Analysis of a Division I Sports Medicine Program's COVID-19 Protocol: Identifying Factors that Predict Testing Demands and Positive Rates During a Pandemic

OBJECTIVE

To determine factors indicating testing frequency and positive test results in a Division I sports department intrapandemic.

DESIGN

Retrospective analysis.

SETTING

A single Division I collegiate sports department.

PATIENTS

All student-athlete (n = 437), student staff (n = 89), and adult staff (n = 202) members of the sports department. Total cohort (n = 728).

INTERVENTIONS

The authors analyzed the independent variables of local positive rates, sport characteristics, and campus events for impact on the volume of the departmental testing and positive rates.

MAIN OUTCOME MEASURES

Measured dependent variables of the volume of departmental testing and positive rates were analyzed.

RESULTS

Positive predictive rates (PPRs) largely differed from local, off-campus rates in timing and duration (59.52%: P < 0.05). Overall, 20633 tests were administered with 201 positive results (0.97% PPR). Student-athlete numbers were highest in all categories, followed by adult then student staff. Greater proportions of contact sports became positive (53.03%: P < 0.001) and all-male sports (47.69%: P < 0.001). No comparative difference was seen for teams using fomites (19.15%: P = 0.403). Spring sports teams had the lowest percentage of the team positive (22.22%: P < 0.001). Winter sports had the highest PPR (1.15%), all occurring during team-controlled activities. Playing sports indoors did not increase inside team-controlled activity positive rates ( P = 0.066).

CONCLUSIONS

Longitudinal changes in local, off-campus infection rates partially affected sports departmental positive results while testing rates were more influenced by sport and university schedule. Testing resources should be directed toward high-risk sports, which included contact sports (football, basketball, and soccer), all-male teams, both Winter and indoor sports inside team-controlled activities, and sports with long periods of time outside team-controlled activities.

Clinical efficacy of ciprofloxacin compared with placebo in bacterial diarrhea

In a double-blind, randomized trial, 85 adult patients with acute diarrhea (more than three watery stools per day) received either 500 mg of ciprofloxacin twice daily or placebo for five days. Seventy-six patients were evaluated, 38 patients in the ciprofloxacin group (16 with Salmonella species, 19 with Campylobacter jejuni, and three with Shigella species) and 38 patients in the placebo group (21 with Salmonella species, 11 with C. jejuni, and six with Shigella species). The duration of fever in patients treated with ciprofloxacin was 1.3 days versus 3.1 days in the placebo group (p less than 0.05). The mean duration of diarrhea in the ciprofloxacin group was 1.5 days versus 2.9 days in the placebo group (p less than 0.001). The corresponding numbers in patients with salmonellosis were 1.9 versus 3.4 days (p less than 0.01). In the ciprofloxacin group, all stool culture results became negative within 48 hours of treatment. Relapse occurred in four patients with salmonellosis within three weeks after the end of treatment. In the placebo group, only four of 38 patients had negative stool culture results during treatment and results were negative in only 13 at one week after the treatment period (p less than 0.001). Modest transient elevation of serum transaminase levels was detected in three patients in the ciprofloxacin group and in two patients in the placebo group. Epigastric pain occurred in one patient, and leukopenia occurred in one patient in the ciprofloxacin group. Gastrointestinal discomfort was recorded in two patients and rash was found in one patient in the placebo group.