Symptom Number and Reduced Preinfection Training Predict Prolonged Return to Training after SARS-CoV-2 in Athletes: AWARE IV.
Journal
Medicine and science in sports and exercise
ISSN: 1530-0315
Titre abrégé: Med Sci Sports Exerc
Pays: United States
ID NLM: 8005433
Informations de publication
Date de publication:
01 01 2023
01 01 2023
Historique:
pubmed:
18
8
2022
medline:
17
12
2022
entrez:
17
8
2022
Statut:
ppublish
Résumé
This study aimed to determine factors predictive of prolonged return to training (RTT) in athletes with recent SARS-CoV-2 infection. This is a cross-sectional descriptive study. Athletes not vaccinated against COVID-19 ( n = 207) with confirmed SARS-CoV-2 infection (predominantly ancestral virus and beta-variant) completed an online survey detailing the following factors: demographics (age and sex), level of sport participation, type of sport, comorbidity history and preinfection training (training hours 7 d preinfection), SARS-CoV-2 symptoms (26 in 3 categories; "nose and throat," "chest and neck," and "whole body"), and days to RTT. Main outcomes were hazard ratios (HR, 95% confidence interval) for athletes with versus without a factor, explored in univariate and multiple models. HR < 1 was predictive of prolonged RTT (reduced % chance of RTT after symptom onset). Significance was P < 0.05. Age, level of sport participation, type of sport, and history of comorbidities were not predictors of prolonged RTT. Significant predictors of prolonged RTT (univariate model) were as follows (HR, 95% confidence interval): female (0.6, 0.4-0.9; P = 0.01), reduced training in the 7 d preinfection (1.03, 1.01-1.06; P = 0.003), presence of symptoms by anatomical region (any "chest and neck" [0.6, 0.4-0.8; P = 0.004] and any "whole body" [0.6, 0.4-0.9; P = 0.025]), and several specific symptoms. Multiple models show that the greater number of symptoms in each anatomical region (adjusted for training hours in the 7 d preinfection) was associated with prolonged RTT ( P < 0.05). Reduced preinfection training hours and the number of acute infection symptoms may predict prolonged RTT in athletes with recent SARS-CoV-2. These data can assist physicians as well as athletes/coaches in planning and guiding RTT. Future studies can explore whether these variables can be used to predict time to return to full performance and classify severity of acute respiratory infection in athletes.
Identifiants
pubmed: 35975934
doi: 10.1249/MSS.0000000000003027
pii: 00005768-202301000-00001
pmc: PMC9770013
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-8Informations de copyright
Copyright © 2022 by the American College of Sports Medicine.
Références
Engebretsen L, Steffen K, Alonso JM, et al. Sports injuries and illnesses during the winter Olympic games 2010. Br J Sports Med . 2010;44(11):772–80.
Mountjoy M, Junge A, Alonso JM, et al. Sports injuries and illnesses in the 2009 FINA world championships (aquatics). Br J Sports Med . 2010;44(7):522–7.
Schwellnus M, Derman W, Page T, et al. Illness during the 2010 super 14 Rugby union tournament—a prospective study involving 22 676 player days. Br J Sports Med . 2012;46(7):499–504.
Doege J, Ayres JM, Mackay MJ, et al. Defining return to sport: a systematic review. Orthop J Sports Med . 2021;9(7):23259671211009589.
Ardern CL, Glasgow P, Schneiders A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med . 2016;50(14):853–64.
Schwellnus M, Sewry N, Snyders C, et al. Symptom cluster is associated with prolonged return-to-play in symptomatic athletes with acute respiratory illness (including COVID-19): a cross-sectional study—AWARE study I. Br J Sports Med . 2021;55(20):1144–52.
Baggish A, Drezner JA, Kim J, Martinez M, Prutkin JM. Resurgence of sport in the wake of COVID-19: cardiac considerations in competitive athletes. Br J Sports Med . 2020;54(19):1130–1.
Kim JH, Levine BD, Phelan D, et al. Coronavirus disease 2019 and the athletic heart: emerging perspectives on pathology, risks, and return to play. JAMA Cardiol . 2021;6(2):219–27.
Sudre CH, Lee KA, Lochlainn MN, et al. Symptom clusters in COVID-19: a potential clinical prediction tool from the COVID symptom study app. Sci Adv . 2021;7(12):eabd4177.
Lochlainn MN, Lee KA, Sudre CH, et al. Key predictors of attending hospital with COVID19: an association study from the COVID Symptom Tracker app in 2,618,948 individuals. medRxiv . 2020:2020.04.25.20079251.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform . 2009;42(2):377–81.
Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform . 2019;95:103208.
Pelliccia A, Caselli S, Sharma S, et al. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete’s heart. Eur Heart J . 2018;39(21):1949–69.
Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long COVID. Nat Med . 2021;27(4):626–31.
Stavem K, Ghanima W, Olsen MK, Gilboe HM, Einvik G. Persistent symptoms 1.5–6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study. Thorax . 2021;76(4):405–7.
Tenforde MW, Self WH, Adams K, et al. Association between mRNA vaccination and COVID-19 hospitalization and disease severity. JAMA . 2021;326(20):2043–54.
Wolter N, Jassat W, Walaza S, et al. Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study. Lancet . 2022;399(10323):437–46.
Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med . 2021;55(19):1099–105.
Steenkamp L, Saggers RT, Bandini R, et al. Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes. Br J Sports Med . 2022;56(10):568–76.
Lee SW, Lee J, Moon SY, et al. Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study. Br J Sports Med . 2022;56(16):901–12.
da Silveira MP, da Silva Fagundes KK, Bizuti MR, Starck É, Rossi RC, de Resende e Silva DT. Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature. Clin Exp Med . 2021;21(1):15–28.
Chastin SFM, Abaraogu U, Bourgois JG, et al. Effects of regular physical activity on the immune system, vaccination and risk of community-acquired infectious disease in the general population: systematic review and meta-analysis. Sports Med . 2021;51(8):1673–86.
Hull JH, Wootten M, Moghal M, et al. Clinical patterns, recovery time and prolonged impact of COVID-19 illness in international athletes: the UK experience. Br J Sports Med . 2021;56(1):4–11.
He CS, Bishop NC, Handzlik MK, Muhamad AS, Gleeson M. Sex differences in upper respiratory symptoms prevalence and oral-respiratory mucosal immunity in endurance athletes. Exerc Immunol Rev . 2014;20:8–22.
Soligard T, Steffen K, Palmer D, et al. Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic summer games: a prospective study of 11274 athletes from 207 countries. Br J Sports Med . 2017;51(17):1265–71.