Sport and exercise during and beyond the COVID-19 pandemic

DeScoD-ECG: Deep Score-Based Diffusion Model for ECG Baseline Wander and Noise Removal

OBJECTIVE

Electrocardiogram (ECG) signals commonly suffer noise interference, such as baseline wander. High-quality and high-fidelity reconstruction of the ECG signals is of great significance to diagnosing cardiovascular diseases. Therefore, this paper proposes a novel ECG baseline wander and noise removal technology.

METHODS

We extended the diffusion model in a conditional manner that was specific to the ECG signals, namely the Deep Score-Based Diffusion model for Electrocardiogram baseline wander and noise removal (DeScoD-ECG). Moreover, we deployed a multi-shots averaging strategy that improved signal reconstructions. We conducted the experiments on the QT Database and the MIT-BIH Noise Stress Test Database to verify the feasibility of the proposed method. Baseline methods are adopted for comparison, including traditional digital filter-based and deep learning-based methods.

RESULTS

The quantities evaluation results show that the proposed method obtained outstanding performance on four distance-based similarity metrics with at least 20% overall improvement compared with the best baseline method.

CONCLUSION

This paper demonstrates the state-of-the-art performance of the DeScoD-ECG for ECG baseline wander and noise removal, which has better approximations of the true data distribution and higher stability under extreme noise corruptions.

SIGNIFICANCE

This study is one of the first to extend the conditional diffusion-based generative model for ECG noise removal, and the DeScoD-ECG has the potential to be widely used in biomedical applications.

Incidence and features of maxillofacial fractures at Jordanian tertiary hospital before, during and after the COVID-19 period

BACKGROUND

The purpose of this retrospective cohort study is to investigate the incidence and treatment of maxillofacial fractures before, during, and after the COVID-19 pandemic.

MATERIAL AND METHODS

This single-center study was conducted at King Abdullah University Hospital (KAUH). The required data was obtained from the electronic clinical records of all patients in whom maxillofacial fractures were confirmed by plain radiography and computed tomography (CT) between January 2019 and December 2021, allowing for a 12-month period before, during and after the COVID-19 pandemic.

RESULTS

During the study period, 595 maxillofacial fractures in 311 patients (234 males and 77 females, mean age 27.28 years) were treated. The most frequent affected age was 21-30 years old in the before and after COvid- 19 period (92 patients, 29.58.%), while in during-COVID-19 period it was 11-20 years old (22 patients, 7.07%). There was similarity in male predominance, RTA cause, anatomical site was the mandible, the type anatomical complexity was single, treatment procedure was ORIF in all three periods.

CONCLUSIONS

The incidence of maxillofacial fractures during the COVID-19 pandemic period was lower compared to the periods before and after the pandemic. Given that most fractures were caused by RTAs, these findings are expected, as movement was restricted during lockdown.

Prevalence and factors associated with anxiety and depression among Chinese prison officers during the prolonged COVID-19 pandemic

Objective

This study examined the prevalence of anxiety and depression-along with the potential risk and protective factors-among Chinese prison officers during the prolonged COVID-19 pandemic.

Method

A cross-sectional survey of 1,268 officers from five prisons in western and southern China was administered between June and July 2022. The questionnaires comprised two sections. In the first section, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the prevalence of anxiety and depression, respectively, among prison officers. In the second section, the potential influencing factors were examined. Categorical data were compared using χ2 tests and t-tests; binary logistic regression analysis was performed to identify factors associated with anxiety and depression.

Results

The prevalence rates of anxiety and depression among the prison officers were 72.6% and 69.8%, respectively. Risk factors for anxiety were older age, being unmarried, work-family conflicts, job demands, and COVID-19 burnout; protective factors were exercise, positive family relationships, and group cohesion. Work-family conflicts, job demands, intolerance of uncertainty regarding COVID-19, and COVID-19 burnout were risk factors for depression, whereas annual income >150,000 RMB, exercise, positive family relationships, group cohesion, and job autonomy were protective factors against depression.

Conclusion

The prevalence of anxiety and depression among Chinese prison officers was relatively high during the prolonged COVID-19 pandemic, and more targeted measures should be implemented to improve their mental health. This study offers a reference for improving prison officers' mental health in response to similar public health emergencies in the future.

The seasonal variation of physical activity and quality of life during the first wave of the COVID-19 pandemic in Finnish older golfers: A cross-sectional study

Background and Aims

The COVID-19 pandemic was associated with reduced physical activity and increased sedentary behavior. Golf is a health-enhancing outdoor exercise and is associated with low risk of viral transmission. The purpose of this study was to describe the seasonal differences in physical activity and quality of life during the first wave of COVID-19 pandemic in 2020 in Finnish older golfers.

Methods

Older golfers (n = 325) from eight golf clubs retrospectively responded to a questionnaire in summer 2020 on their physical activity and golf activity in winter 2019/20 (pre-COVID-19 winter season) and summer season 2020. In addition, they reported their quality of life after the first wave of pandemic in summer 2020. To evaluate the seasonal differences in physical activity, life quality and its association with golf activity, the data were analyzed using the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman's correlation test, and linear regression analysis.

Results

Despite COVID-19 restrictions, golfers' physical activity increased by 24% (p < 0.001) during the COVID-19 restrictions in the summer of 2020. Moderate physical activity increased by 37% (p < 0.001), walking activity increased by 26% (p < 0.001), and sitting decreased by 21% (p < 0.001) compared with the pre-COVID-19 winter season. The full 18-hole golf round activity was positively associated with moderate physical activity both in the summer and winter season, and with walking in the summer season. Over 90% of golfers reported good quality of life during the 2020 summer restrictions.

Conclusion

In contrast to physical activity levels generally decreasing during the first wave of pandemic, physical activity levels in Finnish golfers increased, and these golfers reported a good quality of life. Golf can provide health enhancing physical activity and older golfers seems to be physically active throughout the year.

The Influence of Different SARS-CoV-2 Strains on Changes in Maximal Oxygen Consumption, Ventilatory Efficiency and Oxygen Pulse of Elite Athletes

PURPOSE

The aim of this study was to evaluate the influence of different SARS-CoV-2 strains on the functional capacity of athletes.

METHODS

In total, 220 athletes underwent cardiopulmonary exercise testing (CPET) after coronavirus infection and before returning to sports activities. Eighty-eight athletes were infected by the Wuhan virus, and 66 were infected during the Delta and Omicron strain periods of the pandemic.

RESULTS

The CPET results showed significantly decreased maximal oxygen consumption, ventilatory efficiency, and oxygen pulse in athletes who were infected with Wuhan and Delta strains compared to athletes who suffered from Omicron virus infection. An early transition from aerobic to anaerobic metabolic pathways for energy production was observed in the Wuhan and Delta groups but not in athletes who were infected with the Omicron strain. There were no differences in the obtained results when Wuhan and Delta virus variants were compared.

CONCLUSION

These results suggest that the Wuhan and Delta virus strains had a significantly greater negative impact on the functional abilities of athletes compared to the Omicron virus variant, especially in terms of aerobic capacity and cardiorespiratory function.

Impact of COVID-19 outbreak on the mental health in sports: a review

Global pandemic, lockdown restrictions, and COVID-19 compulsory social isolation guidelines have raised unprecedented mental health in the sports community. The COVID-19 pandemic is found to affect the mental health of the population. In critical situations, health authorities and sports communities must identify their priorities and make plans to maintain athletes' health and athletic activities. Several aspects play an important role in prioritization and strategic planning, e.g., physical and mental health, distribution of resources, and short to long-term environmental considerations. To identify the psychological health of sportspeople and athletes due to the outbreak of COVID-19 has been reviewed in this research. This review article also analyzes the impact of COVID-19 on health mental in databases. The COVID-19 outbreak and quarantine would have a serious negative impact on the mental health of athletes. From the accessible sources, 80 research articles were selected and examined for this purpose such as Research Gate, PubMed, Google Scholar, Springer, Scopus, and Web of Science and based on the involvement for this study 14 research articles were accessed. This research has an intention on mental health issues in athletes due to the Pandemic. This report outlines the mental, emotional and behavioural consequences of COVID-19 home confinement. Further, research literature reported that due to the lack of required training, physical activity, practice sessions, and collaboration with teammates and coaching staff are the prime causes of mental health issues in athletes. The discussions also reviewed several pieces of literature which examined the impacts on sports and athletes, impacts on various countries, fundamental issues of mental health and the diagnosis for the sports person and athletes, and the afterlife of the COVID-19 pandemic for them. Because of the compulsory restrictions and guidelines of this COVID-19 eruption, the athletes of different sports and geographical regions are suffering from fewer psychological issues which were identified in this paper. Accordingly, the COVID-19 pandemic appears to negatively affect the mental health of the athletes with the prevalence and levels of anxiety and stress increasing, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population identified from this review.

Strategies for conducting online-based physical education research during COVID-19: investigate the lecturer's perception

Purpose The many obstacles and difficulties to carry out research in the field of physical education are the gaps and urgency in this research. This study aims to investigate perceptions from lecturers regarding the conveniences and difficulties when carrying out research in physical education during COVID-19. Material and Methods This study uses a qualitative approach with phenomenological methods through online-based in-depth interviews. Five lecturers from two universities in Indonesia and one lecturers from universities in Hungary were willing to participate in this research. The way to select them was by sending an email to their respective universities and only 10 people participated in this study. However, 4 people did not qualify because they did not have 10 years of research experience.  All participants signed a consent letter to participate in this study. The interview started with explanation from participants regarding their research experiences, the conveniences and the difficulties faced when carrying out research during pandemic. After the activity was completed, the results of the interviews were collected and then a qualitative statistical analysis was carried out In this study, statistical analysis used thematic method in the form of interviews transcribed word for word.The transcripts were read repeatedly by researchers and three experts, coding and a collection of phrases were arranged into themes. Results The findings of this study indicate that there were several conveniences in carrying out research physical education during the COVID-19 period, including the implementation can be done anywhere and anytime, cost-effective and saving time, data collection is easier and faster. Meanwhile, the difficulties were in obtaining research subjects, subjects who have inadequate technological literacy, poor internet network and inaccurate data. Conclusions Thus, the conveniences and difficulties of carrying out research were important and must be continuously evaluated, in order to ensure the study able to conduct optimally even during the COVID-19 pandemic crisis.

Relationship between physical exercise and COVID-19 (SARS-CoV-2): systematic review

Background

The SARS-CoV virus is a precursor to the SARS-CoV-2 virus (COVID-19) and has caused millions of deaths worldwide. Although exercise can be a non-pharmacological means for the prevention and treatment of various diseases, the effects on COVID-19 patients are not yet completely clear.

Aims

The aim of this study was to investigate the relationship between physical exercise and symptoms caused by COVID-19.

Methods

The present systematic review was sent for evaluation and received the PROSPERO registration protocol-CRD42021257475. The search for studies related to health and physical exercise was carried out in the following databases; the "National Library in Medicine MEDLINE-Ovid", "Embase", "Web of Science", "SportDiscus-Ebsco", and "Scopus".

Results

Ten articles were included in the systematic review and the findings demonstrated the protective effects of physical exercise in patients with COVID-19. These effects were observed both in symptoms and in the period of hospitalization. In addition, the results show that the benefits of physical exercise seem to collaborate both in an individual manner and as an alternative to drug therapy. Finally, it was possible to verify the effect of physical exercise on variables, such as quality of life, cardiorespiratory capacity, and immunological biomarkers, and on the symptoms of the new Coronavirus.

Conclusions

It is possible to conclude that physical exercise can be a component for the treatment of COVID-19. In addition, it could help to reduce the symptoms and severity of COVID-19, and may be considered as an adjunct to drug therapy in patients contaminated with SARS-CoV-2.

Indoor air quality in a training centre used for sports practice

Background

One of the measures for controlling the coronavirus disease 2019 (COVID-19) pandemic was the mass closure of gyms. This measure leads us to determine the differences between indoor and outdoor air quality. That is why the objective of this study was to analyse the indoor air quality of a sports centre catering to small groups and rehabilitation.

Methods

The study was conducted in a single training centre, where 26 measurements were taken in two spaces (indoors and outdoors). The air quality index, temperature, relative humidity, total volatile compounds, carbon monoxide, ozone, formaldehyde, carbon dioxide, and particulate matter were measured indoors and outdoors using the same protocol and equipment. These measurements were taken twice, once in the morning and once in the afternoon, with all measurements made at the same time, 10 am and 6 pm, respectively. Additionally, four determinations of each variable were collected during each shift, and the number of people who had trained in the room and the number of trainers were counted.

Results

In the different variables analysed, the results show that CO₂ and RH levels are higher indoors than outdoors in both measurement shifts. Temperatures are higher outside than inside and, in the evening, than in the morning. TVOC, AQI and PM show less variation, although they are higher outdoors in the morning. CO is highest indoors. HCHO levels are almost negligible and do not vary significantly, except for a slight increase in the afternoon outside. Ozone levels are not significant. All the variables showed practically perfect reliability in all the measurements, except for ozone measured outside in the morning. On the other hand, the variables exhibit variations between indoors and outdoors during the morning and afternoon, except for the three types of PM. Also, the data show that all the main variables measured inside the sports training centre are similar between morning and afternoon. However, outside, temperature, relative humidity and HCHO levels show significant differences between morning and afternoon while no differences are observed for the other variables.

Conclusion

The indoor air quality of the training centre assessed was good and met current regulations; some of its components even exhibited better levels than fresh air. This article is the first to measure indoor air quality in a sports training centre catering to rehabilitation and small groups.

Acute and chronic effects of physical exercise on IgA and IgG levels and susceptibility to upper respiratory tract infections: a systematic review and meta-analysis

This systematic review and meta-analysis aimed at evaluating acute and chronic effects of physical exercise on IgA and IgG levels, as well as its relationship with the susceptibility to develop upper respiratory tract infections (URTI). This systematic review and meta-analysis was conducted and reported in accordance with PRISMA statement. A systematic search of PubMed, Web of Science, and EMBASE was performed in July 2020. This systematic review and meta-analysis included studies in which participants performed acute exercise or chronic physical training and were subjected to analyses of URTI incidence and concentrations of IgA and IgG. The selected studies for systematic review were divided into the following three groups: (I) trials that evaluated the effects of acute exercise in sedentary subjects, (II) trials that evaluated the effects of acute exercise in athletes/trained individuals, and (III) trials that evaluated the effects of chronic physical training on the incidence of URTI, as well as on the levels of IgA and IgG. Acute exercise increases the IgA levels in trained subjects but does not affect its levels in untrained subjects. Such increase in IgA levels induced by acute exercise is greater in trained individual that performed ultramarathon. On the other hand, chronic physical training reduces IgA levels in both trained and untrained subjects, does not change IgA levels in non-military subjects, besides from not affecting IgG levels. The present systematic review and meta-analysis indicates that acute exercise positively influences IgA levels in trained individuals, being this effect pronounced when a strenuous exercise such as ultramarathon is executed. Chronic physical training, in turn, does not affect IgG levels.

Depression and anxiety of medical students at Kunming Medical University during COVID-19: A cross-sectional survey

An isolation strategy was used to control the transmission and rapid spread of COVID-19 in Yunnan. As a result, students were supposed to stay at home and disrupted their outside activities. It led to a detrimental influence on students' mental health. The purpose of this study was to investigate the prevalence and risk factors of depression and anxiety among medical students and to provide ideas for the prevention of depression and anxiety in medical students. A cross-sectional survey was conducted among 2,116 medical students at Kunming Medical University from July 8 to July 16, 2020. Participants' demographic and living conditions were collected. Depression and anxiety were measured using the Patient Health Questionnaire 9 and General Anxiety Disorder-7, respectively. Uni- and multivariate logistic regression analyses were performed to detect risk factors associated with depression and anxiety. The prevalence rates of depression and anxiety among medical students were 52.5 and 29.6%, respectively. Depression was more likely to be caused by low grades, lack of physical exercise, drug use, irregular diet, extensive screen time on mobile phones, being greatly affected by the COVID-19 pandemic, and inadaptability to offline courses. Anxiety was more likely to be caused by lack of physical exercise, drug use, irregular diet, and inadaptability to offline courses. Depression and anxiety are highly comorbid. Our study showed predictive factors for depression and anxiety and identified a major mental health burden on medical students during the COVID-19 outbreak. More targeted measures should be taken to improve the mental state of students to reduce the incidence of depression and anxiety.

Culture of Movement Awareness through Physical Literacy Integrated in Physical Education, Physical Activity and Sport during COVID-19: Systematic Literature Review

Purpose: A culture of movement awareness through physical literacy in physical education, physical activity and sports is a core aspect that must be promoted continually during the current COVID-19 pandemic. This study aims to conduct a literature review regarding the importance of a culture of movement awareness through physical literacy in physical education, physical activity and sports. Material and Methods: This study used a Systematic Literature Review with Preferred Reporting Item for Systematic Reviews and Meta-Analytic method. There was 4 Stages in collecting data using a database search, namely through Sage Pub, Eric, Pubmed and Sciencedirect. This study adopted 7 international journal articles indexed by Scopus Q1. Results: The results of this study found that a culture of movement awareness through physical literacy which was integrated into physical education, physical activity and sports had a major contribution in creating active participation to lead a healthy life  during the pandemic. Conclusions: Therefore, maintaining and increasing a culture of movement awareness through physical literacy during the COVID-19 period in various settings is the key in maintaining the health status of people around the world

A Study on the Correlation Between Undergraduate Students' Exercise Motivation, Exercise Self-Efficacy, and Exercise Behaviour Under the COVID-19 Epidemic Environment

The outbreak of COVID-19 epidemic has influenced human beings from various aspects including physical exercise behaviours. This study aims to explore the influence of the COVID-19 epidemic on exercise self-efficacy and exercise behaviour, as well as the intermediary effects of exercise motivation. A sample of 1,115 undergraduate students was investigated using the physical exercise behaviour scale, exercise self-efficacy scale, and exercise motivation scale, combined with the COVID-19 epidemic environment as an influencing factor. SPSS was used for statistical analysis and AMOS for the prediction model building. Logical analysis was undertaken to sort out and analyse the data. The structural equation model reveals that exercise self-efficacy has a positive effect on exercise motivation and exercise behaviour. Meanwhile, the COVID-19 epidemic environment negatively influences exercise behaviour through the intermediary role of exercise self-efficacy and exercise motivation. Moreover, the intermediary effect of exercise self-efficacy is greater than that of exercise self-efficacy and exercise motivation. This study provides both theoretical implications and practical guidelines for society and undergraduate students to improve their exercise behaviour during epidemic.

Returning persons with SARS-CoV-2 to the field of play in professional golf: a risk assessment and risk reduction approach

Objectives

This pilot study aimed to see whether a risk assessment and risk reduction approach was a practical and feasible approach, as compared with standard isolation for fully vaccinated, asymptomatic persons positive for SARS-CoV-2.

Methods

This prospective cohort study included all players and caddies participating in two large professional golf events from 7 to 20 February 2022 in South Africa. Fully vaccinated persons testing positive who were asymptomatic were subject to risk assessment and risk reduction measures to protect the integrity of the event. Asymptomatic individuals who could socially distance in outdoor areas were allowed to participate. Close contacts were subject to daily rapid antigen tests and asked to prioritise outdoor space.

Results

The protocols put in place for the events were practical, feasible, and well accepted by event participants and staff during the study period. There was a total of 378 player-week episodes and 378 caddie-week episodes during the study period. Three persons tested positive while registered at events during the study period (0.4% of person episodes). The positive tests were returned from two players and one caddie, all of which were asymptomatic at the time of testing. There was one high-risk contact who consistently returned negative antigen tests. There was no evidence of transmission.

Conclusions

The approach was practical and feasible. A risk assessment and risk reduction approach allowed fully vaccinated asymptomatic persons with SARS-CoV-2 to participate in golf, an outdoor sport where social distancing is possible, compared with standard isolation.

Multimodal Benefits of Exercise in Patients With Multiple Sclerosis and COVID-19

Multiple sclerosis (MS) is a demyelinating disease characterized by plaque formation and neuroinflammation. The plaques can present in various locations, causing a variety of clinical symptoms in patients with MS. Coronavirus disease-2019 (COVID-19) is also associated with systemic inflammation and a cytokine storm which can cause plaque formation in several areas of the brain. These concurring events could exacerbate the disease burden of MS. We review the neuro-invasive properties of SARS-CoV-2 and the possible pathways for the entry of the virus into the central nervous system (CNS). Complications due to this viral infection are similar to those occurring in patients with MS. Conditions related to MS which make patients more susceptible to viral infection include inflammatory status, blood-brain barrier (BBB) permeability, function of CNS cells, and plaque formation. There are also psychoneurological and mood disorders associated with both MS and COVID-19 infections. Finally, we discuss the effects of exercise on peripheral and central inflammation, BBB integrity, glia and neural cells, and remyelination. We conclude that moderate exercise training prior or after infection with SARS-CoV-2 can produce health benefits in patients with MS patients, including reduced mortality and improved physical and mental health of patients with MS.

Return to Play Following COVID-19 Infection-A Systematic Review of Current Evidence

CONTEXT

The COVID-19 pandemic has had catastrophic impact on a global scale, affecting people from all walks of life including elite athletes.

OBJECTIVES

The purpose of this study was to evaluate the reported rates of return to play (RTP) in conjunction with the expert-derived guidelines previously recommended to enable safe RTP post COVID-19 infection.

EVIDENCE ACQUISITION

Two independent reviewers searched the literature based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing the MEDLINE, Embase, and Scopus databases. Only studies that reported rates of RTP and/or recommended guidelines for safe RTP were included.

EVIDENCE SYNTHESIS

Overall, 17 studies (3 level III and 14 level V) were included. A total of 3 studies reported rates of RTP in a total of 1255 athletes and 623 officials; 72 (30 symptomatic) were infected with COVID-19, 100% of whom were able to RTP post COVID-19 infection. Of the 14 studies recommending guidelines for safe RTP, 3 and 9 studies recommended 7 and 14 days of rest in isolation respectively for asymptomatic patients with COVID-19 infection, prior to safe RTP. In contrast, 7 studies recommended 3 to 6 months of rest (following 14 d isolation) in cases of COVID-19-induced myocarditis as a safe timeframe for safe RTP. Of the 11 studies reporting on whether blanket testing prior to RTP was recommended, only 7 studies recommended a negative test result as mandatory prior to RTP for athletes previously infected with COVID-19.

CONCLUSIONS

Although excellent rates of RTP have been reported for elite athletes post COVID-19 infection, discrepancies in recommended rest periods, requirement for mandatory negative test results, and the magnitude of screening investigations required continue to exist in the literature, with a need for further standardized international guidelines required in future.

LEVEL OF EVIDENCE

Level V; systematic review of all forms of evidence.

Changes in Dietary Habits and Exercise Pattern of Korean Adolescents from Prior to during the COVID-19 Pandemic

This study aimed to investigate changes in the exercise pattern and dietary habits in adolescents during the COVID-19 pandemic. The 12–18-year-old population in the Korea Youth Risk Behavior Web-Based Survey data of 2019 and 2020 was enrolled. The exercise pattern and dietary habits of 105,600 participants (53,461 in the 2019 group and 52,139 in the 2020 group) were compared. The odds ratios (ORs) for the dietary habits and exercise pattern of the 2020 group compared to the 2019 group were analyzed using multiple logistic regression analysis with complex sampling. The odds of eating fruit, drinking soda, drinking sweet drinks, and consuming fast food were lower in the 2020 group than in the 2019 group (all p < 0.001). The odds of eating breakfast were higher in the 2020 group than in the 2019 group (all p < 0.001). The 2020 group showed lower odds of frequent vigorous and moderate aerobic exercise and higher odds of frequent anaerobic exercise than the 2019 group (all p < 0.001). During the COVID-19 pandemic, adolescents consumed less fruit, soda, and sweet drinks, while they had more breakfast. The frequency of aerobic exercise was lower, while the frequency of anaerobic exercise were higher during the COVID-19 pandemic period.

Pain experience and mood disorders during the lockdown of the COVID-19 pandemic in the United States: an opportunistic study

INTRODUCTION

The unknown and uncontrollable situation of the coronavirus disease 2019 (COVID-19) pandemic may have triggered changes in pain, anxiety, and depression along with a perception of nonspecific COVID-19 symptoms.

OBJECTIVES

We determined how anxiety, depression, and pain outcomes varied during the "Stay-at-Home" order compared with the prepandemic period and whether nonspecific COVID-19 symptoms would occur.

METHODS

We conducted an online survey to opportunistically reassess clinical anxiety, depression, pain intensity, and pain interference while controlling for somatic symptom severity during the prepandemic and Stay-at-Home order period. During the Stay-at-Home period, anxiety, depression, pain intensity, and pain interference were reassessed. Coping strategies were assessed as a critical factor influencing pain behaviors. In addition, we explored the occurrence of nonspecific COVID-19 symptoms with an ad hoc survey referencing the Centers for Disease Control and Prevention publicly available COVID-19 symptoms.

RESULTS

We observed a significant increase in depression and anxiety levels during the Stay-at-Home period. Coping strategy changes (eg, increased exercise) were linked to lower pain severity and interference which improved overall. Participants who self-reported nonspecific COVID-19 symptoms had higher prepandemic depression. Among the 72 participants not diagnosed with COVID-19, 70.8% of the participants experienced symptoms resembling those associated with COVID-19.

CONCLUSION

We suggest the parallel between pain outcome improvement and worsening anxiety and depression during the Stay-at-Home order might reflect a shift in symptoms, indicating that those patients with underlying mood disorders may require more help than they did before the pandemic.

The Impact of COVID-19 on the Preparation for the Tokyo Olympics: A Comprehensive Performance Assessment of Top Swimmers

BACKGROUND

The Olympic preparation of athletes has been highly influenced by COVID and post-COVID syndrome. As the complex screening of athletes is essential for safe and successful sports, we aimed to repeat the 2019-year sports cardiology screening of the Olympic Swim Team before the Olympics and to compare the results of COVID and non-COVID athletes.

METHODS

Patient history, electrocardiogram, laboratory tests, body composition analysis, echocardiography, cardiopulmonary exercise test (CPET) were performed. We used time-ranking points to compare swimming performance.

RESULTS

From April 2019, we examined 46 elite swimmers (24 ± 4 years). Fourteen swimmers had COVID infection; all cases were mild. During CPET there was no difference in the performance of COVID (male: VO2 max 55 ± 4 vs. 56.5 ± 5 mL/kg/min, p = 0.53; female: VO2 max 54.6 ± 4 vs. 56 ± 5.5 mL/kg/min, p = 0.86) vs. non-COVID athletes (male VO2 max 56.7 ± 5 vs. 55.5 ± 4.5 mL/kg/min, p = 0.50; female 49.6 ± 3 vs. 50.7 ± 2.6 mL/kg/min, p = 0.47) between 2019 and 2021. When comparing the time results of the National Championships, 54.8% of the athletes showed an improvement (p = 0.75).

CONCLUSIONS

COVID infection with short-term detraining did not affect the performance of well-trained swimmers. According to our results, the COVID pandemic did not impair the effectiveness of the preparation for the Tokyo Olympics.

The impact of COVID-19 on the injury pattern for maxillofacial fracture in Daegu city, South Korea

Background

This study aimed to analyze the impact of COVID-19 on oral and maxillofacial fracture in Daegu by comparing the demographic data in 2019 and 2020, retrospectively. We collected data from all patients having trauma who visited the emergency room for oral and maxillofacial fractures.

Methods

This retrospective study was based on chart review of patients who visited the emergency department of Kyungpook National University Hospital in Daegu, South Korea from January 1, 2019, to December 31, 2020. We conducted a comparative study for patients who presented with maxillofacial fractures with occlusal instability during pre-COVID-19 era (2019) and COVID-19 era (2000) with demographics and pattern of injuries.

Results

After the outbreak of COVID-19, the number of monthly oral and maxillofacial fractures, especially sports-related oral and maxillofacial fractures, decreased significantly. Also, the number of alcohol-related fractures increased significantly. In addition, as the number of monthly confirmed cases of COVID-19 increases, the incidence of fracture among these cases tends to decrease.

Conclusions

The COVID-19 pandemic has changed the daily life in Korea. Identifying the characteristics of patients having trauma can provide a good lead to understand this long-lasting infectious disease and prepare for future outbreaks.

Covid-19 and the impact on young athletes

The Covid-19 pandemic has disrupted organised sport in the community as authorities cancelled, greatly modified or postponed sporting participation as part of a strategy to reduce transmission of the virus. This had a significant impact on young athletes and their families in relation to their psycho-social, physical and career progression considerations. The disruption is likely to continue for some years, considering the constraints of lockdowns, the need to overcome dysfunctional national logistics for delivery of medical care, fund and implement an efficacious vaccine programme locally, nationally and worldwide, develop sufficient herd immunity and create an environment of confidence in the safety of returning to sports for participants, coaches, umpires, administrators and observers. This article will consider the interim challenges regarding the physical and psychosocial importance of maintaining an active sporting programme for young athletes, reflect on safety measures for modifying sporting equipment and environmental protections to allow safest participation in training and competition and provide advice on protocols for a gradual return to sport for the young athlete after infection with Covid-19.

Traditional Gender Differences Create Gaps in the Effect of COVID-19 on Psychological Distress of Japanese Workers

The COVID-19 pandemic has caused Japanese workers psychological distress through crises of health, economics, and social relationships. To assess whether these effects are amplified by the gender bias that exists in Japan, we examined male and female worker’s psychological distress and difficulties during the pandemic. An online “COVID-19-related difficulties” questionnaire, based on item response theory, gathered responses from 3464 workers in October and November 2020. The workers’ psychological distress was found concerned to be significantly worse than before the pandemic. Basic stressors related to infection anxiety, economic anxiety, and restrictions on social interactions and outings. Men’s and women’s experiences of difficulties were consistent with traditional gender roles in Japan: men were more likely to face job-related stressors, such as economic insecurity and work-style changes; women were more likely to face non-job-related stressors, such as increased living costs and reduced social interactions. Policymakers and employers should consider the association between gender differences and industry types, and implement measures to strengthen the acceptability of mental health care.

Return to Play Recommendations After COVID-19 Diagnosis in High School Athletes

COVID-19 has drastically changed everyday life across the world and has dramatically impacted how athletics operate. Since the return of high school sports, high school athletic trainers are now responsible for ensuring the safe return of athletes previously diagnosed with COVID-19 to sports. Due to the relatively recent identification of this novel virus, very little is understood about the long-term effects of COVID-19 infection on the cardiac and respiratory systems. Due to the rapid return of athletics, there is unfortunately limited research available regarding how athletes respond to COVID-19 and how it may affect their ability to return to play. Therefore, it is recommended that high school athletes previously diagnosed with COVID-19 undergo a comprehensive medical evaluation with their physician and complete a graduated medically supervised return to play protocol.

Entrepreneurship and Resilience in Spanish Sports Clubs: A Cluster Analysis

Entrepreneurial orientation can be an effective response by sports clubs to manage a recession, such as the COVID-19 crisis. Therefore, its study can be fundamental to understand different ways of managing a recession. This study analyzes the entrepreneurial orientation of Spanish non-profit sports clubs to identify different groups and their profiles. The sample is composed of 145 Spanish non-profit sports clubs. Different validated scales have been used to analyze entrepreneurial orientation, business model adaptation, service quality, and economic and social performance (performance in social impact and performance in social causes). Entrepreneurial orientation is the variable used to differentiate the groups. This is made up of three dimensions: innovation, risk-taking, and proactivity. According to the results obtained, there are three groups of sports clubs according to their entrepreneurial orientation: non-entrepreneurs (n = 11), moderate entrepreneurs (n = 85), and strong entrepreneurs (n = 45). There are substantial differences between the three groups according to the adaptation of the business model, the perceived impact of COVID-19, and the returns analyzed. Strong entrepreneurs have considerably higher levels of business model adaptation, economic performance, social performance, and perceived service quality than non-entrepreneurs. Theoretical and practical implications have been drawn that can bring new information to the sports and organizational sector. For example, the diagnosis of the different profiles according to the level of entrepreneurship can be useful to propose strategies to improve performance. In this way, it can help to evaluate the return on the investment made by sponsors or governments in the organization.

Physical exercise and COVID-19 pandemic in PubMed: Two months of dynamics and one year of original scientific production

Our aim was to conduct a narrative review about physical exercise and Corona Virus Disease 2019 (COVID-19). A literature search was completed crossing the keywords “COVID-19” and “physical exercise”, for a narrative review, and physical activity (PA), physical exercise, physical training, sport, physical fitness, for a systematic review; search strategy (Randomized Controlled Trial, in the last 1 year, English). The first search date was closed on 04/26/2020 and 06/26/2020. This strategy was chosen to assess the dynamics of scientific information production for the pandemic. In two months, an increase of 76%, from 12 (19.4%) to 50 (80.64%) COVID-19 articles (n = 62, 100%) was found. The main types of articles published were editorial articles (16.13%, n = 10 of 62 articles) and commentary (9.68%, n = 6 of 62 articles). The most frequent country of origin of the scientific production was the United States (12.90%, n = 8 of 62 articles), the United Kingdom (12.90%, n = 8 of 62 articles), and Brazil (11.29%, n = 7 of 62 articles). However, in 2020, there were only 2 relevant randomized controlled trials on the COVID-19 topic in the context of physical exercise. Scientific information production shows the concern of the PA science community to bring a solution to the increase in physical inactivity generated by the COVID-19 pandemic. Our findings show the dynamics of scientific production on the COVID-19, in a situation so unique such as a pandemic, denotes that the practice of PA is essential to improve and/or maintain physical and mental health.

The Impact of Reduced Training Activity of Elite Kickboxers on Physical Fitness, Body Build, and Performance during Competitions

Background: Kickboxing is a combat sport where athletes require constant supervision of a coach. The outbreak of the pandemic caused by SARS-CoV-2 has led to a crisis in many sectors, including sport. Global efforts to limit the spread of the pathogen resulted in temporary lockdowns that limited sporting activity, thus deteriorating athletes' physical fitness. Methods: The participants included 20 kickboxers competing at the international level. Their physical fitness was evaluated based on the test developed by the International Committee on the Standardization of Physical Fitness Test (ICSPFT) and their body build was assessed using Tanita BC601 body composition monitor and a body height meter. Differences between physical fitness before the COVID-19 outbreak and during the pandemic after re-opening sports facilities were evaluated. Results: Temporary closing of sports clubs has led to the increase in body mass of the participants by 2.65 kg on average and significantly deteriorated physical fitness. Conclusions: Temporary closing of sports clubs and restrictions on physical activity aimed at containing the spread of COVID-19 caused a significant reduction in physical fitness and increased body mass of the participants. This is likely to cause worse performance in the nearest competitions and have a negative impact on the athletes' health status and immunity to diseases.

Effects of COVID-19 Lockdown on Physical Activity, Sedentary Behavior, and Satisfaction with Life in Qatar: A Preliminary Study

This study examined the effects of home confinement on physical activity (PA) and life satisfaction during the COVID-19 outbreak in Qatar. A total of 1144 subjects participated (male: n = 588; female: n = 556; age: 33.1 ± 11.1 years; mass: 76.1 ± 16.4 kg; height: 1.70 ± 0.11 m; body mass index (BMI): 26.1 ± 4.44  kg/m2). Online survey questions considered "before" and "during" confinement. Confinement reduced all PA intensities (ηp2 = 0.27-0.67, p < 0.001) and increased daily sitting time from 3.57 ± 1.47 to 6.32 ± 1.33 h per weekday (ηp2 = 0.67, p < 0.001). The largest reduction was detected for the sum parameter all physical activity (minutes per week, ηp2 = 0.67, p < 0.001; MET (metabolic equivalent of task)-minutes/week, ηp2 = 0.69, p < 0.001). Life satisfaction decreased, with the score for "I am satisfied with my life" (ηp2 = 0.76, p < 0.001) decreasing from 28.1 ± 4.81 to 14.2 ± 6.41 arbitrary units (AU). Concerning life satisfaction, the largest change was detected for the statement "the conditions of my life are excellent" (dmale = 7.93). For all parameters, time effects were indicative of large negative effects in both genders. In terms of magnitude, the difference between gender was greatest for the parameter "the conditions of my life are excellent" (difference between groups, d = 4.84). In conclusion, COVID-19 confinement decreased PA, increased sitting time, and decreased life satisfaction in Qatar. These precautionary findings explicate the risk of psychosocial impairment and the potential physical harm of reducing physical activity during early COVID-19 confinement in 2020.

Sport and exercise participation in time of Covid-19-A narrative review of medical and health perspective

Coronavirus outbreak during 2020 brought enormous challenges for the world of sport and exercise. Much debated lockdown finished with the first wave in most countries and the “new normal” was the new beginning for professional and recreational sport activities. The aim of this narrative review is to acknowledge the most important medical and health aspects of sport and exercise participation until COVID‐19 pandemic is resolved. Management of existing crisis creates numerous opportunities for medical advances. Remote testing, tele‐health, field laboratories, continuous follow‐up of professional athletes, technological advances and artificial intelligence in new sporting environment using multidisciplinary, and systematic approach can be now thoroughly evaluated and defined for the best SEM practices. Sports and exercise medicine expertise in prevention can have a decisive role in dealing with ongoing and future pandemics.

Safety procedures for exercise testing in the scenario of COVID-19: a position statement of the Società Italiana Scienze Motorie e Sportive

Recent data on coronavirus disease 2019 (COVID-19) pandemic showed that the virus is mostly conveyed by respiratory droplets that are produced at high intensity especially when an infected subject coughs or sneezes. Therefore, elevated volume ventilations, usually reached during physical efforts and exercise, are a potential source of contamination. On the other hand, the lockdown period which has lasted for nearly 2 months and is actually involving several countries worldwide, obliged a large part of human population to sedentary behaviors, drastically reducing their physical activity level, and reducing their cardiopulmonary fitness. Therefore, cardiopulmonary exercise testing could be beneficial, so that a safe and well-weighted return to pre-lockdown active lifestyle can be efficiently planned. However, specific guidelines on exercise testing safety procedures in the era of COVID-19 are unavailable so far. This article is aimed to provide an overview of safety procedures for exercise testing during and after COVID-19 worldwide pandemic.