Clinical patterns, recovery time and prolonged impact of COVID-19 illness in international athletes: the UK experience.

OBJECTIVES: To report COVID-19 illness pattern, symptom duration and time loss in UK elite athletes. METHODS: Observational, clinical and database review of athletes with symptomatic COVID-19 illness managed within the UK Sports Institutes. Athletes were classified as confirmed (positive SARS-CoV-2 PCR or antibody tests) or probable (consistent clinical features) COVID-19. Clinical presentation was characterised by the predominant symptom focus (eg, upper or lower respiratory illness). Time loss was defined as days unavailable for full sport participation and comparison was made with a 2016-2019 respiratory illness dataset from the same surveillance system. RESULTS: Between 24 February 2020 and 18 January 2021, 147 athletes (25 Paralympic (17%)) with mean (SD) age 24.7 (5.2) years, 37% female, were diagnosed with COVID-19 (76 probable, 71 confirmed). Fatigue was the most prevalent symptom (57%), followed by dry cough (50%) and headache (46%). The median (IQR) symptom duration was 10 (6-17) days but 14% reported symptoms >28 days. Median time loss was 18 (12-30) days, with 27% not fully available >28 days from initial date of infection. This was greater than our historical non-COVID respiratory illness comparator; 6 days, 0-7 days (p<0.001) and 4% unavailable at 28 days. A lower respiratory phenotype (ie, including dyspnoea±chest pain±cough±fever) was present in 18% and associated with a higher relative risk of prolonged symptoms risk ratio 3.0 (95% CI: 1.4 to 6.5) and time loss 2.1 (95% CI: 1.2 to 3.5). CONCLUSIONS: In this cohort, COVID-19 largely resulted in a mild, self-limiting illness. The presence of lower respiratory tract features was associated with prolonged illness and a delayed return to sport.

Medical care and first aid: an interassociation consensus framework for organised non-elite sport during the COVID-19 pandemic.

The cessation of amateur and recreational sport has had significant implications globally, impacting economic, social and health facets of population well-being. As a result, there is pressure to resume sport at all levels. The ongoing prevalence of SARS-CoV-2 and subsequent 'second waves' require urgent best practice guidelines to be developed to return recreational (non-elite) sports as quickly as possible while prioritising the well-being of the participants and support staff.This guidance document describes the need for such advice and the process of collating available evidence. Expert opinion is integrated into this document to provide uniform and pragmatic recommendations, thereby optimising on-field and field-side safety for all involved persons, including coaches, first responders and participants.The nature of SARS-CoV-2 transmission means that the use of some procedures performed during emergency care and resuscitation could potentially be hazardous, necessitating the need for guidance on the use of personal protective equipment, the allocation of predetermined areas to manage potentially infective cases and the governance and audit of the process.

Interassociation consensus recommendations for pitch-side emergency care and personal protective equipment for elite sport during the COVID-19 pandemic.

The COVID-19 pandemic has necessitated many novel responses in healthcare including sport and exercise medicine. The cessation of elite sport almost globally has had significant economic implications and resulted in pressure to resume sport in very controlled conditions. This includes protecting pitch-side medical staff and players from infection. The ongoing prevalence of SARS-CoV-2 and the desire to resume professional sport required urgent best practice guidelines to be developed so that sport could be resumed as safely as possible. This set of best practice recommendations assembles early evidence for managing SARS-CoV-2 and integrates expert opinion to provide a uniform and pragmatic approach to enhance on-field and pitch-side safety for the clinician and player. The nature of SARS-CoV-2 transmission creates new hazards during resuscitation and emergency care and procedures. Recommendations for the use and type of personal protective equipment during on-field or pitch-side emergency medical care is provided based on the clinical scenario and projected risk of viral transmission.

Sports injury and illness epidemiology: Great Britain Olympic Team (TeamGB) surveillance during the Sochi 2014 Winter Olympic Games.

BACKGROUND: Sports injury and illness surveillance is the first step in injury and illness prevention, and is important for the protection of both athlete health and performance in major competitions. AIM: To identify the prevalence, severity nature and causes of athlete injuries and illnesses in the Great Britain Olympic Team (TeamGB) during the Sochi 2014 Winter Olympic Games. METHODS: The observational prospective cohort study followed the Great Britain Injury/Illness Performance Project surveillance methodology and obtained information on injuries and illnesses that occurred during the Games between 30 January and 23 February 2014 in TeamGB athletes (n=56). RESULTS: Among the 56 TeamGB athletes, there were 27 injuries and 11 illnesses during the Olympic Games period. This equated to 39% sustaining at least one injury and 18% at least one illness, with an incidence of 48.2 injuries and 19.6 illnesses per 100 athletes, respectively. Of all injuries and illnesses, 9% and 7%, respectively, resulted in time loss. The risk of sustaining an injury was highest for freestyle skiing, skeleton and snowboarding; and lowest for curling, biathlon and Alpine skiing (with no reported injuries); with the lower limb being the most commonly injured location. Respiratory system illnesses were most frequently reported overall, and older female athletes were the ones most affected by illness. CONCLUSIONS: The risk of injury was double the risk of illness for TeamGB athletes. Overall, the rate of time-loss issues was low. Methodological considerations are important when interpreting data, and prevention strategies should focus on those issues causing the greatest risk, in terms of prevalence and severity, to athlete health and performance.

Epidemiology of injuries at the 2023 UCI cycling world championships using the International Olympic Consensus: a protocol for a prospective cohort study.

The sport of cycling consists of several individual sporting disciplines. Indeed, the world governing body for cycling, Union Cycliste Internationale (UCI), oversees the various cycling disciplines, with each of these disciplines having a number of subcategories. While several sports have undertaken prospective injury surveillance studies to understand the risks of their sport, plan event medical support and develop prevention programmes, limited high-quality studies have been undertaken within cycling. Indeed, this is the first prospective study of cycling injuries, particularly when considering the whole sport of cycling together. This current study will therefore aim to describe the incidence, severity, burden and nature of injuries within elite cycling in those athletes participating across 13 championship events at the inaugural World Championships, Glasgow, August 2023. Injury and exposure definitions will be in line with the IOC Consensus for injury surveillance in cycling. Injury incidence will be reported per 1000 athlete match hours or per number of athletes/cyclists and injury severity will be assessed via estimated median or mean days lost to training/competition. Meanwhile injury burden will be assessed via days of absence/1000 athlete match hours (or per number of athletes exposed) and all these results will be compared between male and female cyclists. This paper will also report the most common specific injuries for male and female cyclists (per 1000 hours of participation or per number of athletes exposed). Statistical differences will be tested for incidence or severity measures between sexes and will be compared to other sports.

IOC Olympian Health Cohort: a study protocol for a 15-year, prospective, Olympian health study across Summer and Winter Olympic sports.

Prevention of sports injury and illness and protection of athlete health are key mandates of the IOC. Methodological limitations in Olympic Games surveillance and retired Olympian studies mean there are gaps in the available evidence on Olympian health and the varied challenges occurring at different stages throughout an athlete's career. This (protocol) paper describes the methods for implementation of the IOC Olympian Health Cohort. The study aims to establish a longitudinal cohort of current Olympians and follow them prospectively (around 15 years) throughout their Olympic careers and retirement. The study will use participants who have completed self-report questionnaires. Olympians will be recruited after each Summer and Winter Olympic Games, and all National Olympic Committee (NOC) athletes aged 16 years or older are eligible. The first phase included the Tokyo 2020/2021 and Beijing 2022 Olympians, with the study promoted via IOC platforms, Athlete365 and NOCs. Questionnaires include baseline demographics, sports exposure and history of injuries and illnesses impacting the athlete's ability to continue to train and/or compete for at least 2 weeks. Questions also address retirement from sports, musculoskeletal, mental and general health, and quality of life measures. This protocol describes the methods for the 15-year global IOC Olympian Health Cohort Study, from participant recruitment to the development and distribution of the study questionnaire. This protocol will be updated to report future changes in the study's conduct or questionnaire content. These data will help identify risk factors and inform risk-reduction strategies. The ultimate goal is to protect the health of all athletes during their careers and retirement.