Association of COVID-19 incidence with objectively and subjectively measured mental health proxies in the Austrian Football League: an epidemiological study

van der Zee-Neuen, A.; Seymer, A.; Schaffler-Schaden, D.; Herfert, J.; O Brien, J.; Johansson, T.; Kutschar, P.; Ludwig, S.; Stoeggl, T.; Keeley, D.; Flamm, M.; Osterbrink, J.

Objective We aimed to explore the association of COVID-19 incidence with mental health in 225 team and staff members of five professional Austrian Football clubs captured by objective (location variance) or subjective (self-reported sleep quality, level of recovery, perceived risk of infection) mental health proxies. Methods Data collected during the implementation of a novel monitoring concept to enable safe continuation of professional Football during the COVID-19 pandemic were matched with Austrian COVID-19 incidence data and smartphone collected location data (time-period June 17th to July 31st, 2020). Multivariable linear regression models explored the association of COVID-19 incidence, defined as daily novel or active cases of COVID-19, with the objective and subjective health proxies while adjusting for the occurrence of one COVID-19 case in a staff member in one of the clubs, team status (i.e. player vs staff) and game days. Results Data from 115 participants were analysed. An increasing number of novel COVID-19 cases was significantly associated with deteriorating sleep quality (B 0.48, 95% CI 0.05; 1.00) but with none of the other mental health proxies. An increasing number of active COVID-19 cases was significantly associated with an increase in perceived infection risk (B 0.04, 95% CI 0.00; 0.07) and location variance (B 0.28, 95% CI 0.06; 0.49). Conclusion The adverse association of an increasing COVID-19 incidence with mental health in professional Footballers and staff members became obvious particularly in subjectively measured mental health. During the ongoing pandemic, targeted mental care should be included in the daily routines of this population.