Elite Athletes and COVID-19 Lockdown: Future Health Concerns for an Entire Sector

Respiratory complications following COVID-19 in athletic populations: A narrative review

Athletes typically experience a mild-to-moderate, self-limiting illness following infection with the novel severe acute respiratory syndrome coronavirus 2. Some athletes, however, can develop prolonged symptoms, with breathlessness, cough, and chest tightness impacting return to training and competition. In athletes with persistent cardiopulmonary symptoms following COVID-19, focus is usually placed on the identification and characterization of cardiac complications, such as myocarditis. In this review, we focus on summarizing the literature assessing pulmonary complications and physiological consequences associated with COVID-19 illness in athletes. The review also provides recommendations for clinical assessment of the athlete with pulmonary issues following COVID-19 and directions for future research.

Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care

Background

COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure.

Methods

A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection.

Results

A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex.

Conclusion

The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.

New insights from Norwegian and Swedish sports coaches' employment, practices, and beliefs during the first COVID-19 restriction period

Introduction

This study (i) examined Norwegian and Swedish sports coaches' employment, practices, and beliefs during the first wave of the COVID-19 pandemic, (ii) compared these aspects between coaches in Norway and Sweden, two countries with clearly different movement restrictions strategies in this period.

Methods

An online survey was distributed to coaches via email and social media. The survey was open between June and August 2020. In total, 348 coaches responded, 141 from Norway, and 207 from Sweden.

Results

Among responders, 2% had lost their job due to the pandemic, 17% had been furloughed, 28% worked from home office, and 39% worked as usual. Norwegian coaches were more likely to work from home (48% vs. 15%, p < .001), while Swedish coaches were more likely to work as usual (60% vs. 9%, p < .001). Coaches in both countries communicated less frequently with their athletes (p < .001) and had less in-person communication (p < .001) compared to pre-Covid levels. Larger declines existed among Norwegian coaches regarding communication frequency (p < .001) and in-person communication (p < .001). Video calls and phone calls usage increased (p < .001 and p = .009 respectively). We recorded low levels of concern among coaches about the effects of the pandemic on their relationship with their athletes. There were considerable levels of concern about athletes' maintaining their motivation to train (Norway: 43.3%, Sweden: 50.7%), and low levels of concern about the coaches' relationships with their athletes (Norway: 14.1%, Sweden: 17.8%).

Discussion

Overall, this study showed the imposed movement restrictions had several negative consequences for the employment and work practices of sports coaches in Norway and Sweden. However, it also highlighted that coaches were able to adapt their work practices to the constraints and were able to maintain relationships with their athletes. The consequences raised in this paper can act as a guide during possible future lockdowns.

Epidemiology of injuries in elite Women's Artistic Gymnastics: a retrospective analysis of six seasons

Background

Women's Artistic Gymnastics (WAG) is a sport well known for requiring a heavy and difficult training load from a younger age to reach a high level of performance. This also is associated with an injury risk. Epidemiological studies are thus needed to improve injury prevention strategies.

Objective

We aimed to determine the injury epidemiology in French high-level WAG.

Methods

We conducted a retrospective analysis of injury data collected prospectively over six seasons from the 2014-2015 season to the 2019-2020 season among French high-level Women's Artistic Gymnasts from the France Gymnastics National Centre of Saint-Etienne. We performed descriptive analyses, including the calculation of the 1-year injury prevalence.

Results

43 gymnasts were included in this study, representing 111 gymnast-seasons. A total of 285 injuries were collected over the study period, that was, an average of 2.6 injuries per gymnast per season. On average, 91.4% of gymnasts had at least one injury per season. The estimated injury incidence rate was 1.8 injuries per 1000 hours of gymnastics practice. The knee was the most affected joint (16%), followed by the elbow (12%) and the ankle (12%). The most frequent injury type was physis pathologies (16%) and bone injuries (15%). Eighty-eight per cent of injuries required a modification of the gymnastics practice.

Conclusions

The results of this study allowed a description of the epidemiology of injuries in this population of young and elite gymnasts. This very high injury prevalence supports the need to improve injury risk reduction strategies in WAG.

An analysis of pain intensity, injury incidence, and their associations with socio-demographic factors in high school athletes: A cross-sectional study during the COVID-19 pandemic

This cross-sectional study explored the relationship between pain intensity, injury incidence, and sociodemographic factors in 120 high school athletes (mean age 16.78±0.91) participating in various sports. The aims of this study are to examine the correlation between factors and Verbal Rating Scale (VRS) for pain intensity, to investigate the correlation between sport types and injured region, and to explore the correlation between injured regions and VRS during training and game competition. Using VRS, we found 64 (53.3%) participants experienced pain during training, with varying degrees of intensity. Chi-square analysis revealed a significant association between VRS scores and school grade (p = 0.044) and cool-down practices (p = 0.037). However, no significant associations were found with gender, age, or sport type. In game competition, 29 (24.2%) participants reported experiencing pain. Here, there was no significant association between VRS and any considered variables. Lower limb injuries were predominant (n = 64), particularly to the knee (n = 23) and ankle/foot (n = 18). Certain sports, like Athletics, Karate-Do, Football, and Western Boxing, demonstrated multiple injury sites, whereas Thai boxing was associated primarily with ankle and foot injuries. Pain intensity varied by injury location, with the highest 'worst pain' reported for elbow injuries during training and knee injuries during competition. Significant associations were found between injured region and pain intensity level during both training and competition (p<0.001). Our findings highlight the need for injury prevention strategies and pain management among high school athletes, emphasizing proper cool-down activities. Further research is warranted to confirm these findings and explore underlying mechanisms.

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.

Effect of a home-based exercise training program on anthropometric characteristics and exercise performance during Covid-19 quarantine in young high-level kayak athletes

Purpose

The Covid-19 restriction exposed most athletes to insufficient training stimuli leading to detraining. This study investigated whether a home-based exercise training program could preserve body composition and exercise performance in young high-level kayak athletes during Covid-19 restriction.

Methods

Seventeen healthy young high-level kayak athletes (10 males and 7 females), aged 14.7 ± 1 yrs, participated in this study. A 7-week home-based training program was followed during Covid-19 restriction. Baseline measurements were assessed 4 weeks before Covid-19 pandemic and ended on 4 May 2020. Body composition, flexibility, isometric muscle trunk strength (Biodex), anaerobic power (30-s all-out trial), and aerobic capacity (4-min maximal test) were evaluated. Personal daily loads and wellness details were collected with AthleteMonitoring.com software.

Results

Home-based exercise training program was effective to improve flexibility (9.20 ± 2.85%) and lean body mass (3.96 ± 0.89%), to maintain muscle strength, anaerobic power, body mass, and body fat percentage but insufficient to maintain aerobic capacity (- 8.96 ± 2.49%).

Conclusion

The findings of the present study potentially highlight the importance of the implementation of such a program to minimize the detraining effect on young athletes during periods of movement restriction caused by pandemics.

Psychological Correlates of Perceived Physical Activity Engagement During the COVID-19 Pandemic Among Previously Active Individuals

The COVID-19 pandemic altered daily life in the United States and disrupted how people engage in routine health behaviors, such as physical activity (PA). This study investigates factors that may have helped people sustain recommended levels of moderate to vigorous PA (MVPA) during this time. Using a cross-sectional design, we recruited from Amazon's Mechanical Turk in April/May 2020 a sample of individuals who reported that they had met recommended PA guidelines (≥ 150 weekly MVPA minutes; N = 397) prior to structural changes brought about by COVID-19. We assessed via self-report whether these individuals were meeting recommended levels of MVPA during the COVID-19 pandemic, their intrinsic motivation and identified regulation for exercise, exercise self-efficacy, perceived disruption to their exercise routine, and access to resources for PA. Higher identified regulation, self-efficacy, access to PA resources, and lower perceived disruption were associated with meeting PA guidelines during COVID-19. These findings provide insight into factors that may be important for continued engagement in MVPA when one experiences major disruptions to their exercise routine.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1929811 .

Association between SARS-CoV-2 infection and the physical fitness of young-adult cadets: a retrospective case-control study

OBJECTIVES

To determine the association of symptomatic and asymptomatic mild COVID-19 and the SARS-CoV-2 viral load with the physical fitness of army cadets.

DESIGN

A retrospective case-control study.

SETTING

Officers' Training School of the Israel Defense Forces.

PARTICIPANTS

The study included all cadets (age, 20.22±1.17 years) in the combatant (n=597; 514 males, 83 females; 33 infected, all males) and non-combatant (n=611; 238 males, 373 females; 91 infected, 57 females, 34 males) training courses between 1 August 2020 and 28 February 2021. COVID-19 outbreaks occurred in September 2020 (non-combatants) and January 2021(combatants).

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures were the aerobic (3000 m race) and anaerobic (combatant/non-combatant-specific) physical fitness mean score differences (MSDs) between the start and end of the respective training courses in infected and non-infected cadets. Secondary outcome measures included aerobic MSD associations with various COVID-19 symptoms and SARS-CoV-2 viral loads.

RESULTS

SARS-CoV-2 infection led to declined non-combatant and combatant aerobic fitness MSD (14.53±47.80 vs -19.19±60.89 s; p<0.001 and -2.72±21.74 vs -23.63±30.92 s; p<0.001), but not anaerobic. The aerobic physical fitness MSD decreased in symptomatic cadets (14.69±44.87 s) and increased in asymptomatic cadets (-3.79±31.07 s), but the difference was statistically insignificant (p=0.07). Symptomatic cadets with fever (24.70±50.95 vs -0.37±33.87 s; p=0.008) and headache (21.85±43.17 vs 1.69±39.54 s; p=0.043) had more positive aerobic physical fitness MSD than asymptomatic cadets. The aerobic fitness decline was negatively associated with viral load assessed by the RNA-dependent RNA polymerase (n=61; r = -0.329; p=0.010), envelope (n=56; r = -0.385; p=0.002) and nucleus (n=65; r = -0.340; p=0.010) genes.

CONCLUSIONS

SARS-CoV-2 infection was associated with a lingering decline in aerobic, but not anaerobic, fitness in symptomatic and asymptomatic young adults, suggesting possible directions for individualised symptom-dependent and severity-dependent rehabilitation plans' optimisation.

Efectos del COVID-19 en la carga externa en el fútbol de alto nivel

Analizamos el efecto del cese de la competición por COVID-19 en el rendimiento físico de jugadores de fútbol de la 1ª división española). La muestra se estratificó en tres grupos: rondas 1ª-3ª; 25ª-27ª y 28ª-30ª. Las comparaciones por pares fueron Student-t y Mann-Whitney U. Usamos un valor p de ?0.05 como criterio para la significación estadística. Los valores de umbral para evaluar las magnitudes del tamaño del efecto se realizaron a través (d de Cohen). Tras el parón, las distancias recorridas aumentaron en los equipos locales y visitantes. Hubo un ligero descenso de los esfuerzos de alta intensidad entre el post-confinamiento y las jornadas (25ª-27ª). Comparados el 1er y 3er periodo, los valores fueron ligeramente superiores (rondas 28ª-30ª). Eso mismo se observó en las de aceleraciones y desaceleraciones, con mayores diferencias entre los periodos (1º y 3º). Hubo diferencias, cuando se comparó la reanudación con las jornadas previas al parón.

The effects of aerator masks and medical masks on oxygen saturation (SO2) on mentally retarded athletes

The study purpose was investigated the effect of aerator masks on the oxygen saturation (SO2) of mentally retarded athletes compared to medical masks. The researcher used a comparative study. Parametric test was used to test the difference in SO2 percent and evaluate the questionnaire in the two groups. The results showed after undergoing exercise, SO2 percent in participants was 94.60±0.55 for aerator masks and 96.60±0.55 for medical masks. The study also showed that there was no significant difference in SO2 percent of participants wearing aerator masks and medical masks. However, the decrease in oxygen saturation percent of participants wearing aerator masks experienced a lower decrease, 1.60±0.55 compared to medical masks of 2.00±1.00. On the other hand, wearing an aerator mask is better because it does not prevent maximum performance, better comfort, the mask material feels better on the skin, does not experience difficulties breathable, and suitable for exercise. An aerator mask is a mask with an adequate supply of oxygen so that every breath is maintained even when used during sports activities.

Evaluation of the Perceptions, Attitudes and Practices among Greek Non-Professional Athletes Visiting a Public Hospital during March 2022, towards COVID-19 Vaccination and Its Consequences on Sports Training and Sports Activity

Sports have been majorly impacted by the COVID-19 pandemic. After the lockdown period, vaccination and protocols were implemented to return to normality. We aimed to assess the attitudes and practices related to COVID-19 vaccination among athletes, and to record adverse effects of vaccination, if any. A questionnaire was distributed to 1012 male and female athletes, 15+ years old, within the region of Athens. Vaccination coverage with at least one dose was 93.5%, whereas 53.9% were fully vaccinated. More than half of the participants were infected with SARS-CoV-2 at the time of the study. More than 90% of the participants, considered the vaccines as safe, effective and important for public health. Concern about potential side-effects was raised especially by women athletes (59.1% of women compared to 42.2% of men, p < 0.001). The main reasons for avoiding vaccination were fear of vaccine safety, concern about the short time period for vaccine development and testing and doubt of risk of being exposed to SARS-CoV-2 infection. The main reported side-effects were pain at the injection site, fatigue, fever and headache. Approximately two thirds of the participants reported that vaccination did not affect their training, and none reported missing participation in scheduled athletic events. Participants reported high compliance to preventive measures by themselves and fellow athletes, but low satisfaction regarding the implementation of public protocols and the flow of information provided by the authorities. Athletes of older age and those less concerned about potential side-effects were more likely to get fully vaccinated. Nevertheless, the vast majority of the athletes in our study were vaccinated for COVID-19 despite any hesitation regarding effectiveness, safety, or potential side-effects from the vaccines.

Structure of the training program during the COVID-19 confinement in spanish professional football, a coach survey

OBJECTIVES

To describe and analyze the training programs carried out during the COVID-19 forced confinement in men´s professional football in Spain.

METHODS

Observational Study based on a telematic ad-hoc questionnaire developed to meet the objective of the study. The sample consisted of thirty-six coaches representing thirty-six professional men's soccer teams in the Spanish first and second division.

RESULTS

Training programs developed during confinement prioritized conditioning and functional emphasis, in addition to general and nonspecific resistance training, due to contextual limitations.

CONCLUSION

The structure of training during the COVID-19 confinement was limited by contextual circumstances. This study has made possible to record the training and strategies used in professional football during a confinement due to a worldwide state of alarm, with the aim of resuming competitive activity in the best possible conditions.

Effects of a healthy lifestyle intervention and COVID-19-adjusted training curriculum on firefighter recruits

There are knowledge gaps regarding healthy lifestyle (HLS) interventions in fire academy settings and also concerning the impacts of the pandemic on training. We enrolled fire recruits from two fire academies (A and B) in New England in early 2019 as the historical control group, and recruits from academies in New England (B) and Florida (C), respectively, during the pandemic as the intervention group. The three academies have similar training environments and curricula. The exposures of interest were a combination of (1) an HLS intervention and (2) impacts of the pandemic on training curricula and environs (i.e. social distancing, masking, reduced class size, etc.). We examined the health/fitness changes throughout training. The follow-up rate was 78%, leaving 92 recruits in the historical control group and 55 in the intervention group. The results show an HLS intervention improved the effects of fire academy training on recruits healthy behaviors (MEDI-lifestyle score, 0.5 ± 1.4 vs. − 0.3 ± 1.7), systolic blood pressure (− 7.2 ± 10.0 vs. 2.9 ± 12.9 mmHg), and mental health (Beck Depression score, − 0.45 ± 1.14 vs. − 0.01 ± 1.05) (all P < 0.05). The associations remained significant after multivariable adjustments. Moreover, a 1-point MEDI-lifestyle increment during academy training is associated with about 2% decrement in blood pressures over time, after multivariable adjustments (P < 0.05). Nonetheless, the impacts of pandemic restrictions on academy procedures compromised physical fitness training, namely in percent body fat, push-ups, and pull-ups.

Effects of COVID-19 Lockdown on Physical Performance, Sleep Quality, and Health-Related Quality of Life in Professional Youth Soccer Players

Background

In March 2020, the COVID-19 outbreak led to the declaration of a pandemic. The accompanying restrictions on public life caused a change in the training routines of athletes worldwide. The present study aimed to investigate the effects of a 13-week supervised home training program on physical performance, sleep quality, and health-related quality of life in professional youth soccer players during the first COVID-19 lockdown in Germany.

Methods

Eight professional soccer players (age range 16–19; height: 1.81 ± 0.07 m; body weight: 72.05 ± 6.96 kg) from a Bundesliga team in Germany participated in this study. During the lockdown, they trained 5–6 days per week with home-based training plans and were monitored via tracking apps and video training. To determine the effects of home training, measurements were taken before (March 2020) and after (June 2020) the home training period. Bioelectrical impedance analysis was used to determine body composition, and an isokinetic strength test and a treadmill step test, including lactate measurements, were used to measure physical performance. Two questionnaires were responded to in order to assess health-related quality of life [Short-Form 36 Health Survey (SF-36)] and sleep quality (Pittsburgh Sleep Quality Index).

Results

When comparing measurements before and after the home training period, we observed significant increases in the following variables: body weight (72.05 ± 6.96 kg vs. 73.50 ± 6.68 kg, p = 0.034), fat mass (11.99 ± 3.13 % vs. 13.98 ± 3.92 %, p = 0.030), body mass index (22.04 ± 0.85 kg/m2 vs. 22.49 ± 0.92 kg/m2, p = 0.049), and mental health component summary score (MCS) of the questionnaire SF-36 (53.95 ± 3.47 vs. 58.33 ± 4.50, p = 0.044). Scores on the general health (77.88 ± 14.56 vs. 89.75 ± 13.76, p = 0.025) and mental health (81.50 ± 9.30 vs. 90.00 ± 11.71, p = 0.018) subscales of the SF-36 also increased significantly.

Conclusion

The COVID-19 lockdown led to an increase in body composition parameters and showed an improvement in the MCS and scores on the general and mental health subscales of the SF-36. Physical performance and sleep quality could be maintained during the home training period. These observations may help trainers for future training planning during longer interruptions in soccer training.

Adapted physical activity in subjects and athletes recovering from covid-19: a position statement of the Società Italiana Scienze Motorie e Sportive

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic illness that is impacting the cardiovascular, pulmonary, musculoskeletal, and cognitive function of a large spectrum of the worldwide population. The available pharmacological countermeasures of these long-term effects of COVID-19 are minimal, while myriads of non-specific non-pharmacological treatments are emerging in the literature. In this complicated scenario, particular emphasis should be dedicated to specific exercise interventions tailored for subjects and athletes recovering from COVID-19. Specific guidelines on adapted physical activity in this critical population are unavailable so far, therefore, in this position statement of the Società Italiana di Scienze Motorie e Sportive (SISMeS) the members of the steering committee of the research group Attività Motoria Adattata, Alimentazione, Salute e Fitness have indicated the adapted physical activity approaches to counteract the long-term effects of the COVID-19, both in good health people and athletes.

Changes in Upper-Body Muscular Strength and Power in Paralympic Swimmers: Effects of Training Confinement during the COVID-19 Pandemic

The aim of this case series was to evaluate the effectiveness of a dry-land home-training program conducted during the COVID-19 pandemic period in Paralympic swimmers. Previous evidence showed the importance of muscular strength and power training for Paralympic swimmers due to the positive relationship between severity of impairment, swimming technique and biomechanics parameters. Specifically, we aimed to analyze: (i) the effects of a customized training regime conducted pre, during and post restrictions on upper-body muscular strength and power (one repetition maximum, mean propulsive velocity, and mean relative propulsive power) compared to a regular gym-based program; (ii) the associations between mean propulsive velocity and load during two upper body exercises in order to estimate the one repetition maximum. Four elite Paralympic swimmers were retrospectively analyzed in upper-body muscular strength, mean propulsive velocity and mean relative propulsive power in bench press and lat pull-down exercises at three time points: T0 (prior the Lockdown period), T1 (immediately after the Lockdown confinement), T2 (sixteen weeks after returning to gym training). Our findings suggest a very likely decrement in one repetition maximum, mean propulsive velocity, and mean relative propulsive power during the Lockdown period compared with the T0 period with a subsequent very likely increment in one repetition maximum after returning to gym training (T2) compared with the lockdown period (T0). Conversely, mean relative propulsive power showed an unclear improvement in all athletes in T2 compared with T1. These results were also corroborated by the Friedman’s test followed by the Dunn’s pairwise comparison that mainly showed a decrement from T0 to T1 (p < 0.05). At the same time, it appears that muscle strength and power could be rapidly restored close to the pre-lockdown levels following an adequate training program in the gym, albeit without significance (p > 0.05). Finally, the close relationship between mean propulsive velocity and load in bench press and lat pull-down exercises was also confirmed in para swimming, making a possible estimation of one repetition maximum.

COVID-19 Return to Sport: NFL Injury Prevalence Analysis

Background

Sport injuries have been common among athletes across the globe for decades and have the potential to disrupt athletic careers, performance, and psyche. Many health professionals and organizations have undertaken injury mitigation strategies to prevent sport injuries through protective equipment, training protocols, and a host of other evidence-based practices. Many of these specialized training methods were disrupted due to protocols to mitigate the spread of COVID-19. This research examines the effects of the COVID-19 pandemic in relation to the prevalence of athletic injuries in the National Football League (NFL).

Objective

During the COVID-19 pandemic, NFL teams and athletes across all levels of sport were reported to have reduced training in preparation for their seasons due to protocols to mitigate the spread of COVID-19. This study compares the prevalence of injury during the 2018, 2019, and 2020 NFL seasons, with the aim to determine the potential causes of the differences in injury prevalence.

Methods

Official injury reports from each team were counted during the 17-week regular season of each year (2018, 2019, and 2020). The data were analyzed using an unpaired t test to compare the injury prevalence between each of the three seasons.

Results

The 2018 season produced a total of 1561 injuries and a mean of 48.8 injuries per team. The 2019 season produced a total of 1897 injuries and a mean of 59.3 injuries per team, while the 2020 season produced a total of 2484 injuries and a mean of 77.6 injuries per team. An unpaired t test was performed using the data to compare the mean number of injuries per team during each of the seasons. Comparison of the 2020 season against the 2019 season showed a statistically significant difference (P<.001); comparison of the 2020 season to the 2018 season found a statistically significant difference (P<.001); and comparison between the 2019 and the 2018 seasons found a statistically significant difference (P=.03).

Conclusions

Although the 2019 and 2018 seasons showed a statistically significant difference (P=.03), this difference is not as large when we compare the 2020 seasons versus the 2019 (P<.001) and 2018 (P<.001) seasons. The astronomical increase in injury prevalence during the 2020 season over the previous years raises the possibility that there was a reduced physiological adaptation to stress, due to the limited amount of training as a result of the closure of practice facilities in order to slow the spread of COVID-19.

Impact of Prolonged Absence of Organized Training on Body Composition, Neuromuscular Performance, and Aerobic Capacity: A Study in Youth Male Soccer Players Exposed to COVID-19 Lockdown

The aim of this study is to examine how physical performance has changed after 15 weeks (109 days) long-term absence of organized training in youth soccer players imposed by the stay at home orders. A total of sixty-eight young male soccer players from different age categories (U15, U16, U17 and U19) voluntarily participated in the prospective cohort study. Body fat percentage (BF%), counter-movement jump (CMJ), 30 m sprint, change-of-direction (COD) and yo-yo intermittent recovery test level-1 (YYIRTL-1) were evaluated twice (before and after the detraining period). Subsequently, 2 × 2 repeated measures ANOVA was used to investigate group and time differences in repeated measurements. A significance level of p < 0.05 was implemented. CV and SWC values were calculated to test the reliability of the tests performed at different times. Statistical analysis was performed using the IBM SPSS statistics software (v.25, IBM, New York, NY, USA). Significant increments in BF%, 30 m sprint, and COD (left and right), and also significant decrements in CMJ and YYIRTL-1, were found after the detraining period. A long-term detraining period due to the stay at home orders has a detrimental effect on body composition, neuromuscular performances, and aerobic capacity in youth soccer players.

Pediatric orthopedic injury prevention for team sports post COVID-19

Queries of youth orthopedic sports injuries from the U.S. National Electronic Surveillance System, a database from the Consumer Product Safety Commission, demonstrate decreased orthopedic injuries related to team sports during the COVID-19 pandemic, indicative of reduced sports participation. Multiple articles have shown that COVID-19 had a marked effect on the physical and psychological wellbeing of the youth. The lockdown resulted in a cessation in school attendance and sports activities, especially team sports. Though increased emphasis has been placed on children infected by COVID-19, less attention has been given to healthy children. Numerous articles discussed the physical and psychological benefits for the youth returning to physical activity and sports; however, few have addressed detraining and deconditioning concerns postpandemic. This article discusses a safe return to team sports for the youth experiencing physical and psychological changes related to the pandemic. Orthopedic injuries are anticipated to increase as restrictions are relaxed. A multidisciplinary team presents a review of common youth sports orthopedic injuries, a discussion of psychological issues youths have experienced during COVID and why sports participation is beneficial for youth, and a risk assessment for pain and limited range of motion for youth returning to sports. The intent of this article is to increase awareness of the physical and psychological changes experienced by youth due to their inability to participate in team sports during the pandemic. Family medicine and primary care providers need to recognize the increased risks for injury and proactively encourage the youth to return to sports in a safe manner.

Quantitative Analysis of Performance Recovery in Semi-Professional Football Players after the COVID-19 Forced Rest Period

This study proposes the instrumental analysis of the physiological and biomechanical adaptation of football players to a fatigue protocol during the month immediately after the COVID-19 lockdown, to get insights into fitness recovery. Eight male semi-professional football players took part in the study and filled a questionnaire about their activity during the lockdown. At the resumption of activities, the mean heart rate and covered distances during fatiguing exercises, the normalized variations of mean and maximum exerted power in the Wingate test and the Bosco test outcomes (i.e., maximum height, mean exerted power, relative strength index, leg stiffness, contact time, and flight time) were measured for one month. Questionnaires confirmed a light-intensity self-administered physical activity. A significant effect of fatigue (Wilcoxon signed-rank test p < 0.05) on measured variables was confirmed for the four weeks. The analysis of the normalized variations of the aforementioned parameters allowed the distinguishing of two behaviors: downfall in the first two weeks, and recovery in the last two weeks. Instrumental results suggest a physiological and ballistic (i.e., Bosco test outcomes) recovery after four weeks. As concerns the explosive skills, the observational data are insufficient to show complete recovery.

Training During the COVID-19 Lockdown: Knowledge, Beliefs, and Practices of 12,526 Athletes from 142 Countries and Six Continents

Objective

Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020).

Results

Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], plyometric exercise [30%]) at pre-lockdown levels (higher among world-class, international, and national athletes), with most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification.

Conclusions

COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01573-z.

The Effects of Physical Inactivity and Exercise at Home in Young Patients with Congenital Heart Disease during the COVID-19 Pandemic

Background: The COVID-19 pandemic had a significant impact on the population’s ability to be physically active. Purpose: Evaluate the effect of the COVID-19 mitigation measures on exercise tolerance in patients with congenital heart disease (CHD). Materials and methods: All subjects (880, 6–18 years old) who performed a stress test at our hospital from October 2020 to February 2021 and had a similar test one year earlier were enrolled. A questionnaire on the degree of physical activity carried out in 2020 concerning the period prior to the pandemic was compiled. Exercise tolerance and the main anthropometric parameters between the first and second tests were compared. Results: 110 subjects (11.9 ± 4.1 years) were included in the study. The percentage of patients engaged in regular physical activity (RPA) decreased significantly during the pandemic (p < 0.001), and BMI increased significantly (p < 0.001), except among the subjects who began RPA during the lockdown, whereas test duration did not decrease significantly overall but increased in this last subgroup (p < 0.05) Conclusions: The COVID-19 lockdown led to a less active lifestyle with a significant increase in BMI in our group of CHD. These data could have negative effects on the risk profile of this population. RPA practiced at home seems to be effective in counteracting such effects.

Achilles' tendon rupture dancing the 'Jerusalema' - A case series

Introduction and importance

The weekend warrior has long been prey to musculoskeletal injuries as a result of intermittent, high intensity activity. The Achilles tendon is known to be particularly vulnerable in this population cohort but during the COVID-19 lockdowns in Ireland and all over the world there has been a certain level of detraining and deconditioning among all age groups and populations.

Throughout the worldwide restrictions, viral internet challenges and dances have encapsulated the spirit of a global community with the ‘Jerusalema’ dance being no exception. The rise of this particular viral sensation was at the detriment of the Achilles tendons of three middle aged gentlemen on who we base our case series.

Presentation of cases

Over the space of ten days three cases of Achilles tendon rupture repair presented to the emergency department in Midlands Regional Hospital Tullamore (MRHT) with the mechanism of tendon rupture being through the ‘Jerusalema’ dance.

These patients were surgically managed in line with local institution practice and postoperative outcomes were good with no complications noted. Follow up is ongoing.

Clinical discussion

This retrospective case series is based on the impact of the ‘Jerusalema Dance’ on presentations of Achilles tendon rupture to the Emergency Department in a single regional hospital from January to March 2021. We used these cases in conjunction with a review of current literature to highlight the benefit of an integrated Achilles Tendon rehabilitation programme in this at-risk patient cohort.

Conclusion

This paper highlights the dangers inherent when well intentioned, but physically deconditioned individuals endeavour to perform a physical exercise which is deceptively demanding. Going forward, viral challenges such as the ‘Jerusalema’ may contribute to new and interesting mechanisms of injuries in our ‘weekend warrior’ cohort. In addition to this, given the global deconditioning seen due to the COVID 19 pandemic and subsequent lockdowns we may see a higher rate of Achilles tendon injuries in the near future across a multitude of patient cohorts. Level one evidence suggests that conservative treatment is just as effective as surgical treatments in the majority of patients with an Achilles tendon rupture, as long as a protocol of rehabilitation with early weightbearing is performed. Our accelerated rehabilitation programme in MRHT is in line with others however internal audit and new literature in the future may enable us to refine it further.

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Achilles Tendon Rupture is common amongst the conditioned and deconditioned population.

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Surgical and conservative management options are widely explored in the literature.

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Viral dance challenges such as the Jerusalema offer new and interesting patterns of injury.

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An early weightbearing rehabilitation programme after TA rupture shows lower re-rupture rates.

Impact of the SARS-CoV-2 Coronavirus Pandemic on Physical Activity, Mental Health and Quality of Life in Professional Athletes-A Systematic Review

Due to the rapid rate of spread of the SARS-CoV-2 coronavirus, a number of restrictions have been introduced into public spaces, including those related to the operation of sports facilities, compounding the difficulty for athletes to conduct appropriate forms of training. The aim of this study was to review current scientific reports assessing the impact of the pandemic on the physical activity, mental state, and quality of life of professional athletes. Popular scientific databases—PubMed, Scopus, and Embase—were systematically searched from the beginning of the pandemic until 12 July 2021. According to the adopted criteria, 14 articles were included in the review. Ten of the qualified studies determined the impact of the pandemic on the physical activity of athletes. The authors of 11 papers assessed the mental state and quality of life of athletes during the pandemic. The studies showed negative effects of the pandemic: a decrease in overall physical fitness and number of days and hours of training, as well as an increase in the occurrence of negative emotions (stress, fatigue, and depression) and a decrease in sleep quality. Changes in physical activity had an impact on overall well-being ratings, which depended on the sex of the subjects. Women were more likely to experience negative emotions compared to men. The mental state of the athletes affected the quality of sleep. This review summarises the negative effects of the SARS-CoV-2 coronavirus pandemic on the physical and mental health of professional athletes.

Effects of a period without mandatory physical training on maximum oxygen uptake and anthropometric parameters in naval cadets

The effects of a period without physical training on the civilian population are well established. However, no studies show the effects of a period without mandatory physical training on maximum oxygen uptake (VO₂ max) and anthropometric parameters in naval cadets. This study aimed to investigate changes in VO₂ max and anthropometric parameters after 12 weeks without mandatory physical training in naval cadets. The sample was 38 healthy and physically active naval cadets. The measured variables, including VO₂ max and anthropometric parameters, were evaluated through the 12-minute race test (12MRT) and the somatotype. Both variables had a separation of 12 weeks without mandatory physical training. A t-test for related samples was used to evidence changes between the test and post-test; effect size was calculated through Cohen’s d-test. Distance in 12MRT and VO₂ max showed significant decreases at the end of 12 weeks without mandatory physical training (p < 0.001). Likewise, the tricipital skinfold thickness and the endomorphic component showed significant increases (p < 0.05). 12 weeks without mandatory physical training significantly reduces the VO₂ max in naval cadets. Simultaneously, the same period without physical training increases both the tricipital skinfold thickness and the endomorphic component in this population.

Impact of lockdown on musculoskeletal health due to COVID-19 outbreak in Bangladesh: A cross sectional survey study

BACKGROUND

During the nationwide lockdown implemented by the government of Bangladesh due to the coronavirus, has led to the various changes in the overall activities and lifestyle. Most of the people began living a sedentary lifestyle, spending more time on their phone, watching television and excessive sleeping. Reduction of physical activity level had profoundly negative impact on musculoskeletal health.

AIM

This study aims to investigate the impact of lockdown on musculoskeletal health, association between leisure and musculoskeletal pain during this period.

METHODS

A cross sectional study was conducted among general populations living in a specific area of Bangladesh by simple random sampling methods. A total of 230 participants both male (182) and female (48) age group between 18-60 years have participated. The study was carried out by sending the Google Form link containing demographic questionnaire, numeric pain rating scale and Nordic musculoskeletal Questionnaire. Wilcoxon sign rank t and Chi squire test was used to analyze the data.

RESULTS

The mean height, weight and BMI of the participants were 164.17 ± 8.40 cm, 63.82 ± 10.70 kg and 23.74 ± 3.97 kg/m2 respectively. There was significant increase in time spent in watching television (p= < 0.0001), using smartphone (p= < 0.0001) and sleeping (p= < 0.0001) during the lockdown period. 33.9% participants had pain before the lockdown which increased by 57% during the lockdown periods. There was a significant association between pain intensity and sleeping time (X2 = 54.84; p= < 0.0001), time spent watching television (X2 = 83.70; <0.0001), time spent on smartphone (X2 = 58.39; <0.0001) during the lockdown period.

CONCLUSION

The result of this study concluded that the lockdown has negatively impacted the musculoskeletal health of the participants. The musculoskeletal pain might be short term initially, but can develop to be a long-term problem and burden if proper measures are not taken.

Living in the "Bubble": Athletes' Psychological Profile During the Sambo World Championship

Background: The COVID-19 pandemic has changed the way we conduct daily life, as well as sports training and sports competitions. Given the stress produced by COVID-19, and the "bubble" safety measures for the World Sambo Championship, held in Novi Sad, from the 6th to the 8th of November, 2020, athletes might have experienced more stress than athletes normally would in non-pandemic conditions. Therefore, the current study aimed to create a psychological profile of sambo athletes participating in the Sambo World Championship and living in this condition. Methods: One-hundred-fifteen participants took part in the study, completing the Profile of Mood Scale (POMS), the Pittsburg Sleep Quality Index, the Perceived Stress Scale (PSS), and the Fear of COVID-19 Scale. A mediation model with Fear of COVID-19 predicting both stress level directly and stress level through mood disturbance was hypothesized. Gender differences were evaluated through t-test. Results: The results showed that the sample presented higher levels of stress but no problems in sleeping. In particular, data analysis confirmed an indirect effect of Fear of COVID on Perceived stress through mood disturbance (β = 0.14, Z = 2.80, and p = 0.005), but did not have a significant impact on the direct effect (β = -0.04, Z = -0.48, and p = 0.63). Gender differences emerged in the perceived stress level (t = -2.86, df = 114, and p = 0.005) and daytime dysfunction (t = -2.52, df = 114, and p = 0.01) where females scored higher than males for both aspects. Conclusion: The athletes participating to the World Sambo Championship experienced stress levels determined by the mood disturbance produced by the fear of the COVID-19 pandemic. Female athletes were more stressed and showed higher daytime dysfunction. The findings of the current study are useful to understand the psychological profile of the athletes competing in the "bubble" conditions during COVID-19 pandemic.

Do personality traits have an impact on anxiety levels of athletes during the COVID-19 pandemic?

BACKGROUND

The sports world is one of the sectors most affected by the SARS-CoV-2 (COVID-19) pandemic. Athletes from specific sport disciplines have experienced the new situation in different ways. Therefore, understanding their individual experiences and psychological responses may help to design better intervention programs. Accordingly, this study investigated the relationship between athletes' personality traits and anxiety in the light of their individual experiences during the COVID-19 pandemic.

PARTICIPANTS AND PROCEDURE

The COVID-19 impact questionnaire, Big Five Inventory-35, and the State-Trait Anxiety Inventory were administered to 321 male and 168 female athletes in Turkey from various sport disciplines. At the time of data collection, training and competitions had been canceled in all sports for two months.

RESULTS

Most athletes (70.7%) were worried about being infected with SARS-CoV-2 if competitions were to restart soon. The regression analyses revealed that emotional stability, extroversion, and age were negative predictors of state anxiety; emotional stability, extroversion, and conscientiousness were negative predictors of trait anxiety; agreeableness was a positive predictor of state anxiety. Athletes who perceived that their relationships with family or close friends worsened during home confinement (17.2%) had significantly higher state anxiety and trait anxiety scores than those who perceived a positive relationship change (28%) or no relationship change (54.8%). The agreeableness, conscientiousness, and emotional stability scores of athletes who perceived a negative relationship change with family or close friends were also significantly lower than for athletes who perceived no change or a positive change.

CONCLUSIONS

Overall, personality traits affected athletes' anxiety levels and their relationships during the COVID-19 pandemic.

COVID-19 pandemic impacts physical activity levels and sedentary time but not sleep quality in young badminton athletes

Purpose

Regular physical activity is a good strategy to maintain the health of athletes, and prevent pain and decreased joint flexibility during the pandemic. On the other hand, higher sedentary time during the pandemic period can have deleterious effects. The objective of this study was to compare physical activity levels, sedentary time, and sleep parameters during the pre-COVID period and the COVID-19 pandemic period in young badminton athletes.

Methods

Fifteen young badminton athletes were evaluated during a pre-COVID period (July 2019) and during the COVID-19 period (July 2020). Sleep parameters, physical activity level, and sedentary time were measured using a tri-axial accelerometer. Participants wore the accelerometer on their dominant wrist for 7 days consecutively. In addition, the average of each sleep parameter [time in bed and total sleep time in hours per day, sleep efficiency (%), wake after sleep onset (WASO, total per day), and sleep latency (minutes per day)] was reported over the 7-day period.

Results

Athletes presented increased sedentary time (pre-COVID = 7.0 ± 1.1 vs.COVID-19 = 8.9 ± 1.9 h/day, p = 0.004, d = 1.30) and significant decreases in the total PA observed in counts per day (pre-COVID = 2,967,064.4 ± 671,544.1 vs. COVID-19 = 1,868,210.2 ± 449,768.4 counts/day, p = 0.001, d = 1.99), time in vigorous PA (pre-COVID = 7.7 ± 0.9 vs. COVID-19 = 6.1 ± 1.2 h/day, p = 0.001, d = 1.56), and time in moderate-to-vigorous PA (pre-COVID = 8.1 ± 0.9 vs. COVID-19 = 6.5 ± 1.3 h/day, p = 0.001, d = 1.48). There were no significant differences for time in light and moderate PA or in sleep parameters (p > 0.05).

Conclusion

Young badminton athletes presented increased sedentary time, and decreased total physical activity, time in MVPA, and time in vigorous activities during the COVID-19 pandemic compared to the pre-COVID period, however, there were no significant differences in sleep parameters.

Cardiorespiratory Fitness in Volleyball Athletes Following a COVID-19 Infection: A Cross-Sectional Study

Athletes' lifestyles have been dramatically affected by the coronavirus disease 2019 (COVID-19) pandemic. Since COVID-19 primarily affects the respiratory system and to a lesser degree the cardiovascular system, the goal of this study was to examine the effects of COVID-19-caused detraining on cardiorespiratory fitness (CRF) of recently recovered volleyball athletes. Sixteen experienced volleyball athletes (age 24 ± 4.5 years) who were recently diagnosed and recovered from a COVID-19 infection volunteered to participate in this study and were tested for CRF and spirometry. Given that participants had only mild symptoms of infection, the primary focus of this study was on the effects of detraining on CRF. On average, the time to exhaustion was 9.4 ± 1.4 min. VE, VCO2, RER and oxygen pulse increased, heart rate exceeded 90% of predicted values, and peak VO2 values were typical for this level of athlete (44.1 ± 3.4 mL/kg). Pulmonary function reflected in FVC, FEV1/FVC and MVV values were well above 80% of predicted values for each of the participants while electrocardiography revealed no ischemia, arrythmias or conduction and repolarization abnormalities were found in the tested subjects. Therefore, it can be concluded that participants experienced typical consequences of detraining. Due to a lack of CRF data prior to COVID-19 infection, we were unable to estimate the magnitude detraining had on CRF. Complete CRF assessment after COVID-19 infection in athletes can be useful for screening of residual myocardial and/or respiratory system damage for safe return-to-play decisions.

Mood Responses and Regulation Strategies Used During COVID-19 Among Boxers and Coaches

The COVID-19 pandemic brought unprecedented changes to daily life and in the first wave in the UK, it led to a societal shutdown including playing sport and concern was placed for the mental health of athletes. Identifying mood states experienced in lockdown and self-regulating strategies is useful for the development of interventions to help mood management. Whilst this can be done on a general level, examination of sport-specific effects and the experience of athletes and coaches can help develop interventions grounded in real world experiences. The present study investigated perceived differences in mood states of boxers before and during COVID-19 isolation in the first lockdown among boxers. Boxing is an individual and high-contact sport where training tends to form a key aspect of their identity. Boxers develop close relationships with their coach and boxing. Hence boxers were vulnerable to experiencing negative mood, and support via the coach was potentially unavailable. Participants were 58 experienced participants (44 boxers, male n = 33, female n = 11; 14 boxing coaches, male n = 11, female n = 3). Boxers completed the Brunel Mood Scale to assess mood before COVID-19 using a retrospective approach and during COVID-19 using a "right now" time frame. Boxers responded to open-ended questions to capture mood regulation strategies used. Coaches responded to open ended questions to capture how they helped regulate boxer's mood. MANOVA results indicated a large significant increase in the intensity of unpleasant moods (anger, confusion, depression, fatigue, and tension) and reduction in vigor during COVID-19 (d = 0.93). Using Lane and Terry (2000) conceptual framework, results showed participants reporting depressed mood also reported an extremely negative mood profile as hypothesized. Qualitative data indicated that effective mood-regulation strategies used included maintaining close coach-athlete contact and helping create a sense of making progress in training. When seen collectively, findings illustrate that mood state responses to COVID-19 were severe. It is suggested that that active self-regulation and self-care should be a feature of training programmes to aid coaches and boxers in regulating mood when faced with severe situational changes.

Adapted Physical Activity to Ensure the Physical and Psychological Well-Being of COVID-19 Patients

The novel coronavirus disease 2019 (COVID-19) has been responsible for a global pandemic involving massive increases in the daily numbers of cases and deaths. Due to the emergency caused by the pandemic, huge efforts have been made to develop COVID-19 vaccines, the first of which were released in December 2020. Effective vaccines for COVID-19 are needed to protect the population, especially healthcare professionals and fragile individuals, such as older people or chronic-disease-affected patients. Physical exercise training generally has health benefits and assists in the prevention of several chronic diseases. Moreover, physical activity improves mental health by reducing anxiety, depression, and negative mood and improving self-esteem. Therefore, the present review aims to provide a detailed view of the literature, presenting updated evidence on the beneficial effects of adapted physical activity, based on personalized and tailor-made exercise, in preventing, treating, and counteracting the consequences of COVID-19.

Amateur and Recreational Athletes' Motivation to Exercise, Stress, and Coping During the Corona Crisis

The COVID-19 pandemic has negatively impacted mobility worldwide. As a corollary, the health of top- and lower-level athletes alike is profoundly reliant on movement and exercise. Thus, the aim of this study is to understand impacts of the COVID-19 pandemic lockdown on athletes' motivation to exercise and train. In detail, we aim to better understand who (i.e., demographic, sport-specific, and psychological state and trait variables) reported a change in motivation to train due to the lockdown, why they reported lower motivation (i.e., open-ended questions on problems), what they did to help themselves, what support they received from others, and what they are looking forward to after the lockdown (i.e., open questions). Questionnaire data and answers to these open-ended questions were assessed via an online questionnaire, completed by 95 amateur and recreational athletes during the first COVID-19 lockdown in Germany (April to mid-May 2020). Results show that greater numbers of female athletes are less motivated to train in comparison to male athletes (p = 0.029). No differences in motivation were found regarding type of sport (individual vs. team sport) and number of competitions during the year. Also, more motivated to train amateur and recreational athletes showed lower athletic identity than athletes who reported no change in motivation to exercise during the lockdown (p = 0.03). Additionally, differences in state emotional, perceived stress, and personality variables (i.e., orientation to happiness, volition) were found between athletes who stated that they were less motivated to train compared to athletes who reported no changes in motivation. In particular, closure of sports facilities and social distancing measures were perceived to be highly problematic. Even though athletes received emotional support, organized themselves via routines and schedules, and trained using online tools, they predominately stated that they wished that their coaches would have supported them more. Understanding the impacts of a pandemic-related lockdown on athletes' motivation, athletes' coping strategies, and their desired support will help better support them in future crises.

Anxiety and Motivation to Return to Sport During the French COVID-19 Lockdown

Feeling anxious and presenting self-determined motivations about returning to sport after a break may impair sport performance and increase the risk of sustaining an injury. Hence, the aim of this study is to explore differences in anxiety and motivation to return to sport according to gender, expertise, training status before and during the lockdown, and athletes' availability (i.e., injury status) at the time of the lockdown. A total of 759 competitive athletes (49% female; mean age: 27 ± 10 years old) completed the cross-sectional study. Participants were invited to state their expertise, training status before and during the lockdown (did they have a training program), and whether they were injured at the start of the lockdown. Additionally, participants filled out psychometric self-report measures of anxiety (TFAI-return) and motivation (SMS-return) to return to sport. Due to non-normal distributions in the TFAI and SMS scores, non-parametric group comparisons were performed to compare participants for each categorical variable: non-parametric correlation tests were also performed to test the associations between continuous variables. Group comparisons showed higher scores of anxiety for females, younger athletes, athletes practicing and competing at the highest level, and athletes without a training program during the lockdown. Moreover, results suggested lower motivation scores (i.e., autonomous and controlled) for older athletes, experts (practicing for more than 10 years), athletes practicing and competing at a lower level, and athletes without a training program during the lockdown. Additionally, participants who were injured at the start of the lockdown reported higher scores of cognitive anxiety to return to sport than non-injured participants. The results of this study suggest that elite athletes may have suffered from external pressures to return to sport during the lockdown. Additionally, participants with a training program during the lockdown seemed to be less anxious and more self-determined to return to sport after the lockdown. Future studies may focus on the impact of cognitive behavioral interventions on anxiety and motivation to return to sport.

Dental Office Prevention of Coronavirus Infection

Coronavirus disease is now spreading in different countries of the world. The alarmism created through the media also creates confusion in people about virus spreading. The health care environments among which the dental practice could be places of spread of the virus, especially places where patients with systemic pathology could be exposed to this. The purpose of this article is to clarify coronavirus disease 2019 and its management in the dental practice. Only by following the normal guidelines on disinfection and sterilization of environments and operators, with some additional rules on the management of patients in the waiting room, it is possible to limit this risk. Limiting the risk of spreading the virus is one of the keys to its eradication.

Stay Home: Role of Physical Exercise Training in Elderly Individuals' Ability to Face the COVID-19 Infection

Recently, the novel coronavirus epidemic occurred in China and spread worldwide to become a global pandemic. COVID-19 is a fatal viral infection causing death, particularly in aged individuals, due to impaired immunity. To date, no intervention is available to prevent COVID-19 and its manifestations. Physical exercise training generally has health benefits, and it assists in the prevention of several chronic diseases. Therefore, this review is aimed at exploring the role of physical exercise training in the face of COVID-19 in older adults and elderly individuals. From this point of view, this review suggests that physical exercise training plays a key role in promoting immune system regulation, delaying immunity dysfunction, reducing circulatory inflammation markers, and preventing sarcopenia and thus could prevent the risk of acquiring COVID-19 infection and reduce the complications of recommended self-isolation in older adults and elderly individuals. Additionally, immunity biomarkers were optimistically demonstrated in older adults following physical exercise training, thereby reducing mortality and morbidity rates. Finally, in accordance with recommendations to stay home and perform self-isolation to prevent the spread of COVID-19, all populations are strongly recommended to practice regular home exercise training at home to promote immune system functioning.

#Quarantineworkout: The Use of Digital Tools and Online Training Among Boxers and Boxing Coaches During the COVID-19 Pandemic

The purpose of this article is to explore the use of online training strategies and digital tools amongst coaches and athletes in boxing clubs during the COVID-19 pandemic and the subsequent shutdown of organized sport. A digital qualitative research strategy was applied to boxing clubs, boxers, and boxing coaches in Norway. A total of 46 official clubs, athletes, and coach pages on Facebook were followed from 12th March to 30th June 2020, resulting in a sample of 78 social media posts (texts, photos, and videos). A content analysis approach was used for the material. The results show that the use of digital tools amongst the studied Norwegian coaches and boxing clubs varied in frequency and form during the spring of 2020 (COVID-19 shutdown). For them, the most frequent use of digital instruments was to communicate internally and externally about the COVID-19 situation, national rules and guidelines. The material demonstrated that online training strategies varied between different constellations of three specific factors: (1) synchronized (live-streamed) online training and unsynchronized online training (at home training videos and programmes), (2) publicly published online training that was only accessible through digital registration, and (3) free online training and online training that was only available to paying members. For the athletes in the material, the most frequent content was social media posts for self-promotion purposes. Additionally, several of the athletes expressed that they struggled to cope with and manage the training at home during lockdown, and that they deeply missed training and competing as usual.

New and developing diagnostic platforms for COVID-19: A systematic review

INTRODUCTION

The starting months of 2020 witnessed a global pandemic of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. The first case of Coronavirus Disease 2019 (COVID-19) was reported in December, 2019 in Wuhan, China and millions of cases and thousands of deaths were reported within five months. Currently, reverse transcription-polymerase chain reaction (RT-PCR) and computed tomography (CT) scanning are clinically prescribed for COVID-19 detection across the globe.

AREAS COVERED

This systematic review is focused on currently used diagnostic methods for COVID-19 detection and their future prospects. Online searches on Google Scholar, PubMed and online resources were conducted on the period of year 2017 to mid-2020. Studies investigating laboratory examinations, radiographical analysis, and potential sensors for COVID-19 detection were included. Along with this, the current status of commercially available kits for SARS-CoV-2 coronavirus detection is discussed.

EXPERT OPINION

The search has identified the potential applications of nucleic acid technology, diagnostics radiology examinations, and in-vitro diagnostic kits in detection of COVID-19 infections. Despite having their own limitations of each technology, the emerging diagnostic technologies for COVID-19 detection along with undergoing clinical trials are summarized suggesting more collaborations and funding are required for fast track clinical trials.

The diagnostic methods in the COVID-19 pandemic, today and in the future

INTRODUCTION

The emergence of anovel coronavirus identified in patients with unknown cause of acute respiratory disease in Wuhan, China at the end of 2019 has caused aglobal outbreak. The causative coronavirus was later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease caused by SARS-CoV-2 was named as Coronavirus Disease-2019 (COVID-19). As of 10 August 2020, more than 19,718,030 confirmed cases and 728,013 deaths have been reported. COVID-19 is spread via respiratory droplets which are inhaled into the lungs.

AREAS COVERED

In this article, we summarized the knowledge about the causative pathogen of COVID-19 and various diagnostic methods in this pandemic for better understanding of the limitations and the nuances of virus testing for COVID-19.

EXPERT OPINION

In this pandemic, rapid and accurate identification of COVID-19 patients are critical to break the chain of infection in the community. RT-PCR provides a rapid and reliable identification of SARS-CoV-2 infection. In the future, molecular diagnostics will still be the gold standard and next-generation sequencing can help us to understand more on the pathogenesis and detect novel mutations. It is believed that more sophisticated detection methods will be introduced to detect SARS-CoV-2 as earliest as possible.

SARS-CoV-2 Persistence: Data Summary up to Q2 2020

The coronavirus pandemic is causing confusion in the world. This confusion also affects the different guidelines adopted by each country. The persistence of Coronavirus, responsible for coronavirus disease 2019 (Covid-19) has been evaluated by different articles, but it is still not well-defined, and the method of diffusion is unclear. The aim of this manuscript is to underline new Coronavirus persistence features on different environments and surfaces. The scientific literature is still poor on this topic and research is mainly focused on therapy and diagnosis, rather than the characteristics of the virus. These data could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.

The impact of physical activity on psychological health during Covid-19 pandemic in Italy

The worldwide spread of COVID-19 has upset the normality of Italian daily life, forcing population to social distancing and self-isolation. Since the containment precautions also concern sport-related activities, home workout remained the only possibility to play sports and stay active during the pandemic. The present study aimed to examine changes in the physical activity levels during self-quarantine in Italy, and the impact of exercise on psychological health. A total of 2974 Italian subjects has completed an online survey, but only 2524 subjects resulted eligible for this study. The questionnaire measured the total weekly physical activity energy expenditure before and during quarantine (i.e. the sum of walking, moderate-intensity physical activities, and vigorous-intensity physical activities) in Metabolic Equivalent Task minutes per week (MET-min/wk) using an adapted version of International Physical Activity Questionnaire and their psychological well-being using the Psychological General Well Being Index. Of the 2524 Italian subjects included in the study, 1426 were females (56.4%) and 1098 males (43.6%). Total physical activity significantly decreased between before and during COVID-19 pandemic (Mean: 2429 vs. 1577 MET-min/wk, ∗∗∗∗p < 0.0001), in all age groups and especially in men (Female, mean: 1994 vs. 1443 MET-min/wk, ∗∗∗∗p < 0.0001; Male, mean: 2998 vs. 1754 MET-min/wk, ∗∗∗∗p < 0.0001). Furthermore, a significant positive correlation was found between the variation of physical activity and mental well-being (r = 0.07541, ∗∗∗p = 0.0002), suggesting that the reduction of total physical activity had a profoundly negative impact on psychological health and well-being of population. Based on this scientific evidence, maintaining a regular exercise routine is a key strategy for physical and mental health during a forced rest period like the current coronavirus emergency.

Physical Activity Levels and Related Energy Expenditure during COVID-19 Quarantine among the Sicilian Active Population: A Cross-Sectional Online Survey Study

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Italian government has adopted containment measures to control the virus’s spread, including limitations to the practice of physical activity (PA). The aim of this study was to estimate the levels of PA, expressed as energy expenditure (MET–minute/week), among the physically active Sicilian population before and during the last seven days of the COVID-19 quarantine. Furthermore, the relation between this parameter and specific demographic and anthropometric variables was analyzed. Methods: 802 Sicilian physically active participants (mean age: 32.27 ± 12.81 years; BMI: 23.44 ± 3.33 kg/m2) were included in the study and grouped based on gender, age and BMI. An adapted version of the International Physical Activity Questionnaire—short form (IPAQ-SF) was administered to the participants through an online survey. The Wilcoxon signed-rank test and the Kruskal-Wallis rank-sum test were used for statistical analyses. Results: As expected, we observed a significant decrease of the total weekly energy expenditure during the COVID-19 quarantine (p < 0.001). A significant variation in the MET–min/wk in the before quarantine condition (p = 0.046) and in the difference between before and during quarantine (p = 0.009) was found for males and females. The male group decreased the PA level more than the female one. Moreover, a significant difference in the MET–min/wk was found among groups distributions of BMI (p < 0.001, during quarantine) and of age (p < 0.001, both before and during quarantine). In particular, the highest and the lowest levels of PA were reported by the young and the elderly, respectively, both before and during quarantine. Finally, the overweight group showed the lowest level of PA during quarantine. Conclusion: Based on our outcomes, we can determine that the current quarantine has negatively affected the practice of PA, with greater impacts among males and overweight subjects. In regards to different age groups, the young, young adults and adults were more affected than senior adults and the elderly.