TY - JOUR
AB - Abstract
Background
An infection with SARS-CoV-2 can lead to a variety of symptoms and complications, which can impair athletic activity.
Objective
We aimed to assess the clinical symptom patterns, diagnostic findings, and the extent of impairment in sport practice in a large cohort of athletes infected with SARS-CoV-2, both initially after infection and at follow-up. Additionally, we investigated whether baseline factors that may contribute to reduced exercise tolerance at follow-up can be identified.
Methods
In this prospective, observational, multicenter study, we recruited German COVID elite-athletes (cEAs, n = 444) and COVID non-elite athletes (cNEAs, n = 481) who tested positive for SARS-CoV-2 by PCR (polymerase chain reaction test). Athletes from the federal squad with no evidence of SARS-CoV-2 infection served as healthy controls (EAcon, n = 501). Questionnaires were used to assess load and duration of infectious symptoms, other complaints, exercise tolerance, and duration of training interruption at baseline and at follow-up 6 months after baseline. Diagnostic tests conducted at baseline included resting and exercise electrocardiogram (ECG), echocardiography, spirometry, and blood analyses.
Results
Most acute and infection-related symptoms and other complaints were more prevalent in cNEA than in cEAs. Compared to cEAs, EAcon had a low symptom load. In cNEAs, female athletes had a higher prevalence of complaints such as palpitations, dizziness, chest pain, myalgia, sleeping disturbances, mood swings, and concentration problems compared to male athletes (p < 0.05). Until follow-up, leading symptoms were drop in performance, concentration problems, and dyspnea on exertion. Female athletes had significantly higher prevalence for symptoms until follow-up compared to male. Pathological findings in ECG, echocardiography, and spirometry, attributed to SARS-CoV-2 infection, were rare in infected athletes. Most athletes reported a training interruption between 2 and 4 weeks (cNEAs: 52.9%, cEAs: 52.4%), while more cNEAs (27.1%) compared to cEAs (5.1%) had a training interruption lasting more than 4 weeks (p < 0.001). At follow-up, 13.8% of cNEAs and 9.9% of cEAs (p = 0.24) reported their current exercise tolerance to be under 70% compared to pre-infection state. A persistent loss of exercise tolerance at follow-up was associated with persistent complaints at baseline, female sex, a longer break in training, and age > 38 years. Periodical dichotomization of the data set showed a higher prevalence of infectious symptoms such as cough, sore throat, and coryza in the second phase of the pandemic, while a number of neuropsychiatric symptoms as well as dyspnea on exertion were less frequent in this period.
Conclusions
Compared to recreational athletes, elite athletes seem to be at lower risk of being or remaining symptomatic after SARS-CoV-2 infection. It remains to be determined whether persistent complaints after SARS-CoV-2 infection without evidence of accompanying organ damage may have a negative impact on further health and career in athletes. Identifying risk factors for an extended recovery period such as female sex and ongoing neuropsychological symptoms could help to identify athletes, who may require a more cautious approach to rebuilding their training regimen.
Trial Registration Number
DRKS00023717; 06.15.2021—retrospectively registered.
AU - Widmann, Manuel
AU - Gaidai, Roman
AU - Schubert, Isabel
AU - Grummt, Maximilian
AU - Bensen, Lieselotte
AU - Kerling, Arno
AU - Quermann, Anne
AU - Zacher, Jonas
AU - Vollrath, Shirin
AU - Bizjak, Daniel Alexander
AU - Beckendorf, Claudia
AU - Egger, Florian
AU - Hasler, Erik
AU - Mellwig, Klaus-Peter
AU - Fütterer, Cornelia
AU - Wimbauer, Fritz
AU - Vogel, Azin
AU - Schoenfeld, Julia
AU - Wüstenfeld, Jan C.
AU - Kastner, Tom
AU - Barsch, Friedrich
AU - Friedmann-Bette, Birgit
AU - Bloch, Wilhelm
AU - Meyer, Tim
AU - Mayer, Frank
AU - Wolfarth, Bernd
AU - Roecker, Kai
AU - Reinsberger, Claus
AU - Haller, Bernhard
AU - Niess, Andreas M.
AU - Birnbaum, Mike Peter
AU - Burgstahler, Christof
AU - Cassel, Michael
AU - Deibert, Peter
AU - Esefeld, Katrin
AU - Erz, Gunnar
AU - Greiss, Franziska
AU - Halle, Martin
AU - Hesse, Judith
AU - Keller, Karsten
AU - Kopp, Christine
AU - Matits, Lynn
AU - Predel, Hans Georg
AU - Rüdrich, Peter
AU - Schneider, Gerald
AU - Stapmanns, Philipp
AU - Steinacker, Jürgen Michael
AU - Szekessy, Sarah
AU - Venhorst, Andreas
AU - Zapf, Stephanie
AU - Zickwolf, Christian
ID - 50798
JF - Sports Medicine
KW - Physical Therapy
KW - Sports Therapy and Rehabilitation
KW - Orthopedics and Sports Medicine
SN - 0112-1642
TI - COVID-19 in Female and Male Athletes: Symptoms, Clinical Findings, Outcome, and Prolonged Exercise Intolerance—A Prospective, Observational, Multicenter Cohort Study (CoSmo-S)
ER -
TY - JOUR
AU - Benjaminse, A
AU - Webster, KE
AU - Gokeler, A
ID - 20421
IS - 8
JF - Sports Med
SN - 0112-1642
TI - Reply to Koller and Schobersberger: Comment on: "Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-analyses".
VL - 49
ER -
TY - JOUR
AU - Gokeler, A
AU - Neuhaus, D
AU - Benjaminse, A
AU - Grooms, DR
AU - Baumeister, Jochen
ID - 20425
IS - 6
JF - Sports Med
SN - 0112-1642
TI - Correction to: Principles of Motor Learning to Support Neuroplasticity After ACL Injury: Implications for Optimizing Performance and Reducing Risk of Second ACL Injury.
VL - 49
ER -
TY - JOUR
AU - Gokeler, Alli
AU - Neuhaus, D
AU - Benjaminse, A
AU - Grooms, DR
AU - Baumeister, Jochen
ID - 15425
IS - 6
JF - Sports Med
SN - 0112-1642
TI - Principles of Motor Learning to Support Neuroplasticity After ACL Injury: Implications for Optimizing Performance and Reducing Risk of Second ACL Injury.
VL - 49
ER -
TY - JOUR
AU - Benjaminse, Anne
AU - Webster, Kate E.
AU - Kimp, Alexander
AU - Meijer, Michelle
AU - Gokeler, Alli
ID - 45113
IS - 4
JF - Sports Medicine
KW - Physical Therapy
KW - Sports Therapy and Rehabilitation
KW - Orthopedics and Sports Medicine
SN - 0112-1642
TI - Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses
VL - 49
ER -