The COVID-19 in athletes (COVA) study: a national study on cardio-pulmonary involvement of SARS-CoV-2 infection among elite athletes

Abstract

Background COVID-19 can cause cardiopulmonary involvement. Physical activity and cardiac complications can worsen prognosis, while pulmonary complications can reduce performance. Aims To determine the prevalence and clinical implications of SARS-CoV-2 cardiopulmonary involvement in elite athletes. Methods An observational study between 1 July 2020 and 30 June 2021 with the assessment of coronary biomarkers, electrocardiogram, echocardiography, Holter-monitoring, spirometry, and chest X-ray in Danish elite athletes showed that PCR-tested positive for SARS-CoV-2. The cohort consisted of male football players screened weekly (cohort I) and elite athletes on an international level only tested if they had symptoms, were near-contact, or participated in international competitions (cohort II). All athletes were categorized into two groups based on symptoms and duration of COVID-19: Group 1 had no cardiopulmonary symptoms and duration ≤7 days, and; Group 2 had cardiopulmonary symptoms or disease duration >7 days. Results In total 121 athletes who tested positive for SARS-CoV-2 were investigated. Cardiac involvement was identified in 2/121 (2%) and pulmonary involvement in 15/121 (12%) participants. In group 1, 87 (72%), no athletes presented with signs of cardiac involvement, and 8 (7%) were diagnosed with radiological COVID-19-related findings or obstructive lung function. In group 2, 34 (28%), two had myocarditis (6%), and 8 (24%) were diagnosed with radiological COVID-19-related findings or obstructive lung function. Conclusions These clinically-driven data show no signs of cardiac involvement among athletes who tested positive for SARS-CoV-2 infection without cardiopulmonary symptoms and duration <7 days. Athletes with cardiopulmonary symptoms or prolonged duration of COVID-19 display, exercise-limiting cardiopulmonary involvement.

COVID-19 in Female and Male Athletes: Symptoms, Clinical Findings, Outcome, and Prolonged Exercise Intolerance—A Prospective, Observational, Multicenter Cohort Study (CoSmo-S)

“…Taken together, our findings are in line with previous reports, which suggest that cardiac sequelae after infection with SARS-CoV-2 among athletes seems to be less frequent than assumed in the initial phase of the pandemic. Similar to others [ 1 , 23 , 33 ], no severe cardiac events have been reported up to now in our study population. However, a remaining risk of an acute myocardial involvement in athletes with SARS-CoV-2 infection must be kept in mind and long-term effects on the heart cannot be excluded.…”

“…No evidence of spirometric impairments were reported in competitive athletes [ 25 ] but also in a larger number of young healthy adults [ 34 ]. In contrast, Rasmusen et al found an obstructive lung function or radiological signs of COVID-19 in 15 of 122 elite athletes after SARS-CoV-2 infection [ 33 ]. It cannot be ruled out that a more comprehensive pulmonary diagnostic procedure including the assessment of diffusion capacity and respiratory muscle strength may reveal abnormal results relevant for exercise performance.…”

A follow‐up study on respiratory outcomes, quality of life and performance perception of SARS‐CoV‐2 primary and reinfection in elite athletes: A 9‐month prospective study

“…In a small cohort of professional football players, aerobic capacity was decreased 60 days after infection (Parpa & Michaelides, 2022). Likewise, a cohort of 10 different sports disciplines showed that the exercise capacity of athletes decreased during the acute infection period (Rasmusen et al., 2022). The present study, reporting data from an elite athlete cohort, suggests that physiological deteriorations may prolong recovery time, in accordance with previously reported findings (Hull et al., 2022), however, the respiratory capacity of athletes with primary infection typically recovers significantly within 6 months, suggesting that this could potentially allow them for an earlier resumption of routine training compared to those with reinfections.…”