Risk of SARS-CoV-2 transmission from on-field player contacts in amateur, youth and professional football (soccer)

Abstract

ObjectiveTo investigate the risk of transmission among potentially infectious SARS-CoV-2-positive football players while participating in training or matches at amateur, youth and professional levels.MethodsBetween August 2020 and March 2021, football players who tested positive for SARS-CoV-2 and participated in matches or training during the period of potential contagiousness were identified through media search (professional level) and a nationwide registry in Germany (amateur and youth level) to determine symptoms, source of infection and hygiene measures adopted. The definition of potentially infectious players was based on the time of a positive PCR testing and symptom onset. Transmission-relevant contacts on the pitch were evaluated through doubly reviewed video analysis.ResultsOut of 1247 identified football matches and training sessions (1071 amateur and youth level, 176 professional level), 104 cases (38 training sessions, 66 matches) with 165 potentially infectious players were detected. Follow-up PCR testing at the professional level (44 cases) revealed no transmission. At the amateur and youth level, the combination of partial PCR testing (31 of 60 cases) and symptom monitoring within 14 days post-exposure (46 of 60 cases) identified 2 of 60 matches in which follow-up infections occurred that were attributed to non-football activities. This is consistent with the video analysis of 21 matches demonstrating frontal contacts were <1 per player-hour (88%, 30 of 34 players), each lasting no longer than 3 s.ConclusionOn-field transmission risk of SARS-CoV-2 in football is very low. Sources of infections in football players are most likely not related to activities on the pitch.

A video-based analysis of situations bearing the risk of respiratory disease transmission during football matches

“…This finding is in line with the studies by Jones, Phillips, Kemp, Payne, Hart, Cross and Stokes 8 as well as by Egger, Faude, Schreiber, Gärtner and Meyer 9 who were not able to identify an infection on the pitch, though in total 26 players participated during four rugby and three football matches. These findings were confirmed by a larger study analyzing more than 100 matches or training sessions in which 165 infected players participated 10 . The authors were able to exclude on-field transmission in all but one case.…”

“…Egger, Faude, Schreiber, Gärtner and Meyer 9 conducted a very similar study in football and observed no transmission during a two-week period after three matches with 18 infected participating players in total. In a more comprehensive study, analyzing 104 matches and training sessions in amateur, youth and professional football with 165 potentially infectious SARS-CoV-2 positive players on-field transmission risk appeared to be low 10 . Video-analysis of 21 matches with 34 potentially infectious players in the same study revealed that football-specific contacts were likely not sufficient to transmit the virus.…”

COVID-19 Infection among Elite Football Players: A Nationwide Prospective Cohort Study

“…Further, a two-month cohort study among footballers in German Bundesliga revealed a similar COVID-19 infection rate and very low risk of SARS-CoV-2 transmission during football match play [ 8 ]. Another German study found no evidence of transmission of SARS-CoV-2 on the pitch as verified by intensive PCR testing among professional footballers [ 9 ]. Notably, a prospective cohort study among players, staff, and referees of the national professional league of Qatar during a truncated football season of nine weeks reported a COVID-19 infection rate among footballers at 4.57%.…”

“…Given that football is an outdoor activity the risk of airborne transmission can be considered as very low, or even negligible. With respect to transmission via large respiratory droplets (direct mode of transmission), there is evidence based on video records of football games that shows that direct contact between professional footballers in the field is rare in frequency and of short duration (<3–6 s) [ 9 ]. There is also some evidence that other outdoor sport activities (e.g., ski) are associated with a very low risk of COVID-19 transmission [ 18 ].…”

“…Little is known about the incidence of COVID-19 infection among professional footballers. Although there are some lines of evidence suggesting a low risk of COVID-19 transmission and a mild illness (in terms of symptomatic status and need for hospitalization [ 6 , 7 ] among professional footballers, little is known about the relative risk of footballers for the acquisition of COVID-19 infection [ 8 , 9 , 10 , 11 ]. In addition, many of the relevant studies employed a short follow-up period.…”