A deep dive into testing and management of COVID-19 for Australian high performance and professional sport

Abstract

The purpose of testing for any communicable disease is to support clinicians in the diagnosis and management of individual patients and to describe transmission dynamics. The novel coronavirus is formally named SARS-CoV-2 and the clinical disease state resulting from an infection is known as COVID-19. Control of the COVID-19 pandemic requires clinicians, epidemiologists, and public health officials to utilise the most comprehensive, accurate and timely information available to manage the rapidly evolving COVID-19 environment. High performance sport is a unique context that may look towards comprehensive testing as a means of risk mitigation. Characteristics of the common testing options are discussed including the circumstances where additional testing may be of benefit and considerations for the associated risks. Finally, a review of the available technology that could be considered for use by medical staff at the point of care (PoC) in a high-performance sporting context is included.

Diagnostic Efficiency of Three Fully Automated Serology Assays and Their Correlation with a Novel Surrogate Virus Neutralization Test in Symptomatic and Asymptomatic SARS-COV-2 Individuals

“…Also, a false positive PCR result or high CT-value (above 30 cycles) are plausible explanations, if an RT-PCR-positive COVID-19 participant had no detectable antibodies. It is noteworthy to mention that false positive PCR results due cross-contamination, or the interference of pure technical artifacts have been regularly documented even in the most highly regarded laboratories [ 45 , 46 , 47 ].…”

Deployment of COVID-19 diagnostic testing: challenges and key considerations for the future

“…This is often supported by isolation, social distancing, personal protective equipment for staff, and other measures to prevent infection. [87][88][89] In these professional settings, the funding is often available to test regularly to ensure that the sports continue to operate, and these decisions sit with the sporting leagues and national governments.…”

Considerations and best practices for elite football officials return to play after COVID-19 confinement

“…Therefore, a standardised pre-competition medical assessment (PCMA), comprising of a general physical, orthopedic, and detailed cardiac examination (with rest and exercise electrocardiogram), has become a crucial part in match officials' health protection (Bizzini et al, 2012;Keller et al, 2013). The PCMA must therefore be performed on referees before restarting a structured physical preparation towards match appointments in the agreed COVID-19 return to play phase (Hughes et al, 2020;Mooney et al, 2020). Additionally, within this pandemic situation, the medical staff must ensure that COVID-19 testing is systematically performed on the officiating team, and possibly add detailed pulmonary function tests.…”

“…Additionally, within this pandemic situation, the medical staff must ensure that COVID-19 testing is systematically performed on the officiating team, and possibly add detailed pulmonary function tests. However, currently no consensus of a specific medical screening in athletes after the COVID-19 pandemic period is available (Hughes et al, 2020;Mooney et al, 2020). The hygienic-sanitary prevention strategies for COVID-19 transmission must be strictly followed, and each "suspected" case must be accordingly medically managed.…”

“…The risk of contracting infections remains unpredictable, thus extreme caution in the return to play is warranted (M. Mohr et al, 2020;Nussbaumer-Streit et al, 2020). Specific reference to elite level match officials is justified since the stringent medical and physiological testing proposed by sport medicine national organisations is sustainable for this competitive level (Hughes et al, 2020;Mooney et al, 2020;Webb, 2020).…”