COVID-19 Infection among Elite Football Players: A Nationwide Prospective Cohort Study

Abstract

Little is known about the risk of COVID-19 infection among footballers. We aimed to investigate the incidence and characteristics of COVID-19 infection among footballers. In total, 480 football players of Super League Greece and 420 staff members participated in a prospective cohort study, which took place from May 2020 to May 2021. Nasopharyngeal swabs were collected from footballers and staff members weekly. All samples (n = 43,975) collected were tested using the reverse transcriptase polymerase chain reaction (RT-PCR) test for the detection of “SARS-CoV-2”. In total, 190 positive cases (130 among professional football players and 60 among staff) were recorded. Out of the 190 cases that turned positive, 64 (34%) cases were considered as symptomatic, and 126 (66%) cases were asymptomatic. The incidence rate of a positive test result for footballers was 0.57% (confidence interval (CI) 0.48–0.68%) and for staff members it was 0.27% (CI 0.20%, 0.34%), respectively. Footballers recorded a twofold increased risk of COVID-19 infection in comparison to staff members (relative risk = 2.16; 95% CI = 1.59–2.93; p-value < 0.001). No significant transmission events were observed during the follow-up period. We found a low incidence of COVID-19 infection among professional footballers over a long follow-up period. Furthermore, the implementation of a weekly diagnostic testing (RT-PCR) was critical to break the transmission chain of COVID-19, especially among asymptomatic football players and staff members.

How Different Predominant SARS-CoV-2 Variants of Concern Affected Clinical Patterns and Performances of Infected Professional Players during Two Soccer Seasons: An Observational Study from Split, Croatia

“…These clusters are similar to the corresponding waves notified nationwide in the same period of time, as well as pandemic waves that were recorded simultaneously across Europe [41,42]. It is reasonable to assume that the disease incidence in the community would impact the burden of the disease among the players and should thus be accounted for as presented in a study by Papagiannis [32].…”

“…Symptoms' presentation, the severity of the disease, the number of days without physical activity, as well as the time to return to full form after isolation, showed, to a large extent, similarity with other studies. All infected players in both seasons had mild clinical presentation of COVID-19 disease with no desaturation or required hospital care, as shown elsewhere [9,[11][12][13]31,32]. However, the proportion of asymptomatic cases in these studies highly varies.…”

“…This may be explained by different national testing recommendations/club testing protocols, study design, and dominant virus variant. Some sport clubs adopted the strategy of weekly testing to minimise the risk of transmission and avoid the clusters by reducing undetected asymptomatic players which was found to be useful to some extent [32]. In this soccer club, testing was performed only upon indication (after symptom appearance or following occurrence of cluster) and not as a part of a regular testing.…”

Risks, Epidemics, and Prevention Measures of Infectious Diseases in Major Sports Events: Scoping Review

“…Two studies indicated that the increase in COVID-19 cases and cluster epidemics during the 2020 European Football Championship (EURO) were more likely to occur as a result of aggregations and celebrations in private settings, pubs/other public buildings, or public squares rather than from the official football events [34,35]. In addition, previous studies found that athletes had a higher risk of COVID-19 than staff members during professional football competitions [36,37] (Figure 4).…”

Impact of COVID-19 on football attacking players’ match technical performance: a longitudinal study

“…Research into the impact of COVID-19 on individual players provides valuable insights for developing specific training and match preparation strategies. Representative studies on players primarily center on the SARS-CoV-2 infection rate 15 , 16 and transmission risk after resuming professional football 17 – 19 , the testing protocol 20 – 24 and surveillance for COVID-19 2 , 25 and infection control policies for players 26 . Certain studies offer practical suggestions for designing training sessions to aid players in returning to sports following the lockdown imposed by the COVID-19 pandemic 27 .…”