Returning to Sport during the Covid-19 pandemic: The sports physicians’ role

Bio-secure bubble during the COVID-19 pandemic to host the Asian Football Confederation (AFC) Champions League: A retrospective observational study

Background and Aims

To describe the COVID-19 positivity rate among football players, team staff, and local organizing committee members participated in the Asian Football Confederation (AFC) Champions League (West) tournament organized with the Bio-secure bubble protocol in place.

Methods

A retrospective observational study was carried out to include a total of 2184 participants during the AFC-West tournament in Qatar, which was a 3-week event (September 14-October 3, 2020). This event was undertaken under the Bio-secure bubble protocol, which was developed and implemented for sports events in Qatar during the pandemic. Within 72 h of departure and upon arrival in Qatar, all participants underwent reverse-transcriptase polymerase chain reaction testing (RT-PCR) to diagnose COVID-19. The test was considered positive based on the cycle threshold (cT) value which was <30, whereas, reactive if cT value was ≥30 and <40, and negative (cT > 40).

Results

Of the 2184 participants (528 players, 388 team staff, and 1268 local staff), 916 international participants were tested for COVID-19 PCR upon arrival at the Hamad International Airport, whereas the local staff (n = 1268) were tested 2 days before entering the bubble. The mean age of the players was 27.5 ± 9.8. Fifteen teams participated and as many as 60 matches were played over 3 weeks. Most participants tested negative (95.3%) and 3.9% tests were inconclusive. During the entire tournament, the positivity rate was 2.7% among all participants. Of the total positive cases, 0.8% were positive before entering the bubble system. The remaining (1.9%) tested positive during the tournament phase (19 players, 16 team officials, and 8 organizing committee staff).

Conclusion

Bio-secure bubble protocol operated in a controlled environment presents a minimal risk of COVID-19 infection for hosting international football events. This framework could be benchmarked to resume professional football competitions under unprecedented pandemic situations.

COVID-19 in European Soccer: A Public 2-Year Comparison of COVID-19 Case Management and Case Characteristics between the 1st Bundesliga, La Liga, Serie A and the Premier League

To evaluate the extent and characteristics of COVID-19 cases in relation to environmental COVID-19 incidences in the four best European soccer leagues (Bundesliga, Premier League, Serie A and La Liga) from the first of January 2020 until the end of January 2022. Methods: A retrospective evaluation of all publicly available COVID-19 cases in the studied cohorts was performed. The 14-day case incidences from epidemiological national data were used as reference values. The leagues studied are the Bundesliga (Germany), Premier League (Great Britain), Serie A (Italy) and La Liga (Spain). For all cases, the duration of time loss and date of case notification were recorded. Results: League-specific mean time loss due to disease or quarantine per COVID-19 case differs significantly between La Liga (11.45; ±5.21 days) and the other leagues studied (Bundesliga 20.41; ±33.87; p 0.0242; Premier League 17.12; ±10.39; p 0.0001; Serie A 17.61; ±12.71; p < 0.0001). A positive correlation between 14-day national incidence with COVID-19 disease occurrence in soccer leagues was found for all leagues studied. The correlations were strong in the Bundesliga (r 0.5911; CI 0.4249−0.7187; p < 0.0001), Serie A (r 0.5979; CI 0.4336−0.7238; p < 0.0001) and La Liga (r 0.5251; CI 0.3432−0.6690; p < 0.0001). A moderate correlation was found for the Premier League (r 0.3308; CI 0.1147−0.5169; p 0.0026). Odds ratios for altered environmental case risk in the cohorts studied could be calculated for four different national COVID-19 incidence levels (<50/100.000 to >500/100.000). A trend towards shorter COVID-19 case duration in the second half of 2021 was shown for all leagues studied. Conclusions: There was a significantly lower mean time-loss caused by a COVID-19 infection for cases occurred in La Liga compared with the other three leagues studied. For all four leagues studied, a positive, significant correlation of national environmental COVID-19 incidence level and the incidence of COVID-19 cases in the cohort of a football league was found.

Medical care and first aid: an interassociation consensus framework for organised non-elite sport during the COVID-19 pandemic

The cessation of amateur and recreational sport has had significant implications globally, impacting economic, social and health facets of population well-being. As a result, there is pressure to resume sport at all levels. The ongoing prevalence of SARS-CoV-2 and subsequent 'second waves' require urgent best practice guidelines to be developed to return recreational (non-elite) sports as quickly as possible while prioritising the well-being of the participants and support staff.This guidance document describes the need for such advice and the process of collating available evidence. Expert opinion is integrated into this document to provide uniform and pragmatic recommendations, thereby optimising on-field and field-side safety for all involved persons, including coaches, first responders and participants.The nature of SARS-CoV-2 transmission means that the use of some procedures performed during emergency care and resuscitation could potentially be hazardous, necessitating the need for guidance on the use of personal protective equipment, the allocation of predetermined areas to manage potentially infective cases and the governance and audit of the process.

The COVID-19 Pandemic Impact on Away and Home Victories in Soccer and Rugby Union

Objective: To measure the impact of restrictions due to COVID on the proportion of matches won at home, away and draw in professional soccer and rugby union.

Materials and Methods: Two samples of professional soccer and rugby union matches were collected from 2012–13 to 2020–21 seasons. For soccer, data involved first and second division matches of the England, Spain, Germany, Italy, France, Belgium, Scotland, Greece, Portugal, and Turkey championships. For rugby union, championships concerned are Premiership Rugby, Celtic League, Top 14, and Pro D2. The proportions of home, away wins and draw were calculated and compared. A chi-square test of independence between years and types of result was realized to identify an overall inhomogeneity.

Results: The proportion of away matches won between the 2012–13 and 2020–21 seasons increased significantly from 28.5 ± 1.2% to 32.5 ± 1.5% in soccer and from 38.0 ± 3.6% to 42.8 ± 5.0% in rugby union. In Premiership Rugby championship, the victory percentage at home dropped from 55.8 ± 3.1% when tifosi were present to 45.8 ± 12.8% when they were not.

Conclusion: The home advantage was drastically reduced in empty stadiums for several European soccer and rugby union professional championships. It vanished in the Premiership Rugby and Celtic League during the 2020–21 season.

Lower Level of Interleukin-6 and Hepcidin Found in Lower Density of Physical Exercise among Athlete During Pandemic of Covid-19

The pandemic of Covid-19 affected entire daily human life worldwide, including sports activities among athletes. An athlete was pushed to suit their routine activities with a new health protocol for Covid-19 prevention. Some of them were programmed to train at home with a moderate density of exercise, but others were still in a high density of exercise. This study compared the serum level of hemoglobin (Hb), interleukin-6 (IL-6), and hepcidin among athletes with a high versus moderate exercise density training program during the pandemic. Thirty-four indoor soccer athletes of a soccer football school in Malang voluntarily registered as a subject. Half of them received moderate exercise density exercise programs, and others received high-density exercise programs during June-July 2020. Interleukin-6 and hepcidin level mean was found significantly lower in the moderate group compared to the high-density group. Hemoglobin level mean was found not different between those groups. The lower density of exercise influenced on IL-6 and hepcidin serum level of athlete, but not on hemoglobin level.