RT Journal Article SR Electronic T1 Risk of SARS-CoV-2 transmission from on-field player contacts in amateur, youth and professional football (soccer) JF British Journal of Sports Medicine JO Br J Sports Med FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine SP bjsports-2021-104441 DO 10.1136/bjsports-2021-104441 A1 Sebastian Schreiber A1 Oliver Faude A1 Barbara Gärtner A1 Tim Meyer A1 Florian Egger YR 2021 UL http://bjsm.bmj.com/content/early/2021/11/08/bjsports-2021-104441.abstract AB Objective To 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.Methods Between 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.Results Out 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.Conclusion On-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.No data are available.