ABSTRACT
Introduction: There is increased scrutiny on cardiac screening of competitive athletes after COVID19 illness, and cardiac magnetic resonance (CMR) is frequently undertaken. Limited reports with echocardiography-based strain techniques suggest occult abnormalities in collegiate athletes after COVID-19. Cardiac involvement in the adolescent athlete has not been well characterized. The purpose of this study is to describe CMR findings, including strain encoded (SENC) imaging, in adolescent athletes after COVID-19 (C19+AA). Methods: Retrospective review was performed of ambulatory C19+AA patients who underwent CMR (Group A). Healthy athletes (Group B) and nonathlete healthy controls (Group C) underwent CMR with SENC for comparison. Myocardial strain was evaluated by MyoStrain (Myocardial Solutions, Morrisville, NC). LV global (GLS) and regional strain (from modified AHA-16 segment model) were compared between the three groups with abnormal defined as magnitude <17 and statistical significance set at p < 0.05. Results: Group A patients were younger (n = 87, 52% male, age 15.4±1.8 yrs) than Group B (n = 19, 63% male, age 21.3±1.6 yrs) and Group C (n = 9, 52.6% male, age 19.3±1.1 yrs) with no difference in LVEF between the three groups (Group A = 59.1±3.9%, Group B = 60.3±6.2%, Group C = 61.0±4.1%). Despite preserved global function, Group A had significantly lower GLS (-17.6±2.3% vs Group B =-20.8±1.4%, p <0.04 and Group C =-19.1±2.4%, p = 0.02) with no difference between the latter groups (p = 0.07). Higher numbers of abnormal segments were observed in Group A (6.9±3.7, 43.1%) vs Group B (2.4±1.9, p < 0.0001) and Group C (3.7±3.5, p < 0.0001) with no difference between the latter groups (p = 0.1). Conclusions: Global and regional strain abnormalities were common in C19+AA in the setting of normal LVEF. This may represent occult myocardial abnormalities in adolescents after COVID-19. Future longitudinal studies with age matched controls are needed to monitor for progression.
ABSTRACT
Viruses are recognised for their ability to induce genetic evolution and cause disease. SARS-CoV-2 has catalysed rapid evolutionary changes in the delivery of preclinical teaching of the Griffith University medical program across diverse sites by inducing the use of progressive student feedback to enhance active learning in an online flipped format. These COVID-induced adaptations in medical education delivery, innovation and fasttracked modernisation are, unlike viral infection, a curve that we embrace and do not want to squash.
ABSTRACT
Children have a right to have their views sought and given due weight on all matters affecting them, including at times of emergency and crisis. This article describes the process and findings of the ground-breaking CovidUnder19 survey (“Life Under Coronavirus”) which was co-designed with children for children, capturing the experiences of over 26,000 children in 137 countries as to the realisation of their human rights during the first six months of the Covid-19 pandemic. Key findings are discussed through the lens of the crc’s four general principles, read alongside children’s rights, inter alia, to education, play and to be protected from harm. It argues that governments and public bodies should have sought children’s views – not just because they were under an obligation to do so – but because such engagement, now and in crises to come, provides an early warning system that enables decision-makers to mitigate some of the adverse consequences of their responses for children and their rights. © Laura Lundy et al., 2021