@article{50798,
  abstract     = {{<jats:title>Abstract</jats:title><jats:sec>
              <jats:title>Background</jats:title>
              <jats:p>An infection with SARS-CoV-2 can lead to a variety of symptoms and complications, which can impair athletic activity.</jats:p>
            </jats:sec><jats:sec>
              <jats:title>Objective</jats:title>
              <jats:p>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.</jats:p>
            </jats:sec><jats:sec>
              <jats:title>Methods</jats:title>
              <jats:p>In this prospective, observational, multicenter study, we recruited German COVID elite-athletes (cEAs, <jats:italic>n</jats:italic> = 444) and COVID non-elite athletes (cNEAs, <jats:italic>n</jats:italic> = 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, <jats:italic>n</jats:italic> = 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.</jats:p>
            </jats:sec><jats:sec>
              <jats:title>Results</jats:title>
              <jats:p>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 (<jats:italic>p</jats:italic> &lt; 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 (<jats:italic>p</jats:italic> &lt; 0.001). At follow-up, 13.8% of cNEAs and 9.9% of cEAs (<jats:italic>p</jats:italic> = 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 &gt; 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.</jats:p>
            </jats:sec><jats:sec>
              <jats:title>Conclusions</jats:title>
              <jats:p>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.</jats:p>
            </jats:sec><jats:sec>
              <jats:title>Trial Registration Number</jats:title>
              <jats:p>DRKS00023717; 06.15.2021—retrospectively registered.</jats:p>
            </jats:sec>}},
  author       = {{Widmann, Manuel and Gaidai, Roman and Schubert, Isabel and Grummt, Maximilian and Bensen, Lieselotte and Kerling, Arno and Quermann, Anne and Zacher, Jonas and Vollrath, Shirin and Bizjak, Daniel Alexander and Beckendorf, Claudia and Egger, Florian and Hasler, Erik and Mellwig, Klaus-Peter and Fütterer, Cornelia and Wimbauer, Fritz and Vogel, Azin and Schoenfeld, Julia and Wüstenfeld, Jan C. and Kastner, Tom and Barsch, Friedrich and Friedmann-Bette, Birgit and Bloch, Wilhelm and Meyer, Tim and Mayer, Frank and Wolfarth, Bernd and Roecker, Kai and Reinsberger, Claus and Haller, Bernhard and Niess, Andreas M. and Birnbaum, Mike Peter and Burgstahler, Christof and Cassel, Michael and Deibert, Peter and Esefeld, Katrin and Erz, Gunnar and Greiss, Franziska and Halle, Martin and Hesse, Judith and Keller, Karsten and Kopp, Christine and Matits, Lynn and Predel, Hans Georg and Rüdrich, Peter and Schneider, Gerald and Stapmanns, Philipp and Steinacker, Jürgen Michael and Szekessy, Sarah and Venhorst, Andreas and Zapf, Stephanie and Zickwolf, Christian}},
  issn         = {{0112-1642}},
  journal      = {{Sports Medicine}},
  keywords     = {{Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine}},
  publisher    = {{Springer Science and Business Media LLC}},
  title        = {{{COVID-19 in Female and Male Athletes: Symptoms, Clinical Findings, Outcome, and Prolonged Exercise Intolerance—A Prospective, Observational, Multicenter Cohort Study (CoSmo-S)}}},
  doi          = {{10.1007/s40279-023-01976-0}},
  year         = {{2024}},
}

@article{32877,
  author       = {{Gaidai, Roman and Gölz, Christian Johannes and Mora, K. and Rudisch, J. and Reuter, E.-M. and Godde, B. and Reinsberger, C. and Voelcker-Rehage, C. and Vieluf, S.}},
  issn         = {{0006-8993}},
  journal      = {{Brain Research}},
  keywords     = {{Developmental Biology, Neurology (clinical), Molecular Biology, General Neuroscience}},
  publisher    = {{Elsevier BV}},
  title        = {{{Classification characteristics of fine motor experts based on electroencephalographic and force tracking data}}},
  doi          = {{10.1016/j.brainres.2022.148001}},
  volume       = {{1792}},
  year         = {{2022}},
}

@article{30117,
  abstract     = {{<jats:p><jats:bold>Objective:</jats:bold> It is unclear whether and to what extent COVID-19 infection poses health risks and a chronic impairment of performance in athletes. Identification of individual health risk is an important decision-making basis for managing the pandemic risk of infection with SARS-CoV-2 in sports and return to play (RTP).</jats:p><jats:p><jats:bold>Methods:</jats:bold> This study aims 1) to analyze the longitudinal rate of seroprevalence of SARS-CoV-2 in German athletes, 2) to assess health-related consequences in athletes infected with SARS-CoV-2, and 3) to reveal effects of the COVID-19 pandemic in general and of a cleared SARS-CoV-2 infection on exercise performance. CoSmo-S is a prospective observational multicenter study establishing two cohorts: 1) athletes diagnosed positive for COVID-19 (cohort 1) and 2) federal squad athletes who perform their annual sports medical preparticipation screening (cohort 2). Comprehensive diagnostics including physical examination, laboratory blood analyses and blood biobanking, resting and exercise electrocardiogram (ECG), echocardiography, spirometry and exercise testing added by questionnaires are conducted at baseline and follow-up.</jats:p><jats:p><jats:bold>Results and Conclusion:</jats:bold> We expect that the results obtained, will allow us to formulate recommendations regarding RTP on a more evidence-based level.</jats:p>}},
  author       = {{Niess, Andreas Michael and Widmann, Manuel and Gaidai, Roman and Gölz, Christian Johannes and Schubert, Isabel and Castillo, Katty and Sachs, Jan Philipp and Bizjak, Daniel and Vollrath, Shirin and Wimbauer, Fritz and Vogel, Azin and Keller, Karsten and Burgstahler, Christof and Quermann, Anne and Kerling, Arno and Schneider, Gerald and Zacher, Jonas and Diebold, Katharina and Grummt, Maximilian and Beckendorf, Claudia and Buitenhuis, Johannes and Egger, Florian and Venhorst, Andreas and Morath, Oliver and Barsch, Friedrich and Mellwig, Klaus-Peter and Oesterschlink, Julian and Wüstenfeld, Jan and Predel, Hans-Georg and Deibert, Peter and Friedmann-Bette, Birgit and Mayer, Frank and Hirschmüller, Anja and Halle, Martin and Steinacker, Jürgen Michael and Wolfarth, Bernd and Meyer, Tim and Böttinger, Erwin and Flechtner-Mors, Marion and Bloch, Wilhelm and Haller, Bernhard and Roecker, Kai and Reinsberger, Claus}},
  issn         = {{1661-8564}},
  journal      = {{International Journal of Public Health}},
  keywords     = {{Public Health, Environmental and Occupational Health, Health (social science)}},
  publisher    = {{Frontiers Media SA}},
  title        = {{{COVID-19 in German Competitive Sports: Protocol for a Prospective Multicenter Cohort Study (CoSmo-S)}}},
  doi          = {{10.3389/ijph.2022.1604414}},
  volume       = {{67}},
  year         = {{2022}},
}

@article{30114,
  author       = {{Gölz, Christian Johannes and Mora, K. and Rudisch, J. and Gaidai, Roman and Reuter, E. and Godde, B. and Reinsberger, Claus and Voelcker-Rehage, C. and Vieluf, S.}},
  issn         = {{0893-6080}},
  journal      = {{Neural Networks}},
  keywords     = {{Artificial Intelligence, Cognitive Neuroscience}},
  pages        = {{363--374}},
  publisher    = {{Elsevier BV}},
  title        = {{{Classification of visuomotor tasks based on electroencephalographic data depends on age-related differences in brain activity patterns}}},
  doi          = {{10.1016/j.neunet.2021.04.029}},
  volume       = {{142}},
  year         = {{2021}},
}