Impaired Cardiorespiratory Fitness of Elite Athletes after Asymptomatic or Mild SARS-CoV-2 Infection.

Background and Objectives: The aim of the study was to evaluate the health status of professional athletes after recovering from COVID-19 and the impact that SARS-CoV-2 had on their overall cardiorespiratory fitness, which was done by conducting cardiopulmonary exercise testing (CPET). Materials and Methods: A total of twenty-seven professional basketball players (Euroleague Basketball and the ABA League) participated in the study. CPET was performed before (as part of their regular preparticipation exam, during the pre-season period), as well as after SARS-CoV-2 infection (after two weeks of home isolation, during the competitive part of the season). CPET was performed on a treadmill, while cardiovascular, respiratory, and metabolic functions were evaluated by using a breath-by-breath analysis technique (Quark CPET system manufactured by Cosmed, Rome, Italy). Results: Maximal oxygen consumption and aerobic efficiency were significantly reduced after SARS-CoV-2 infection (p = 0.000). An obvious decrease in oxygen pulse was observed during CPET after recovering from COVID-19 (p = 0.001), as was deterioration of ventilatory efficiency. Internal respiration was the most negatively affected. An early transition from aerobic to anaerobic mechanisms of creating energy for work and intensive metabolic fatigue were obvious after SARS-CoV-2 infection. Conclusions: Although it was believed that SARS-CoV-2 only affects the cardiopulmonary status of the elderly population and people with associated comorbidities, it is clear from this research that professional athletes can also be at certain risk. Even though no pathological cardiovascular and respiratory changes were found in athletes after COVID-19, results showed significantly decreased cardiorespiratory fitness, with an emphasis on internal respiration.

The Influence of Different SARS-CoV-2 Strains on Changes in Maximal Oxygen Consumption, Ventilatory Efficiency and Oxygen Pulse of Elite Athletes.

PURPOSE: The aim of this study was to evaluate the influence of different SARS-CoV-2 strains on the functional capacity of athletes. METHODS: In total, 220 athletes underwent cardiopulmonary exercise testing (CPET) after coronavirus infection and before returning to sports activities. Eighty-eight athletes were infected by the Wuhan virus, and 66 were infected during the Delta and Omicron strain periods of the pandemic. RESULTS: The CPET results showed significantly decreased maximal oxygen consumption, ventilatory efficiency, and oxygen pulse in athletes who were infected with Wuhan and Delta strains compared to athletes who suffered from Omicron virus infection. An early transition from aerobic to anaerobic metabolic pathways for energy production was observed in the Wuhan and Delta groups but not in athletes who were infected with the Omicron strain. There were no differences in the obtained results when Wuhan and Delta virus variants were compared. CONCLUSION: These results suggest that the Wuhan and Delta virus strains had a significantly greater negative impact on the functional abilities of athletes compared to the Omicron virus variant, especially in terms of aerobic capacity and cardiorespiratory function.

Focal Myocarditis after Mild COVID-19 Infection in Athletes.

COVID-19 infection in athletes usually has a milder course, but in the case of complications, myocarditis and even sudden cardiac death may occur. We examined an athlete who felt symptoms upon returning to training after asymptomatic COVID-19 infection. Physical, laboratory, and echocardiography findings were normal. The cardiopulmonary exercise test was interrupted at submaximal effort due to severe dyspnea in the presence of reduced functional capacity in comparison to previous tests. Cardiac magnetic resonance (CMR) detected the focal myocarditis. After three months of recovery, CMR still revealed the presence of focal myocarditis and the persistence of decreased functional capacity. This case raises the question of screening athletes even after asymptomatic forms of COVID-19 infection.

Positive impact of prescribed physical activity on symptoms of schizophrenia: randomized clinical trial.

BACKGROUND: The purpose of this study was to examine functional capacity of cardio-respiratory system in patients with schizophrenia, and to evaluate the effects of 12 weeks prescribed physical activity on aerobic capacity and symptoms of schizophrenia. SUBJECTS AND METHODS: Study involved 80 hospitalized patients with any of the subtypes of schizophrenia (42 men, 38 women). They were divided into two groups: exercise and control group, both with 40 patients. Maximal aerobic capacity (VO2 max) as an indicator of cardiovascular fitness has been obtained by cardiopulmonary stress test on a treadmill. Twelve weeks program of prescribed physical activity (45 minutes, four times per week) was made for every patient individually. Patients in exercise group practiced in training zone between 65 and 75% of their maximum heart rate (HR). Target HR was controlled by Polar F4 monitors. Symptoms of schizophrenia were measured by using Positive and Negative Symptoms Scale (PANSS). RESULTS: Before the exercise program was introduced, measured VO2 max was significantly lower in patients with schizophrenia, than the expected average value in matched healthy subjects (p<0.001). After twelve weeks, patients in exercise group showed a significant increase of VO2max (p=0.002), and significantly higher level of VO2max compared to the control group (p=0.000). Significant differences were also observed on PANSS general psychopathology subscale (p=0.007) and on PANSS total score (p=0.001). The pharmacotherapy and exercise had influence on PANSS general psychopathology (p=0.002) and PANSS total score (p=0.001). CONCLUSIONS: Individuals with schizophrenia have lower levels of aerobic capacity compared to general population. Prescribed physical activity significantly improves aerobic capacity in people with schizophrenia and it is effective in amelioration of some psychiatric symptoms. Prescribed physical activity could be an effective adjunctive treatment for patients with schizophrenia, not only for prevention and treatment of comorbidities, but also having an impact on symptoms of schizophrenia.

Lactobacillus helveticus Lafti L10 Supplementation Modulates Mucosal and Humoral Immunity in Elite Athletes: A Randomized, Double-Blind, Placebo-Controlled Trial.

Michalickova, DM, Kostic-Vucicevic, MM, Vukasinovic-Vesic, MD, Stojmenovic, TB, Dikic, NV, Andjelkovic, MS, Djordjevic, BI, Tanaskovic, BP, and Minic, RD. Lactobacillus helveticus Lafti L10 supplementation modulates mucosal and humoral immunity in elite athletes: a randomized, double-blind, placebo-controlled trial. J Strength Cond Res 31(1): 62-70, 2017-To test the influence of probiotic supplementation on humoral immune response, a double-blind, placebo-controlled trial was conducted. Thirty athletes (24 males and 6 females, females: V[Combining Dot Above]O2max 38.2 ± 4.9 ml·kg·min, age 23.2 ± 1.4 years; males: V[Combining Dot Above]O2max 57.5 ± 9.2 ml·kg·min, age 24.0 ± 2.4 years, mean ± SD) were randomized either to the probiotic group (Lactobacillus helveticus Lafti L10, 2 × 10 colony-forming units) or to the placebo group. Serum and saliva samples were collected at the baseline and after 14 weeks. Total and specific antibacterial antibody levels of IgM, IgG, and IgA classes were determined for different bacteria in the serum, and in saliva, total and specific antibacterial IgA levels were examined. Total IgM was elevated in both probiotic (18%, 15-20%; mean, 90% confidence interval; p = 0.02) and placebo group (35%, 22-47%; p = 0.02), without observed differences in changes between the groups. No significant changes in IgM levels specific for tested bacteria were found. Total IgG level was constant in both groups. A significant (16%, -2.8 to 35%, p = 0.04) reduction of anti-Enterococcus faecalis IgG was noted in the placebo group, in comparison with the probiotic group. There was a substantial decrease in total IgA level in the placebo group, when measured either in serum (15%, 12-18%, p = 0.04) or in saliva (35%, -1.4 to 53%, p = 0.03). Significantly reduced levels of serum anti-lactic acid bacteria IgA antibodies in the placebo group compared with the probiotic group were detected for Lactobacillus rhamnosus LA68 (24%, 5.8-42%, p = 0.02) and for L. rhamnosus LB64 (15%, 2.7-27%, p = 0.02). Probiotic administration could have beneficial effects on systemic humoral and mucosal immune responses.

Lactobacillus helveticus Lafti L10 supplementation reduces respiratory infection duration in a cohort of elite athletes: a randomized, double-blind, placebo-controlled trial.

A randomized, double-blind, placebo-controlled study was conducted to evaluate if Lactobacillus helveticus Lafti L10 (Lallemand Health Solutions, Montreal, Que., Canada) supplementation during 14 weeks in winter can influence the duration, severity, and incidence of upper respiratory tract illness (URTI), as well as to monitor different immune parameters in the population of elite athletes. Before and after the treatment, cardiopulmonary testing and self-rated state of moods evaluation (by Profile of Mood States questionnaire) were performed and blood samples were collected. Thirty-nine elite athletes were randomized either to the placebo (n = 19) or the probiotic (n = 20) group. The probiotic group received L. helveticus Lafti L10, 2 × 10(10) Colony Forming Units. Lafti L10 significantly shortened the URTI episode duration (7.25 ± 2.90 vs. 10.64 ± 4.67 days, p = 0.047) and decreased the number of symptoms in the probiotic group (4.92 ± 1.96 vs. 6.91 ± 1.22, p = 0.035). Severity and incidence of URTI did not differ between the treatments. There were no significant changes in leukocyte subpopulation abundance, transforming growth factor-ß serum levels, level of interleukin-10 secreted from peptidoglican stimulated peripheral blood mononuclear cells (PBMCs), interferon-γ level secreted from concanavalin A-stimulated PBMCs or viability/proliferation of PBMCs upon antigen stimulation. Group effect for CD4+/CD8+ ratio was significant (F[1,37] = 6.99, p = 0.020, η(2) = 0.350); this difference was not significant at baseline, but was evident after 14 weeks (p = 0.02). A significant interaction effect was noted for self-rated sense of vigor (F[1,37] = 11.76, p = 0.009, η(2) = 0.595). Self-rated sense of vigor increased in the probiotic group (18.5 ± 4.1 vs. 21.0 ± 2.6, p = 0.012). Probiotic strain Lafti L10 can be a beneficial nutritional supplement for the reduction of URTI length in elite athletes.

Sweat rate and fluid intake in young elite basketball players on the FIBA Europe U20 Championship.

BACKGROUND/AIM: Previous investigations in many sports indicated that continued exercise, especially in hot environments, can cause high sweat rate and huge water and electrolyte losses, thus impairing the performance of athletes. Most these studies were conducted during training sessions, but rarely during an official competition. Therefore, the aim of our study was to determine pre- and post-competition hydration, fluid intake and sweat loss of young elite basketball players during the FIBA Europe U20 Championship. METHODS: The study included 96 basketball male players, (19 ± 0.79 years) of eight national teams. Ambient temperature was 30 ± 2°C, humidity 55 ± 4% and the mean playing time in game 18.8 ± 10.5 min. The following parameters related to hydration status were measured: fluid intake, urine output, sweat rate, percent of dehydration, urine parameters (specific gravity, color and osmolarity), body mass and body surface area. RESULTS: We found that the mean fluid intake was 1.79 ± 0.8 L/h, sweat rate 2.7 ± 0.9 L/h, urine output 55 ± 61 mL and the percentage of dehydration 0.99 ± 0.7%. According to urine osmolarity more than 75% of players were dehydrated before the game and the process continued during the game. The difference in body mass (0.9 ± 0.7 kg) before and after the game was statistically significant. There were statistically significant correlations between the sweat rate and fluid intake, urine osmolarity, body mass loss, body surface area and percentage of dehydration. Fluid intake correlated with the percentage of dehydration, body mass loss, urine specific gravity and urine color. The sweat rate, which varied between the teams, was the highest for centers when this parameter was calculated on the effective time in game. CONCLUSION: Most of the athletes start competition dehydrated, fail to compensate sweat loss during the game and continue to be dehydrated, regardless what kind of drink was used. These results suggest that hydration strategies must be carefully taken into account, not only by the players, but also by the coaches and the team doctors.