," runs on alternate Fridays. 


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