Higher rates of concussion following COVID-19 infection in high school athletes

Abstract

ObjectiveTo compare concussion rates (CRs) over one academic year in high school athletes with and without a COVID-19 infection prior to concussion.MethodsIllness and concussion were prospectively reported for male and female high school athletes across six states over one academic year in the Players Health Rehab surveillance system. Concussion was truncated to 60 days following recovery and return to sport from COVID-19. CRs were estimated per 1000 athletes per academic year and stratified by those who tested positive for COVID-19 infection (with COVID-19) and those who did not (no COVID-19). Poisson regression analyses estimated rate ratio (RR) of concussion controlling for state, gender and an offset of the log athlete participation (with COVID-19 and no COVID-19).ResultsOf 72 522 athletes, 430 COVID-19 infections and 1273 concussions were reported. The CR was greater in athletes who reported COVID-19 (CR=74.4/1000 athletes/year, 95% CI 49.6 to 99.3) compared with those who did not (CR=17.2, 95% CI 16.3 to 18.2). Athletes with recent COVID-19 had a threefold higher rate of concussion (RR=3.1, 95% CI 2.0 to 4.7).ConclusionAthletes returning from COVID-19 had higher CRs than those who did not experience COVID-19. This may be related to ongoing COVID-19 sequelae or deconditioning related to reduced training and competition load during the illness and when returning to sport. Further research is needed to understand the association of recent COVID-19 infection and concussion in order to inform preventive strategies.

Incidence of Concussions in Elite Female Water Polo: A Retrospective Analysis

“…The link between the incidence of concussions and COVID-19 infections is outside the scope of this study; however, this was also recently observed in a cohort of high school athletes. 34 This study suffers from limitations because of the relatively small sample of participants; however, it contributes to filling the knowledge gap about concussions in female athletes. 35 In the 2020 to 2021 season, most international competitions were cancelled because of the COVID-19 pandemic, and the low prevalence observed should be considered with this context in mind.…”

“…The link between the incidence of concussions and COVID-19 infections is outside the scope of this study; however, this was also recently observed in a cohort of high school athletes. 34…”

Long-Term Effects of SARS-CoV-2 in the Brain: Clinical Consequences and Molecular Mechanisms

“…As mentioned above, neurological symptoms seen in individuals with post-concussive syndrome (PCS) are strikingly similar to neurological symptoms occurring in COVID-19, either in acute or long COVID cases, and include headaches, dizziness, and problems with concentration and memory [87]. A recent study by Bullock and collaborators [88] showed that high school athletes who had an active COVID-19 infection were three times more likely to sustain a concussion. This may be due to deconditioning because of reduced training habits during illness but could also potentially be due to parallel pathophysiological events in the brain.…”