144. COVID, BIG10 FOOTBALL

In this study of a cohort of German patients recently recovered from COVID-19 infection, CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions,


this was a freak out statement if I have ever heard of one
I mean Covid is doing something directly to the heart? and this thing it is doing to the heart is independent of preexisting conditions??

this study was viewed over 500K times and on 196 news outlets with 12,000 tweets


this is in and of itself one of the main reasons that the BIG TEN shut down football.

of course we will never know for sure but it has been cited in many of the articles as one of the biggest concerns for player safety and potential damage to the heart!!

Nevermind the fact that this mean age in the study was almost 50 and the mean age of a college football player is around 20. That is just a small detail and we need to shut down sports for the safety of the athletes because we the big ten have a HEART and dont want to ruin theirs.

BUT turns out that was not the only problem and twitter erupted with more errors- and you might say, wait twitter!? yep


the authors even say--

We were made aware of the errors in our original report as they were discussed on Twitter through a journalist, who was covering the publication of the article. We immediately studied the Twitter discussion, which made note of 2 problems: the use of inaccurate metrics for the data analysis as well as inconsistencies between the reported data in the legend of Figure 1 and the data points provided for the patients with COVID-19 in Figure 2. As a result, we have reviewed the data and repeated the analysis.

https://jamanetwork.com/journals/jamacardiology/fullarticle/2770026?fbclid=IwAR1ke0Afd5vLUhGMeGDggExbzvy8xy8j81OEMXnqg9aK5PNaq5RujkUnLqI


part of the problem was the authors misuse of mean and median and standard deviation and (interquartile ranges)

median is the middle number and mean is the average. the SD and the IQR

The standard deviation takes into account all the values of a dataset, including any outliers. It is dependent on the mean, because the value is used to tell how much the data deviates from the mean of a dataset.

the interquartile range (IQR), also called the midspread, middle 50%, --The Interquartile Range tells us how spread the data is. The larger this value is, the more spread out the data is, and the smaller the value, the less spread the data is.

in the original paper

The EF of the Covid 19 patients is shown as 56 (54-58) -- what weird is when the calculations were done on this 54-58 was not
Not IQRs
Not ± SD
Not ± SE (standard error)
Not ± 1.96 SD
Not ± 1.96 SE
Not ± 2 SD
Not ± 2 SE
but lets pretend it was an IQR-
This means that half of the EF values lie between 54 and 58. So with a 100 people in the Covid arm that means that 50 people or 50% had an EF between 54-58. Obviously this is so insane its impossible or certainly so close to impossible it should make you says hold the phone

another problem was blood pressures originally reported at median 129 with a range of (125-133)-- again was is the 125-133?? no way 50% of the people had a bp pressure in this rand so almost certainly not IQR and almost no way the standard deviation was only 8 blood pressure points. it was this mystery number range that still doesn't have a clear answer to it and has not been answered by the authors --

What about in age- the original paper had an age of 49 with IQR 45-53. that is 8 yr difference to account for 50% of the population. That is insane unless you are trying to account for a certain age.




in the Original Investigation, “Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19),”1 published in JAMA Cardiology on July 27, 2020.



We have recalculated all data according to data type. Now, we correctly report means (SDs) or medians (interquartile ranges).

During the correction and recalculation process, we were able to provide some missing data from the original CMR scans as well as correct some data entry errors.

-- but the authors dont say how they were able to provide this missing data and why was it missing in the first place- and where did the calculated numbers originally come from. but they go one to say. I have read an interview with the authors and they basically say -- ya it was a mistake-- I commend them on saying it was a mistake but sad that it hapened and got past the editors and checks and balances that are suppose to have checks and balances-- they go on to say


We are pleased to confirm that reanalysis of the data has not led to a change in the main conclusions of the study.
which as a reminder was--
"CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions,"


NOW this is a problem because this statement would have you believe that if you got Covid you had a 78% chance of having cardiac involvement and if you dont get Covid then your odds of myocardial inflammation is 0%.

almost that Covid acts as a light switch and 78% of the time you are at risk of cardiac problems and there are no other factors in the world the could possibly give you these findings.

Its almost like they are ignoring that fact that those individuals with baseline CAD, htn, hlp, obesity, noncompliance, DM could ever have an abnormal finding. Like those individuals are of perfect health without any cardiac abnormalities EVER.

this is absurd and
what we really really want to know is in the individuals who have Covid how many MORE TIMES are their hearts affected compared to a risk factor matched control group.

well if you look at the CRP and the high sensitivity trop which are two blood test you would expect to be elevated with acute myocarditis you will see that whether you had Covid or not once you matched up the risk factors the CRP and Hstrp were basically the same and wnl.

wnl is the important factor-- so sure maybe you can have an MRI that shows 'signs concerning for myocarditis, correlate clinically' but when you correlate clinically with someone who has normal Hstrp and normal CRP then the diagnosis is not myocarditis.

and what about what you look at the data for T1 abnormalities
73 individuals out of 100 with Covid
compared to the risk adjusted match that had 33 of 57 which happens to be 58%

well when you look at the numbers for the new data!

73% of 100 Coviders had the abnormal T1 imaging

58% of 57 non-Coviders (with similar risk factors) had abnormal t1 imaging.

Drum roll please ....

Difference 15 %
95% CI-0.1902% to 30.0537%
Chi-squared3.703
DF 1Significance level
P = 0.0543


Covid survivors DO have abnormalities in their T1.
But it is JUST AS COMMON or not statically different in people with similar risk factors who have NOT had Covid.

it is the risk factors that make it so people are at risk of having badness with their heart so if you look at this study you shouldn't say hey look at this we should stop sports you should say hey look at this we all need to take a multivitamin and by take a multivitamin I of course mean you leave a vitamin at the store and you walk 5 miles to the store every day to take the medication but that is the only way a multivitamin will work and the best way to prevent a problem in imaging....

exercise more, sit less
it really is the best
to decrease cardiac magnetic resonance
and I can say that without any hesitance



finally in the interview I read with the authors the authors basically say

Q. Would you stop such patients doing sport?

A. After a bad infection, I would encourage them to only gradually ease themselves back into heavy activity.