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  1. Baal is offline
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    #41
    That Danish study should never have been published and I would bet a lot that the editor in chief overruled recommendations of the primary reviewers. The antibody tests alone have enough uncertainty to make it uninterpretable. More importantly the conditions at the time and place are not what we have now. I'm not trashing the authors either, however what they attempted to do is virtually impossible. Something Dr. Evil noted indirectly.

    So in modern science, what is done when you can't in practical ways do what the Danish scientists sttempted is a combination of comparative studies correlating outbreaks with various policies in place, and also many types of epidemiological modeling studies based on realistic and often data-driven parameters, as well as physical studies of mask physics, aerosols, etc., p.us experience with other respiratory viruses.

    And the vast majority of those studies, most of which won't hit your newspaper or Google feed, indicate that where more masks are used, the less severe the outbreak. Pretty much every serious public health expert in the US and most of Europe agrees with me.

    They will also say it's not sufficient.

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    Last edited by Baal; 12-10-2020 at 05:56 PM.

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    #42
    Good video and article from the Washington Post.

    https://www.washingtonpost.com/inves...frared-spread/
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  3. Baal is offline
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    #43
    The 6 foot rule is another one of those things that will give you a false sense of security. At this point it has no basis in reality..

    As a first approximation, there are three key things that directly determine the probability that you become infected:

    (1) The concentration of active virus particles that reach airways,

    (2) the duration you spend around the virus particles, and

    (3) The state of your immune system, which will be a complex mixture of general health, vitamin D status, even blood type, among countless other things.


    • Masks are repeatedly proven to reduce virus particles that leave people's airways and enter the common space. They might also reduce or block the entry of viruses into your airways, but this definitely depends on the type of mask and the fit. An N95 or KN95 properly worn is a lot better than a surgical mask. Clearly if everybody wears masks, viral concentration in a given space decreases. When masks get wet, they don't work as well.
    • Small poorly ventilated indoor spaces are more risky in some proportion to number of people per cubic meter and the prevailing infection rate in that city. Risk increases if the people's respiratory rate increases (singing, shouting, playing sports).
    • If you have to go to common indoor spaces, go in and get out as fast as you can. For example, when I get restaurant take-out food, I wait for it outside.
    • At the end of the day, we are talking about a stochastic process, which in regular English means everything we are discussing here is affecting probabilities and you could have good luck or bad luck for awhile. Over time, your "luck" will approach the actual probability. Like flipping a coin you might easily get 4 heads in a row. You are not going to get 40 in a row!


    How serious the risk is depends on several other factors too, like temperature and humidity not to mention what other respiratory viruses are going around. It is likely that colder and more dry conditions increase viral lifetime in the air (and where the droplets go and their size), but outdoors the UV light very much reduces viral half-life.

    Obviously if you live in the US right now the risk is high -- very likely more here right now than anyplace else in the world, even in places that had low infection rates earlier. Most of Europe is also having to deal with a new wave (a common pattern in viral pandemics and of course it is winter). If you live in New Zealand, Taiwan or Vietnam, risks are very low.
    Last edited by Baal; 12-11-2020 at 06:28 PM.

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    #44
    Quote Originally Posted by NextLevel
    Good video and article from the Washington Post.

    https://www.washingtonpost.com/inves...frared-spread/
    Interesting to see a visual representation of one's aerosolized breath.

    Probably hard to measure this but I'm curious on what type of viral load does it take to get infected? I'm sure at this point living in mid part of the states and wearing a mask, I've at at least X amount of that virus particles land on me. But how much is too much to where you're infected?

    Still, interesting video. Thanks for sharing.
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  5. Baal is offline
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    #45
    It's simply not known (and pretty much impossible to know) what amount of viral load will make you sick, because it will also depend on how deep into the airways the virions penatrate ( this will depend in part on how hard you're breathing), your immune status and about a gazillion other things. It is also extremely difficult to measure the concentration of active viral particles in air, plus it won't necessarily be uniform in a room.

    There are many good reasons to think that your viral dose affects eventual disease severity, but again, it's a stochastic process at multiple levels. In other words, most conclusions have to be prefaced with the words "on average".

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    Last edited by Baal; 12-11-2020 at 08:53 PM.

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    #46
    It is vital thing that we ignore of bad side of Covid-19 and it run fast as we thing. Sport person suffer from this pandemic need to extra care as test and treatment So we could stop this channel of Covid-19.

  7. Baal is offline
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    #47
    Back around November 22, the University of Florida men's basketball team had a Covid-19 outbreak that caused them to cancel some games. Their best player was among those who tested positive. Two days ago he collapsed suddenly in a game and was rushed to the hospital. He is in now in critical but stable condition. Now there are rare cases of undiagnosed genetic cardiac disease that can lead to death of young elite athletes (Hank Gathers was a recent case). But a post Covid-19 myocarditis could produce this effect too. Again, this has been seen in people who did not have significant respiratory symptoms, and the mechanism behind it is not known (but may relate to immune cytokine responses, rather than to viruses infecting the heart muscle). Obviously privacy rules mean we won't know anything soon or maybe ever in this case. Right now I don't think it is possible to say how common this is, but for sure it can happen.

    Covid-19 has been raging through college athletic programs in the US. There is a lot of money at stake. Player health seems to be taking a back seat.
    Last edited by Baal; 12-13-2020 at 06:18 PM.

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    #48
    Quote Originally Posted by Baal
    Back around November 22, the University of Florida men's basketball team had a Covid-19 outbreak that caused them to cancel some games. Their best player was among those who tested positive. Two days ago he collapsed suddenly in a game and was rushed to the hospital. He is in now in critical but stable condition. Now there are rare cases of undiagnosed genetic cardiac disease that can lead to death of young elite athletes (Hank Gathers was a recent case). But a post Covid-19 myocarditis could produce this effect too. Again, this has been seen in people who did not have significant respiratory symptoms, and the mechanism behind it is not known (but may relate to immune cytokine responses, rather than to viruses infecting the heart muscle). Obviously privacy rules mean we won't know anything soon or maybe ever in this case. Right now I don't think it is possible to say how common this is, but for sure it can happen.

    Covid-19 has been raging through college athletic programs in the US. There is a lot of money at stake. Player health seems to be taking a back seat.
    https://jamanetwork.com/journals/jam...h%20as%2010%25.

    "Current evidence suggests that the development of myocarditis during acute influenza infection is surprisingly common.5"


    "Based on these findings, a recent review reported the prevalence rates of myocarditis in acute influenza infection to be as high as 10%.5"

    But later:

    "In conclusion, using more sensitive and specific markers of myocardial injury than in previous studies, we have found that the prevalence of myocarditis during acute influenza infection may be considerably lower than previous studies have implied."

    The warnings make sense but let's put it in context and give it time.
    Last edited by NextLevel; 12-13-2020 at 08:15 PM.
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  9. Baal is offline
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    #49
    NL is citing a 17 year old article on influenza. Here is a July 2020 article on Covid-19

    https://www.sciencedirect.com/scienc...89790X20300640

    And a summary in more ordinary language, which includes the uncertainties

    https://www.medpagetoday.com/infecti.../covid19/88487

    This German study below is the most scary report of cardiac issues in Covid-19 that I've seen. It also uses cardiac imaging.

    https://jamanetwork.com/journals/jam...rticle/2768916

    The main point is even if mortality rates are fairly low, this thing can mess you up. That's all I'm trying to say. Be safe out there!

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    Last edited by Baal; 12-13-2020 at 09:17 PM.

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    #50
    Quote Originally Posted by Baal
    NL is citing a 2003 article on influenza. Here is a July article on Covid-19

    https://www.sciencedirect.com/scienc...89790X20300640

    And a summary in more ordinary language, which includes the uncertainties

    https://www.medpagetoday.com/infecti.../covid19/88487

    The main point is even if mortality rates are fairly low, this thing can mess you up. That's all I'm trying to say.

    Also, there are numerous reports of cardiac arrhythmia even when you can't really find laboratory evidence for myocarditis.

    Why didn't you post the second article when you made your initial point?

    While you admit the risk is small, you get an anecdote from another story/article, use it to scare people, and then mock me for citing research because the research is old, not because the research is wrong.

    It was actually while following Darrel Francis on Twitter I got a link to the paper which you state is out of date, so I presume cardiologists don't take 2003 papers seriously. Darrel Francis was one of the researchers who pilloried a study claiming that covid19 was causing myocarditis in 30-35% of athletes that was discussed in the second article. The truth is that a lot of people have issues we have never looked at with MRIs or taken seriously to the degree to which we are now doing with covid19. Francis's view at a high level is that if you MRI a lot of people, you will find a lot of things. That's why MRIs are usually not done on people without symptoms.

    "Darrel Francis, MD, of the National Heart and Lung Institute of Imperial College London, saw reason for reassurance in Nagel's corrected data rather than reason to stop sports."

    The authors of the link between Covid19 and myocarditis in athletes initially overstated the risk, got pilloried on Twitter, and then re-evaluated the risk.

    I posted a link (either here or on MYTT) of a healthy 23 year old who almost died of the flu and had to have multiple surgeries - I just wanted to illustrate how stories can be written to incite fear (this was part of a promotion for flu shots). I don't doubt covid19 is more serious than the flu in some ways, but there is a level of hysteria that you keep pushing that you may not realize needs a counterweight.

    Unfortunately, people who don't actually immerse themselves to some degree in the actual data will never be able to get that counterweight because the whole press is driving a narrative. I am hearing now from family that taking your baby to church is irresponsible because they can get covid19. Schools which have been open in many countries are not open in many parts of the US because of covid19. Even having a dispassionate discussion of data leads to people sneering at you just because you decided to think differently about the situation. It's why I have decided when I state things to post links to research from experts as much as possible. Usually mainstream so that it is clearly not a fringe view. And data driven.

    Let's try as much to stay away from scary anecdotes and to give people data driven information that lets them assess the risks. Usually, if someone is focusing on an anecdote without strong data, it is usually a hint that the data is likely not as scary as they are making it out to be.

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    Last edited by NextLevel; 12-13-2020 at 11:26 PM.
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    #51
    Quote Originally Posted by NextLevel

    Let's try as much to stay away from scary anecdotes and to give people data driven information that lets them assess the risks. Usually, if someone is focusing on an anecdote without strong data, it is usually a hint that the data is likely not as scary as they are making it out to be.
    3,000+ deaths a day in the US. Perhaps this could be the starting point of the discussion on relevant data.

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    #52
    Quote Originally Posted by PushSmasher
    3,000+ deaths a day in the US. Perhaps this could be the starting point of the discussion on relevant data.
    Okay. That sounds like a lot but let's put it in context. If we had 3000 deaths a day, that would be over 1mm deaths in the US YTD. So it's more likely you are citing a particular day. Which day?

    1. How many people die on an average day in the US?
    2. What were the ages of the people that died amongst the 3000? What would their life expectancy be?
    3. What was the health status of the 3,000 people? Were they healthy people or people with potentially serious health issues?
    4. Did they die of ARDS or a covid19 related complication? Or did they test PCR+ for the SarsCov2 virus and get diagnosed with covid19? https://www.nytimes.com/2020/08/29/h...s-testing.html
    5. Year over year, what is the impact of covid19 when you look at the impacted demographic?
    6. A daily average of 7,500-8,000 people die in the US of various causes. If we look at the annual trends, which deaths are being replaced by covid19 deaths and why? Or is it obvious that covid19 is killing a lot of people in its demographics and easily explains the deaths?

    There are other questions, but this is where I would start. And based on the answers, you might have a very different perspective. And that is fine. But I think that as long as none of us is distorting the data, we can interpret it differently. My own thing is that if you can, put the data in context. My initial reaction is that 3,000 deaths a day is a lot of deaths. But when I know it would mean that you have 1.1mm Covid deaths in a year, or that Covid19 would be responsible for over 1/3 of the deaths in the US if it kept that rate, then I have to rethink what that means given that the current trends are closer to 300K - 330K deaths.

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    Last edited by NextLevel; 12-14-2020 at 03:39 PM.
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    #53
    Next Level has been downplaying this from the start. On various previous threads he cited Dr Scott Atlas, and a pair of Fox doctors who made claims that would have been embarrassing to anyone actually in the business of science or clinical trials -- and of course arguing about the effectiveness of masks, in spite of mountains of different types of studies and recommendations of nearly all real public health experts. He clearly has no idea of how biomedical science or clinical trials are done and he is certainly not able to evaluate the studies he does find.

    I do this for a living.

    For sure 3,000 deaths/day is awful -- we've reached that recently and we'll be at that for awhile. Here though I want to emphasize that deaths are not the whole story. Short of that there are very well documented chronic complications in a certain percentage of Covid-19 survivors. Estimates vary a lot because different laboratory measurements vary in specifities and power to discern problems, but that German study I cited is scary because of number of different ways they evaluated their patients.

    I would suggest to all of you that there are lots of places where TT right now is a risky activity. Hopefully it won't stay that way for long. I want to play.

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    Last edited by Baal; 12-13-2020 at 11:36 PM.

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    #54
    Quote Originally Posted by Baal
    Next Level has been downplaying this from the start. On various previous threads he cited Dr Scott Atlas, and a pair of Fox doctors who made claims that would have been embarrassing to anyone actually in the business of science or clinical trials -- and of course arguing about the effectiveness of masks, in spite of mountains of different types of studies and recommendations of nearly all real public health experts. He clearly has no idea of how biomedical science or clinical trials are done and he is certainly not able to evaluate the studies he does find.

    I do this for a living.

    For sure 3,000 deaths/day is awful -- we've reached that recently and we'll be at that for awhile. Here though I want to emphasize that deaths are not the whole story. Short of that there are very well documented chronic complications in a certain percentage of Covid-19 survivors. Estimates vary a lot because different laboratory measurements vary in specifities and power to discern problems, but that German study I cited is scary because of number of different ways they evaluated their patients.

    I would suggest to all of you that there are lots of places where TT right now is a risky activity. Hopefully it won't stay that way for long. I want to play.
    Baal has repeatedly performed character assassination of anyone who disagrees with him. I do not remember ever citing Scott Atlas on this forum because I had stopped discussing Covid19 on TT forums well before Scott Atlas became a lightning rod for covid19 debate. So the fact that Baal associates me with Scott Atlas is clearly something ideologically motivated. Definitely not based in any facts.

    No one wants to get covid19 (if you know someone who does, let me know). Just as no one wants to get a bad case of influenza, or get in a car accident etc. And anyone who falls seriously sick from covid19 (or any influenza-like illness) usually has a compromised immune system in a variety of ways already. Any such person should work hard to avoid getting *any* respiratory disease. Here is a 2018 paper (linked to by the CDC) showing that influenza( and to a lesser degree, influenza-like illness of just about any kind) raises your risk of a heart attack by 6 times. Does the risk go away after you recover from influenza?

    https://www.nejm.org/doi/full/10.105...=featured_home

    Usually, after a serious illness, most people need to recover. And if you are doing the same things that got your body sick before you fell sick, it is unlikely you will recover. As someone who has autoimmune and possibly viral issues (Lyme's), I don't think they should be downplayed. But people should be given information in away that enables them to understand risks. So if you are someone who thinks that covid19 is going to make you very sick and you feel you know how to avoid it based on what Baal has written, then avoid it by all means. And since no one wants to get covid19, the question is how to advise people so that they can live their lives meaningfully while accounting for the risks of covid19.

    My problem is not so much that I think covid19 should be "downplayed". I think that the current approach to covid19 has affected a lot of things in society that are very important, and there hasn't been a serious analysis of the costs and benefits of the interventions currently being forced on many cities which have hurt many people and will lead to many deaths from causes other than covid19. The focus on covid19 is often myopic. *Some* of these interventions are based on data/science that over time will be revealed to be questionable.

    The biggest issue most clearly is the way we treat and view children, many of whom have (depending on what state you are in) not been able to attend in-person classes or visit public playgrounds. IF anyone believes that science explains why Disneyland is closed but Disneyworld is open, I am yet to hear it. Or why schools can be open in Scandinavian countries and England and closed in the USA. No, it is not covid19. It is what you prioritized in response to covid19.

    In everything, it is best to always let the expert communicate their views, but to always question them. My superpower is that I am the least ideological person I know because I always have a commitment to yield to the evidence and to make sure my skepticism is adequate to the evidence.

    TT is a risky activity for some people - for some people, it is a likely a low risk activity. But you don't have that choice because most TT clubs in many places are closed, including mine in Philadelphia. Since Baal thinks that his assessment of risk is such that it should govern how everyone should be treated, it would be wise for all of us to be sure that it is founded in the best science and be experimentally demonstrated. He is a good guy, but this is not about good and bad people. At least for me it isn't. It's about making sure that risks are communicated in a way that informs decision making and not scaring people per se into doing what you want them to do. Because the road to tyranny is paved with good intentions.

    I repeat no one wants to catch covid19.

    If he had written something like:

    "Covid19 has a serious effect on circulation which seemed in one study to affect as many as 78% of people who had it for 2 weeks. While this risk has been known to exist with other respiratory illnesses prior to covid19, it seems more severe with covid19, and is just another reason not to want an serious illness. Continue with your protective measuires."

    It begins to place things in context. It is unfortunate that he just wants to demonize people who have good reason to discuss issues with covid19 data.

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    Last edited by NextLevel; 12-14-2020 at 02:36 AM.
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    #55
    [QUOTE=NextLevel;331941Because the road to tyranny is paved with good intentions.
    [/QUOTE]
    Amen. There are too many petty dictators/governors in the US.
    One thing is for sure. The US Constitution died of the CCP-Virus.
    The damage they have done to the economy and people's rights will have repercussions far worse than the virus. Much depends on the view one wants to take. Are you trying to save a nation or individual lives. It is not the same thing. I am sure the politician's "cure" will be worse than the disease in the long run.
    The true economic fallout has yet to be felt.

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    #56
    Amazing how this gets politicized. Wacky hoe basic sanitary measures in the midst of a pandemic that’s on the verge of collapsing the health care system gets equated to an infringement.

    We need to stop that, folks. No, strike that. We need to take many steps back and stop there.

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    #57
    just dropping 2 lines. We played a tournament again yesterday. I hope nobody catches Covid. We played a few tournaments last month. Haven't heard of anyone catching it...

    Personally i'm way more scared to get a cancer or cerebral attack for example than getting Covid.

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    #58
    The true economic fallout has yet to be felt.
    True economic effects have been felt by tens of millions out of business or out of work in USA for many months and have and will effect others.

    I think BB is meaning that there will be MUCH MORE effect felt in the next few months and in 2021.

    I also remmeber Thomas Sowell once or thrice saying that the road to hell has been paved with Ivy League degrees...

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    #59
    Quote Originally Posted by Takkyu_wa_inochi
    Personally i'm way more scared to get a cancer or cerebral attack for example than getting Covid.
    These are scary things, and if you live long enough chances of encountering one of these are substantial enough to justify that. However, right now the spread of SARS-CoV-2 is the more imminent threat, I'd say.

    Anecdotal, but since it concerns myself I can attest to its truth and am willing to share.

    I contracted Covid-19 end october/early november - one of my children picked it up in a clinic where she had been residing for a while, and was forced out upon an outbreak. I had her in isolation at home, yet two weeks after she was symptom free I nevertheless ran up a fever, and was out of it for a few days with mild symptoms.

    At that point, I considered myself to have gotten off easy. Then the leg cramps started (a common thing that covid patients suffer), and I couldn't walk for a few days. As that subsided, I still thought, well, that's that then. But then an excruciating pain started shooting down from my right hip, with the right leg cramping up and pain flaring up to unprecedented high levels. Docter says it's probably a nerve being pinched somewhere near the lower back - and he thinks it's caused indirectly by the burden posed by the post-covid leg cramps.

    Right now I can't walk at all, or sit, and am waiting for an MRI while looking for options to deal with the pain. So, anecdotal, but I can attest: covid-19 is no laughing matter — even though what I went through is considered to be a very mild case.

    TL;DR Covid-19 is real and serious, even in so-called mild cases, and I'm surprised to see it downplayed so easily and often.
    Last edited by yoass; 12-14-2020 at 12:51 PM.

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    Nov 2010
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    Takyu, in Japan the risk is lower than the US.

    Regarding cardiac consequences of Covid-19, the German study found this (obviously this isn't the final word on the subject)
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    Exposure Recent recovery from severe acute respiratory syndrome coronavirus 2 infection, as determined by reverse transcription–polymerase chain reaction on swab test of the upper respiratory tract.


    Main Outcomes and Measures Demographic characteristics, cardiac blood markers, and cardiovascular magnetic resonance (CMR) imaging were obtained. Comparisons were made with age-matched and sex-matched control groups of healthy volunteers (n = 50) and risk factor–matched patients (n = 57).


    Results Of the 100 included patients, 53 (53%) were male, and the mean (SD) age was 49 (14) years. The median (IQR) time interval between COVID-19 diagnosis and CMR was 71 (64-92) days. Of the 100 patients recently recovered from COVID-19, 67 (67%) recovered at home, while 33 (33%) required hospitalization. At the time of CMR, high-sensitivity troponin T (hsTnT) was detectable (greater than 3 pg/mL) in 71 patients recently recovered from COVID-19 (71%) and significantly elevated (greater than 13.9 pg/mL) in 5 patients (5%). Compared with healthy controls and risk factor–matched controls, patients recently recovered from COVID-19 had lower left ventricular ejection fraction, higher left ventricle volumes, and raised native T1 and T2. A total of 78 patients recently recovered from COVID-19 (78%) had abnormal CMR findings, including raised myocardial native T1 (n = 73), raised myocardial native T2 (n = 60), myocardial late gadolinium enhancement (n = 32), or pericardial enhancement (n = 22). There was a small but significant difference between patients who recovered at home vs in the hospital for native T1 mapping (median [IQR], 1119 [1092-1150] ms vs 1141 [1121-1175] ms; P = .008) and hsTnT (4.2 [3.0-5.9] pg/dL vs 6.3 [3.4-7.9] pg/dL; P = .002) but not for native T2 mapping. None of these measures were correlated with time from COVID-19 diagnosis (native T1: r = 0.07; P = .47; native T2: r = 0.14; P = .15; hsTnT: r = −0.07; P = .50). High-sensitivity troponin T was significantly correlated with native T1 mapping (r = 0.33; P < .001) and native T2 mapping (r = 0.18; P = .01). Endomyocardial biopsy in patients with severe findings revealed active lymphocytic inflammation. Native T1 and T2 were the measures with the best discriminatory ability to detect COVID-19–related myocardial pathology.


    Conclusions and Relevance 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, severity and overall course of the acute illness, and time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

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