After N.C. State’s first football practice of the season Tuesday, coach Dave Doeren told reporters that although he is concerned about coronavirus this fall, he’s more worried about other football-related health issues, like heat stroke and serious injuries.

Doeren’s comments echoed a fairly wide-held belief that young, healthy athletes who contract coronavirus probably won’t be off the sideline for long.

“I don’t mean this in a way that I am not respecting COVID, because there are so many precautions here for that,” Doeren said. “But I am more concerned about heat illness and season-ending injuries than I am about a virus that in most cases in our age group of guys is three to five days.”

Heat illness and major injuries are certainly reasonable concerns for coaches. And Doeren’s assertion that most young men recover quickly from COVID-19 is true, too, although three to five days days for recovery is optimistic, according to health professionals.

“In general, younger individuals tend to do much better than older individuals,” Dr. Rabih Bechara, a spokesman for the American Lung Association, told the N&O.

Still, Doeren’s assessment missed a key element: Although a lot is still unknown about the possible long-term health effects of coronavirus, there is evidence that even young, healthy people will sometimes get very sick and might have lingering health problems, such as heart, lung and cognitive issues.

Take Indiana University freshman offensive lineman Brad Feeney, whose mother, Deborah Rucker, posted about his experiences with COVID-19 on Facebook on Monday.

Within three weeks of volunteer workouts starting in June, Rucker’s son was one of several players to test positive, forcing the school to pause workouts. Feeney, a healthy college athlete with no preexisting conditions, ended up in the ER because of trouble breathing.

“Now we are dealing with possible heart issues!” she said in the post. “He is still experiencing additional symptoms and his blood work is indicating additional problems.”

Attempts to reach Rucker for comment were unsuccessful.

“The whole point of my Facebook post is because in Missouri, where we live, the state is not taking this as seriously as they should,” Rucker told the Indianapolis Star on Monday. “With everything Brady is going through and has been struggling through, it has been infuriating to me that people are not taking this seriously and not wearing masks.”

Feeney, from St. Louis, is listed at 6-foot-4 and 325 pounds on Indiana’s football website. Bechara said the breathing problems Feeney experienced are one of the issues to watch for with coronavirus, which can cause inflammation in the lungs, often the root cause of other difficulties.

“If inflammation in lung tissues happened, then you will have multiple factors and multiple cells that are involved that cause immediate damage, and we don’t know if long-standing damage will occur,” Bechara said.

Denver Broncos linebacker Von Miller had coronavirus in April. Miller, who has asthma, told The Washington Post the worst of his symptoms was “not being able to breathe.”

“I got asthma, but it was past the asthma attack — like my lungs were constricting,” Miller said. “My asthma nebulizer helped, but it still didn’t feel like it was supposed to. That was the most frightening part. Just going to sleep knowing that my oxygen level could drop and I could wake up and have to go to the hospital.”

According to the Centers for Disease Control and Prevention, 31 to 40 percent of coronavirus patients experience shortness of breath. The symptom usually sets in between four and 10 days after infection.

While breathing problems are serious for all patients, they have the potential to negatively affect the performances of athletes, who rely heavily on breathing levels and lung capacity, in both the short and long term.

Heart issues are also becoming more common in coronavirus patients.

A study by the University of Frankford in Germany recently found that 75 percent of people studied who had recovered from coronavirus had abnormal heart findings, according to Hackensack Meridian Health.

Dr. Eugene Chung, chair of the American College of Cardiology’s Sports and Exercise Council, said it’s believed COVID-19 can cause arrhythmias in the heart, affect the heart muscles by causing inflammation, which can lead to myocarditis, and cause blood clotting that elevates the risk of heart attacks.

Boston Red Sox pitcher Eduardo Rodriguez, 27, listed at 6-foot-2 and 231 pounds, has been shut down for the season after recovering from COVID but experiencing myocarditis, an inflammation of the heart that affects the heart muscle and electrical system and can reduce the heart’s ability to pump blood and cause abnormal heart rhythms. Rodriguez said last week that his doctors told him that 10 to 20 percent of people who have had COVID-19 also have been diagnosed with myocarditis.

“That’s the most important part of your body, so when you hear that, the first time I hear it I was kind of scared a little,’‘ Rodriguez told The Associated Press.

While hospitalized patients are still at the most risk for long-term effects, Chung said COVID-19 can affect the heart even in asymptomatic patients.

“If someone has COVID, but doesn’t have symptoms, we still want to ask the questions, and depending on exposure and depending on symptoms, we want to do a cardiac evaluation because [COVID-19] does seem to have the ability to affect the heart and not cause symptoms, Chung told the N&O.

“And while the numbers we have seen are small, there have been some reports of inflammation picked up in the heart with cardiac MRI, even in the absence of symptoms. So that is definitely a concern.”

Cardiology evaluations include checking for cardiac biomarkers, which can be early signs of damage to the heart muscle.

“An advantage of being part of an athletic program is access to medical care- trainers, staff, clinicians who can help evaluate student athletes pretty quickly,” Chung said.

The brain can also be affected by COVID-19, specifically by blood clotting. Ischemic strokes, or strokes caused by clotting, account for 87 percent of all strokes, according to the American Stroke Association.

Research done by University of Utah Health found that inflammatory proteins produced while an individual has coronavirus alters the function of blood platelets, making them hyperactive and more prone to dangerous and possibly deadly clots. And according to data collected in three specialized COVID-19 centers of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China, 36.4 percent of coronavirus patients had neurological symptoms such as dizziness, headache, seizures, taste, smell or vision impairment and nerve pain.

Travez Moore, an outside linebacker at LSU, said in a tweet Tuesday that he lost his appetite while he had coronavirus because he couldn’t taste any foods or liquids. Moore lost 27 pounds because of the virus.

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The virus can also have negative effects on mental health, both for those who have it and even those who don’t.

Clemson defensive end Xavier Thompson is redshirting this season after battling both COVID-19 and strep throat before his return to campus. Coach Dabo Swinney said Thomas having the virus and not being able to work out “put him in a bad place mentally as well.”

Although the elderly are most commonly thought of as at-risk, there’s actually a plethora of demographics with varying increased risk from COVID-19.

Individuals who are obese or have sickle cell disease or Type 2 diabetes are considered by the CDC to be at increased risk. Those with asthma, high blood pressure, Type 1 diabetes or who smoke might also be at higher risk.

Asthma is common among athletes, even those performing at the highest level of their sports. A 2016 research study by the University of Western Australia found that 8 percent of Olympic athletes have asthma, the same percentage as the general U.S. population.

The CDC’s website classifies obesity as a body mass index of 31 or higher. For the University of North Carolina’s 23 offensive linemen on the roster, the average height and weight is 6-foot-4, 298 pounds, which is a 36.3 BMI according to the CDC’s calculator. This would put them in a higher risk group for coronavirus complications than most of their teammates.

Any man or woman that fits the CDC’s definition of obese, or has any of other preexisting conditions, could be at an increased risk despite their standing as an NCAA or professional athlete.

Dr. Joshua Berkowitz, a team physician at the University of North Carolina and assistant professor of orthopaedics, said that up to this point UNC hasn’t had any severe cases of COVID-19 among its student-athletes. The athletic department reported 37 positive tests on July 8. N.C. State reported five positive tests between athletes, coaches and staff July 9, and Duke reported 25. Neither have reported serious problems.

Of course, the scariest possible outcome isn’t injury or a decrease in performance. It’s death.

Atlanta Braves first baseman Freddie Freeman feared for his life when his fever spiked to 104.5 degrees while battling the virus. Luckily, Freeman recovered.

“We all want sports to happen,” Bechara said. “We all want student-athletes to get back on the field. But, if anyone has symptoms, then we need to know and prioritize safety for the student-athlete on the individual level, and the team, staff, university, on a community level.

“We all need to be committed together to make this happen.”


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