Background There are no data relating symptoms of an acute respiratory illness (ARI) in general, and COVID-19 specifically, to return to play (RTP).
Objective To determine if ARI symptoms are associated with more prolonged RTP, and if days to RTP and symptoms (number, type, duration and severity) differ in athletes with COVID-19 versus athletes with other ARI.
Design Cross-sectional descriptive study.
Setting Online survey.
Participants Athletes with confirmed/suspected COVID-19 (ARICOV) (n=45) and athletes with other ARI (ARIOTH) (n=39).
Methods Participants recorded days to RTP and completed an online survey detailing ARI symptoms (number, type, severity and duration) in three categories: ‘nose and throat’, ‘chest and neck’ and ‘whole body’. We report the association between symptoms and RTP (% chance over 40 days) and compare the days to RTP and symptoms (number, type, duration and severity) in ARICOV versus ARIOTH subgroups.
Results The symptom cluster associated with more prolonged RTP (lower chance over 40 days; %) (univariate analysis) was ‘excessive fatigue’ (75%; p<0.0001), ‘chills’ (65%; p=0.004), ‘fever’ (64%; p=0.004), ‘headache’ (56%; p=0.006), ‘altered/loss sense of smell’ (51%; p=0.009), ‘Chest pain/pressure’ (48%; p=0.033), ‘difficulty in breathing’ (48%; p=0.022) and ‘loss of appetite’ (47%; p=0.022). ‘Excessive fatigue’ remained associated with prolonged RTP (p=0.0002) in a multiple model. Compared with ARIOTH, the ARICOV subgroup had more severe disease (greater number, more severe symptoms) and more days to RTP (p=0.0043).
Conclusion Symptom clusters may be used by sport and exercise physicians to assist decision making for RTP in athletes with ARI (including COVID-19).
Data availability statement
No data are available. No additional data are available.
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Contributors MS: responsible for the overall content as guarantor, study concept, study planning, data collection, data interpretation, manuscript (first draft), manuscript editing and facilitating funding. NS: study planning, data collection, data cleaning, data interpretation, manuscript (first draft) and manuscript editing. CS: study planning, data collection, data interpretation and manuscript editing. KK and PSW: study planning, data collection, data interpretation, manuscript (first draft) and manuscript editing. IS: study planning, development of the data management system, data collection, data cleaning and manuscript editing. WD, JHH and MV: data interpretation and manuscript editing. EJ: study planning, data cleaning, data management, data analysis including statistical analysis, data interpretation and manuscript editing.
Funding IOC Research Centre (South Africa) (partial funding). South African Medical Research Council (partial funding, statistical analysis).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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