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College athletes with COVID-19 rarely had heart complications and could safely return to playing sports after recovery, according to new research.

Even those with abnormal cardiac test results showed no evidence of heart damage, according to the small study, published Monday in the ·¬ÇÑÊÓƵ journal . Most athletes had mild symptoms that did not require treatment.

This study confirms published last month in Circulation, which found no cardiac problems related to COVID-19 infections in more than 3,000 college athletes during short-term clinical surveillance. Those findings also suggested athletes who had mild or no symptoms could safely resume playing sports without cardiac testing.

In the spring of 2020, concerns that college athletes with COVID-19 could develop inflammation of the heart led the American College of Cardiology to recommend heart screenings before athletes could return to training or competition. The preferred diagnostic test for heart inflammation is magnetic resonance imaging, or MRI. The recommendations do not advise cardiac MRI as an initial screening test based on COVID symptoms alone.

So, in this new study, researchers investigated if symptom severity was associated with heart inflammation or poor recovery after COVID-19.

All the athletes underwent initial heart imaging tests, including ultrasound and electrocardiogram. They also were given blood tests to check their troponin levels. Troponin, a protein released in the blood and in heart muscles, can indicate heart damage. Only participants who had abnormal test results received a cardiac MRI.

Less than 4% of the 137 athletes showed heart abnormalities on initial screening tests. Then, cardiac MRIs of those five athletes found no heart damage or inflammation. After COVID-19 recovery, all athletes were able to resume full training and competition without complications.

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