# Has COVID-19 led to more sudden cardiac deaths in football?

## TL;DR

This study found no significant increase in sudden cardiac deaths or arrests among football players during the COVID-19 pandemic compared to before.

## Contribution

The study provides the first global comparison of sudden cardiac events in football players during and before the pandemic.

## Key findings

- There were 454 SCD/SCA cases pre-pandemic and 380 during the pandemic, with no statistically significant difference.
- Myocarditis cases were rare in both periods, while coronary artery disease remained the most common cause.
- Survival rates slightly improved during the pandemic, but the difference was not statistically significant.

## Abstract

It is unclear whether the number of sudden cardiac death (SCD) and survived sudden cardiac arrest (SCA) has increased among football players during the COVID-19 pandemic. This study aims to compare the SCD/SCA burden between the pre-pandemic period and COVID-19 pandemic in football players worldwide.

The COVID-19 pandemic and an equivalent pre-pandemic period (each lasting 1151 days) were analyzed for SCD/SCA by extracting data from the prospective FIFA (Fédération Internationale de Football Association) Sudden Death Registry. Particular focus was placed on cardiac diseases acquired through the novel coronavirus SARS-CoV-2, such as myocarditis and coronary artery disease (CAD), potentially leading to SCD/SCA.

There were 454 SCD/SCA (survival rate: 24%) and 380 SCD/SCA (survival rate: 27%) during the pre-pandemic period and COVID-19 pandemic, respectively (p = 0.27). In the pre-pandemic period, out of 191 confirmed and suspected diagnoses, there were 6 (3%) cases of myocarditis and 69 (36%) cases of CAD and during the pandemic out of 136 confirmed and suspected diagnoses, there was 1 (1%) case of myocarditis and 58 (43%) cases of CAD.

The burden of SCD/SCA, particularly myocarditis and CAD, in football players worldwide seemingly has not been higher during the COVID-19 pandemic than during a comparable period before.

The online version contains supplementary material available at 10.1007/s00392-024-02569-1.