Elite athletes with COVID-19 – predictors of the course of disease

Krzywański, Jarosław; Mikulski, Tomasz; Krysztofiak, Hubert; Pokrywka, Andrzej; Młyńczak, Marcel; Małek, Łukasz A.; Kwiatkowska, Dorota; Kuchar, Ernest

OBJECTIVES: The aim of the study was to identify predictors determining the course of COVID-19 and antibody response in elite athletes. DESIGN: Observational study. METHODS: Routine medical screening with physical examination, resting ECG, and laboratory tests including antibody response was performed 12-68 days after the diagnosis of COVID-19 in 111 athletes of different sports. RESULTS: Clinical symptoms were observed in 84% of subjects. The severity of COVID-19 was mild in 82% of athletes and moderate in 2% of cases. Athletes aged above 26 and male were more likely to develop symptomatic COVID-19. Asymptomatic subjects were younger and predominantly female. In 18% of subjects, symptoms were still present 20 (12-68) days (median and range) since positive diagnosis. Antibody response was observed in 88% of athletes, and its magnitude correlated with time since diagnosis of COVID-19 (RT-PCR), fatigue, fever, and conjunctivitis. There were no differences in antibody response between groups distinguished by sports discipline (p=0.50), and sex (p=0.59), and antibody response did not correlate with BMI (p=0.12), age (p=0.13), the number of symptoms (p=0.43) or their duration (p=0.19). CONCLUSIONS: The severity of COVID-19 in elite athletes is predominantly mild and without complications. Athletes can return to sport after two symptom-free weeks and additional heart screening is usually not required. Determination of antibodies has been shown to be a useful indicator of a previous COVID-19 disease, and some symptoms can be used as predictors of antibody response.