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J Sport Health Sci . Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to r

tetano

Editor, Senior Moderator
J Sport Health Sci


. 2023 Oct 21:S2095-2546(23)00103-5.
doi: 10.1016/j.jshs.2023.10.005. Online ahead of print. Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance-AWARE VIII: Athlete return to full performance after recent COVID-19

Carolette Snyders[SUP] 1 [/SUP], Marlise Dyer[SUP] 2 [/SUP], Nicola Sewry[SUP] 3 [/SUP], Esme Jordaan[SUP] 4 [/SUP], Martin Schwellnus[SUP] 5 [/SUP]



Affiliations
Abstract

Purpose: The aim of the study was to identify factors associated with prolonged time to return to full performance (RTFP) in athletes with recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Methods: Prospective cohort study with cross sectional analysis. A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a Coronavirus disease 2019 (COVID-19) recovery clinic gave a history of: age, sex, type/level of sport, co-morbidities, pre-infection training hours, and 26 acute SARS-CoV-2 symptoms from 3 categories ("nose and throat", "chest and neck", and "whole body"/systemic). Data on days to RTFP were obtained by structured interviews. Factors associated with RTFP were: demographics, sport participation, history of co-morbidities, pre-infection training history, acute symptoms (type, number). Outcomes were: (a) days to RTFP (median, interquartile range (IQR)) in asymptomatic (n = 7) and symptomatic athletes (n = 77), and (b) hazard ratios (HR; 95% confidence interval (95%CI)) for symptomatic athletes with vs. without a factor (univariate, multiple models). HR < 1 was predictive of higher % chance of prolonged RTFP. Significance was p < 0.05.
Results: Days to RTFP were 30 days (23-40 days) for asymptomatic and 64 days (42-91 days) for symptomatic participants (p > 0.05). Factors associated with prolonged RTFP (univariate models) were: females (HR = 0.57; p = 0.014), endurance athletes (HR = 0.41; p < 0.0001), co-morbidity number (HR = 0.75; p = 0.001), respiratory disease history (HR = 0.54; p = 0.026). In symptomatic athletes, prolonged RTFP (multiple models) was significantly associated with increased "chest and neck" (HR = 0.85; p = 0.017) and "nose and throat" (HR = 0.84); p = 0.013) symptoms, but the association was more profound between prolonged RFTP and increased total number of "all symptoms" (HR = 0.91; p = 0.001) and "whole body"/systemic (HR = 0.82; p = 0.007) symptoms.
Conclusion: A larger number of total symptoms and specifically "whole body"/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

Keywords: Athletes; COVID-19; Performance; Recovery; Return to play.

 
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