You are here

Article Text

Article menu
Download PDFPDF
Original research
Higher rates of concussion following COVID-19 infection in high school athletes
  1. Garrett S Bullock1,
  2. Carolyn A Emery2,
  3. Vicki R Nelson3,
  4. Albert Prats-Uribe4,
  5. Robert Gill Gilliland5,
  6. Charles A Thigpen6,
  7. Ellen Shanley5,6
  1. 1 Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  2. 2 Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
  3. 3 Sports Medicine, Prisma Health, Greenville, South Carolina, USA
  4. 4 Pharmaco Epi-Device Unit, University of Oxford, Oxford, Oxfordshire, UK
  5. 5 Sports Medicine, ATI Physical Therapy, Bolingbrook, Illinois, USA
  6. 6 Clinical Excellence, ATI Physical Therapy, Greenville, Illinois, USA
  1. Correspondence to Dr Garrett S Bullock, Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA; garrettbullock{at}gmail.com

Abstract

Objective To compare concussion rates (CRs) over one academic year in high school athletes with and without a COVID-19 infection prior to concussion.

Methods Illness and concussion were prospectively reported for male and female high school athletes across six states over one academic year in the Players Health Rehab surveillance system. Concussion was truncated to 60 days following recovery and return to sport from COVID-19. CRs were estimated per 1000 athletes per academic year and stratified by those who tested positive for COVID-19 infection (with COVID-19) and those who did not (no COVID-19). Poisson regression analyses estimated rate ratio (RR) of concussion controlling for state, gender and an offset of the log athlete participation (with COVID-19 and no COVID-19).

Results Of 72 522 athletes, 430 COVID-19 infections and 1273 concussions were reported. The CR was greater in athletes who reported COVID-19 (CR=74.4/1000 athletes/year, 95% CI 49.6 to 99.3) compared with those who did not (CR=17.2, 95% CI 16.3 to 18.2). Athletes with recent COVID-19 had a threefold higher rate of concussion (RR=3.1, 95% CI 2.0 to 4.7).

Conclusion Athletes returning from COVID-19 had higher CRs than those who did not experience COVID-19. This may be related to ongoing COVID-19 sequelae or deconditioning related to reduced training and competition load during the illness and when returning to sport. Further research is needed to understand the association of recent COVID-19 infection and concussion in order to inform preventive strategies.

  • Neurology

Data availability statement

No data are available. Due to ethical considerations, data is not available.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bjsports-2022-106436

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    No data are available. Due to ethical considerations, data is not available.

    View Full Text

    Footnotes

    • Twitter @DRGSBullock, @CarolynAEmery

    • Contributors GSB, VRN and ES conceived the study idea. GSB, CE, VRN, AP-U and ES were involved in the design and planning. GSB and ES wrote the first draft of the manuscript. GSB, CE, VRN, AP-U, RGG, CT and ES critically revised the manuscript. GSB, CE, VRN, AP-U, RGG, CT and ES approved the final version of the manuscript. ES guarantees the veracity of these findings.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, conduct, reporting or dissemination plans of this research. Refer to the Methods section for further details.

    • Provenance and peer review Not commissioned; externally peer reviewed.