Reports have indicated that COVID-19 may cause heart damage in hospitalized patients with severe cases of the disease, but it’s unclear whether cardiac injury also occurs in infected patients who are asymptomatic or experience only mild symptoms. This question is of particular concern for athletes because myocarditis–inflammation in the heart usually caused by viral infection–can cause sudden cardiac death during exercise. In a special report published in JAMA Cardiology, a group led by sports cardiologists at Massachusetts General Hospital (MGH) and Emory University School of Medicine offers guidance for athletes’ return to play after they have recovered from COVID-19.

The researchers observed that athletes infected with COVID-19 who experienced no or mild symptoms did not exhibit signs of heart injury. For such athletes, they do not recommend detailed cardiac screening. The prevalence of cardiac injury in athletes who were infected with COVID-19 is still unknown, however, and the team believes it’s prudent to screen for heart damage in athletes with moderate to severe symptoms. The experts also note that despite recent small studies showing that cardiac magnetic resonance imaging has detected potential cardiac abnormalities in individuals who have recovered from COVID-19, they feel that current evidence doesn’t justify its use as a universal screening tool for athletes’ return to play.

Myocarditis

Cupping therapy has re-emerged as a potential approach to boost post-exercise metabolic recovery, reduce pain, and improve range of motion by increasing local microcirculation. But what does science tell us about the effectiveness or safety of cupping? A new systematic review that examines the results of eleven clinical trials encompassing nearly 500 participants is published in The Journal of Alternative and Complementary Medicine.

Despite some reports of benefits, including some related to reduced pain and disability, the authors found the reports uneven and found a high risk of bias in the trial designs. They therefore determined that no conclusive recommendations for or against the value of cupping in sports performance can be made until further trials are carried out.