Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patient and Public Involvement
2.3. Setting
2.4. Inclusion Criteria
- SARS-CoV-2 infection characteristics, defined as [33]:
- Polymerase Chase Reaction (PCR) COVID-19 test positivity and subsequent PCR negativization date;
- Return to play (RTP) date;
- Clinical classification of COVID-19 severity.
- 2.
- Injuries:
- Injury occurrence and RTP date;
- Anatomical location of the injury;
- Situation in which the injury occurred (i.e., training or competition);
- Type of injury (i.e., first injury or re-injury).
- 3.
- Exposure:
- Day-by-day players’ exposure time in training or match.
2.5. Exclusion Criteria
2.6. Subjects
2.7. Data Collection
- The number of subjects who contracted COVID-19 during the observation period. For each subject affected by SARS-CoV-2 infection, the days lost due to infection (RTP time) and the severity of the disease were also collected. The severity was classified based on five levels according to the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines [34] (Table 1). RTP was defined as the moment when a player made a full return to training and competition, without any restrictions [35,36].
- 2.
- The total number of indirect muscle injuries that occurred during training and competition. For these muscle strains, the team’s physician made the final diagnosis and this was supported with medical imaging (ultrasound or MRI) and correctly classified [20]. The time-loss injury, the injury anatomical location, and the site of injury within the muscle were also registered. Other types of acute injuries, overuse injuries and illness were not considered events of interest. Each indirect muscle injury was classified as COVID-19 or Non-COVID-19 depending on whether it was preceded by a positive SARS-CoV-2 test during the observational period.
- 3.
- For each subject, the match or training exposure time (ET) [37].
- 4.
- The injury burden (number of days lost to injury per 1000 h of player exposure injuries) for each injured subject.
- 5.
- The number of days between RTP and the first recorded indirect muscle injury.
2.8. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Ciotti, M.; Ciccozzi, M.; Terrinoni, A.; Jiang, W.-C.; Wang, C.-B.; Bernardini, S. The COVID-19 Pandemic. Crit. Rev. Clin. Lab. Sci. 2020, 57, 365–388. [Google Scholar] [CrossRef]
- Jones, B.; Phillips, G.; Kemp, S.; Payne, B.; Hart, B.; Cross, M.; Stokes, K.A. SARS-CoV-2 Transmission during Rugby League Matches: Do Players Become Infected after Participating with SARS-CoV-2 Positive Players? Br. J. Sports Med. 2021, 55, LP807–LP813. [Google Scholar] [CrossRef]
- Knudsen, N.; Thomasen, M.; Andersen, T. Spread of Virus during Soccer Matches. medRxiv 2020, 8, e001268. [Google Scholar]
- Hull, J.H.; Loosemore, M.; Schwellnus, M. Respiratory Health in Athletes: Facing the COVID-19 Challenge. Lancet Respir. Med. 2020, 8, 557–558. [Google Scholar] [CrossRef]
- Ramani, S.L.; Samet, J.; Franz, C.K.; Hsieh, C.; Nguyen, C.V.; Horbinski, C.; Deshmukh, S. Musculoskeletal Involvement of COVID-19: Review of Imaging. Skelet. Radiol. 2021, 50, 1763–1773. [Google Scholar] [CrossRef] [PubMed]
- Mehrsafar, A.H.; Zadeh, A.M.; Gazerani, P.; Sanchez, J.C.J.; Nejat, M.; Tabesh, M.R.; Abolhasani, M. Mental Health Status, Life Satisfaction, and Mood State of Elite Athletes during the COVID-19 Pandemic: A Follow-Up Study in the Phases of Home Confinement, Reopening, and Semi-Lockdown Condition. Front. Psychol. 2021, 12, 630414. [Google Scholar] [CrossRef]
- Martinez, M.W.; Tucker, A.M.; Bloom, O.J.; Green, G.; DiFiori, J.P.; Solomon, G.; Phelan, D.; Kim, J.H.; Meeuwisse, W.; Sills, A.K.; et al. Prevalence of Inflammatory Heart Disease Among Professional Athletes with Prior COVID-19 Infection Who Received Systematic Return-to-Play Cardiac Screening. JAMA Cardiol. 2021, 6, 745–752. [Google Scholar] [CrossRef] [PubMed]
- Corsini, A.; Bisciotti, G.N.; Eirale, C.; Volpi, P. Football Cannot Restart Soon during the COVID-19 Emergency! A Critical Perspective from the Italian Experience and a Call for Action. Br. J. Sports Med. 2020, 54, 1186–1187. [Google Scholar] [CrossRef] [Green Version]
- Eirale, C.; Bisciotti, G.; Corsini, A.; Baudot, C.; Saillant, G.; Chalabi, H. Medical Recommendations for Home-Confined Footballers’ Training during the COVID-19 Pandemic: From Evidence to Practical Application. Biol. Sport 2020, 37, 203–207. [Google Scholar] [CrossRef] [PubMed]
- Cohen, D.D.; Restrepo, A.; Richter, C.; Harry, J.R.; Franchi, M.V.; Restrepo, C.; Poletto, R.; Taberner, M. Detraining of specific neuromuscular qualities in elite footballers during COVID-19 quarantine. Sci. Med. Footb. 2021, 5 (Suppl. 1), 26–31. [Google Scholar] [CrossRef]
- Carmody, S.; Murray, A.; Borodina, M.; Gouttebarge, V.; Massey, A. When Can Professional Sport Recommence Safely during the COVID-19 Pandemic? Risk Assessment and Factors to Consider. Br. J. Sports Med. 2020, 54, 946–948. [Google Scholar] [CrossRef]
- Douryang, M.; Bouba, Y.; Makemjio, E.Z.; Wondeu, A.L.D.; Pillay, L. COVID-19 Considerations and Strategy for a Safe Return to International Football Competitions: An African Perspective. Br. J. Sports Med. 2022, 56, 246–248. [Google Scholar] [CrossRef]
- Herrero-Gonzalez, H.; Martín-Acero, R.; del Coso, J.; Lalín-Novoa, C.; Pol, R.; Martín-Escudero, P.; de la Torre, A.I.; Hughes, C.; Mohr, M.; Biosca, F.; et al. Position Statement of the Royal Spanish Football Federation for the Resumption of Football Activities after the COVID-19 Pandemic (June 2020). Br. J. Sports Med. 2020, 54, 1133–1134. [Google Scholar] [CrossRef]
- Mota, G.R.; Santos, I.A.; Marocolo, M. Change in Soccer Substitutions Rule Due to COVID-19: Why Only Five Substitutions? Front. Sports Act. Living 2020, 2, 588369. [Google Scholar] [CrossRef]
- Vaishya, R.; Jain, V.K.; Iyengar, K.P. Musculoskeletal Manifestations of COVID-19. J. Clin. Orthop. Trauma 2021, 17, 280–281. [Google Scholar] [CrossRef] [PubMed]
- Ali, A.M.; Kunugi, H. Skeletal Muscle Damage in COVID-19: A Call for Action. Medicina 2021, 57, 372. [Google Scholar] [CrossRef] [PubMed]
- Disser, N.P.; de Micheli, A.J.; Schonk, M.M.; Konnaris, M.A.; Piacentini, A.N.; Edon, D.L.; Toresdahl, B.G.; Rodeo, S.A.; Casey, E.K.; Mendias, C.L. Musculoskeletal Consequences of COVID-19. J. Bone Joint Surg. Am. 2020, 102, 1197–1204. [Google Scholar] [CrossRef] [PubMed]
- Demir, C.; Subasi, B.; Harput, G. Effects of the COVID-19 Confinement Period on Hip Strength, Flexibility and Muscle Injury Rate in Professional Soccer Players. Phys. Sports Med. 2023, 51, 56–63. [Google Scholar] [CrossRef] [PubMed]
- Maestro, A.; Varillas-Delgado, D.; Morencos, E.; Gutiérrez-Hellín, J.; Aguilar-Navarro, M.; Revuelta, G.; del Coso, J. Injury Incidence Increases after COVID-19 Infection: A Case Study with a Male Professional Football Team. Int. J. Environ. Res. Public Health 2022, 19, 10267. [Google Scholar] [CrossRef] [PubMed]
- Palermi, S.; Massa, B.; Vecchiato, M.; Mazza, F.; de Blasiis, P.; Romano, A.M.; di Salvatore, M.G.; della Valle, E.; Tarantino, D.; Ruosi, C.; et al. Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise. J. Funct. Morphol. Kinesiol. 2021, 6, 75. [Google Scholar] [CrossRef]
- Ekstrand, J.; Bengtsson, H.; Waldén, M.; Davison, M.; Khan, K.M.; Hägglund, M. Hamstring Injury Rates Have Increased during Recent Seasons and Now Constitute 24% of All Injuries in Men’s Professional Football: The UEFA Elite Club Injury Study from 2001/02 to 2021/22. Br. J. Sports Med. 2022, 57, 292–298. [Google Scholar] [CrossRef] [PubMed]
- Mannino, B.J.; Yedikian, T.; Mojica, E.S.; Bi, A.; Alaia, M.; Gonzalez-Lomas, G. The COVID Lockdown and Its Effects on Soft Tissue Injuries in Premier League Athletes. Phys. Sportsmed. 2023, 51, 40–44. [Google Scholar] [CrossRef] [PubMed]
- Annino, G.; Manzi, V.; Alashram, A.R.; Romagnoli, C.; Coniglio, M.; Lamouchideli, N.; Perrone, M.A.; Limongi, D.; Padua, E. COVID-19 as a Potential Cause of Muscle Injuries in Professional Italian Serie A Soccer Players: A Retrospective Observational Study. Int. J. Environ. Res. Public Health 2022, 19, 11117. [Google Scholar] [CrossRef] [PubMed]
- Waldén, M.; Ekstrand, J.; Hägglund, M.; McCall, A.; Davison, M.; Hallén, A.; Bengtsson, H. Influence of the COVID-19 Lockdown and Restart on the Injury Incidence and Injury Burden in Men’s Professional Football Leagues in 2020: The UEFA Elite Club Injury Study. Sports Med. Open 2022, 8, 67. [Google Scholar] [CrossRef]
- Seshadri, D.R.; Thom, M.L.; Harlow, E.R.; Drummond, C.K.; Voos, J.E. Case Report: Return to Sport Following the COVID-19 Lockdown and Its Impact on Injury Rates in the German Soccer League. Front. Sports Act. Living 2021, 3, 604226. [Google Scholar] [CrossRef]
- Wezenbeek, E.; Denolf, S.; Willems, T.M.; Pieters, D.; Bourgois, J.G.; Philippaerts, R.M.; de Winne, B.; Wieme, M.; van Hecke, R.; Markey, L.; et al. Association between SARS-COV-2 Infection and Muscle Strain Injury Occurrence in Elite Male Football Players: A Prospective Study of 29 Weeks Including Three Teams from the Belgian Professional Football League. Br. J. Sports Med. 2022, 56, 818–823. [Google Scholar] [CrossRef]
- Marotta, N.; de Sire, A.; Gimigliano, A.; Demeco, A.; Moggio, L.; Vescio, A.; Iona, T.; Ammendolia, A. Impact of COVID-19 Lockdown on the Epidemiology of Soccer Muscle Injuries in Italian Serie A Professional Football Players. J. Sports Med. Phys. Fit. 2022, 62, 356–360. [Google Scholar] [CrossRef] [PubMed]
- Orhant, E.; Chapellier, J.-F.; Carling, C. Injury Rates and Patterns in French Male Professional Soccer Clubs: A Comparison between a Regular Season and a Season in the Covid-19 Pandemic. Res. Sports Med. 2021, 30, 80–91. [Google Scholar] [CrossRef]
- Mazza, D.; Annibaldi, A.; Princi, G.; Arioli, L.; Marzilli, F.; Monaco, E.; Ferretti, A. Injuries during Return to Sport after the COVID-19 Lockdown: An Epidemiologic Study of Italian Professional Soccer Players. Orthop. J. Sports Med. 2022, 10, 23259671221101612. [Google Scholar] [CrossRef]
- dos Santos, P.K.; Sigoli, E.; Bragança, L.J.G.; Cornachione, A.S. The Musculoskeletal Involvement after Mild to Moderate COVID-19 Infection. Front. Physiol. 2022, 13, 813924. [Google Scholar] [CrossRef]
- Waldén, M.; Mountjoy, M.; McCall, A.; Serner, A.; Massey, A.; Tol, J.L.; Bahr, R.; D’Hooghe, M.; Bittencourt, N.; Della Villa, F.; et al. Football-Specific Extension of the IOC Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sport 2020. Br. J. Sports Med. 2023, 106405. [Google Scholar] [CrossRef] [PubMed]
- International Olympic Committee Injury; Illness Epidemiology Consensus Group; Bahr, R.; Clarsen, B.; Derman, W.; Dvorak, J.; Emery, C.A.; Finch, C.F.; Hägglund, M.; Junge, A.; et al. International Olympic Committee consensus statement: Methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS)). Br. J. Sports Med. 2020, 54, 372–389. [Google Scholar] [CrossRef] [Green Version]
- Yüce, M.; Filiztekin, E.; Özkaya, K.G. COVID-19 Diagnosis—A Review of Current Methods. Biosens. Bioelectron. 2021, 172, 112752. [Google Scholar] [CrossRef]
- COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Natl. Inst. Health 2020, 2019, 130. Available online: https://covid19treatmentguidelines.nih.gov/ (accessed on 24 October 2022).
- Fuller, C.W.; Ekstrand, J.; Junge, A.; Andersen, T.E.; Bahr, R.; Dvorak, J.; Hägglund, M.; McCrory, P.; Meeuwisse, W.H. Consensus Statement on Injury Definitions and Data Collection Procedures in Studies of Football (Soccer) Injuries. Scand. J. Med. Sci. Sports 2006, 16, 83–92. [Google Scholar] [CrossRef]
- Bisciotti, G.N.; Volpi, P.; Alberti, G.; Aprato, A.; Artina, M.; Auci, A.; Bait, C.; Belli, A.; Bellistri, G.; Bettinsoli, P.; et al. Italian Consensus Statement (2020) on Return to Play after Lower Limb Muscle Injury in Football (Soccer). BMJ Open Sport Exerc. Med. 2019, 5, e000505. [Google Scholar] [CrossRef] [Green Version]
- Hägglund, M.; Waldén, M.; Bahr, R.; Ekstrand, J. Methods for Epidemiological Study of Injuries to Professional Football Players: Developing the UEFA Model. Br. J. Sports Med. 2005, 39, 340. [Google Scholar] [CrossRef] [Green Version]
- Stroup, W.W. Generalized Linear Mixed Models: Modern Concepts, Methods and Applications. Gen. Linear Mix. Model. 2016. [Google Scholar] [CrossRef] [Green Version]
- Jorgensen, B. Exponential Dispersion Models. J. R. Stat. Soc. Ser. B (Methodol.) 1987, 49, 127–162. [Google Scholar] [CrossRef]
- Maronna, R.A.; Martin, R.D.; Yohai, V.J. Robust Statistics: Theory and Methods. Robust Stat. Theory Methods 2006, 8, 23–74. [Google Scholar] [CrossRef]
- R Core Team. European Environment Agency. 2020. Available online: https://www.eea.europa.eu/data-and-maps/indicators/oxygen-consuming-substances-in-rivers/r-development-core-team-2006 (accessed on 24 October 2022).
- Bahr, R.; Clarsen, B.; Ekstrand, J. Why We Should Focus on the Burden of Injuries and Illnesses, Not Just Their Incidence. Br. J. Sports Med. 2018, 52, 1018–1021. [Google Scholar] [CrossRef] [PubMed]
- Sprouse, B.; Alty, J.; Kemp, S.; Cowie, C.; Mehta, R.; Tang, A.; Morris, J.; Cooper, S.; Varley, I. The Football Association Injury and Illness Surveillance Study: The Incidence, Burden and Severity of Injuries and Illness in Men’s and Women’s International Football. Sports Med. 2020; Online ahead of print. [Google Scholar] [CrossRef] [PubMed]
- Dhakal, B.P.; Sweitzer, N.K.; Indik, J.H.; Acharya, D.; William, P. SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart. Heart Lung Circ. 2020, 29, 973–987. [Google Scholar] [CrossRef]
- Guo, L.; Jin, Z.; Gan, T.J.; Wang, E. Silent Hypoxemia in Patients with COVID-19 Pneumonia: A Review. Med. Sci. Monit. 2021, 27, e930776. [Google Scholar] [CrossRef]
- Østergaard, L. SARS CoV-2 Related Microvascular Damage and Symptoms during and after COVID-19: Consequences of Capillary Transit-time Changes, Tissue Hypoxia and Inflammation. Physiol. Rep. 2021, 9, e14726. [Google Scholar] [CrossRef] [PubMed]
- Compagno, S.; Palermi, S.; Pescatore, V.; Brugin, E.; Sarto, M.; Marin, R.; Calzavara, V.; Nizzetto, M.; Scevola, M.; Aloi, A.; et al. Physical and Psychological Reconditioning in Long COVID Syndrome: Results of an out-of-Hospital Exercise and Psychological–Based Rehabilitation Program. IJC Heart Vasc. 2022, 41, 101080. [Google Scholar] [CrossRef] [PubMed]
- Huygaerts, S.; Cos, F.; Cohen, D.D.; Calleja-González, J.; Guitart, M.; Blazevich, A.J.; Alcaraz, P.E. Mechanisms of Hamstring Strain Injury: Interactions between Fatigue, Muscle Activation and Function. Sports 2020, 8, 65. [Google Scholar] [CrossRef]
- Reilly, T.; Drust, B.; Clarke, N. Muscle Fatigue during Football Match-Play. Sports Med. 2008, 38, 357–367. [Google Scholar] [CrossRef] [Green Version]
- Mujika, I.; Padilla, S. Detraining: Loss of Training-Induced Physiological and Performance Adaptations. Part I. Sports Med. 2000, 30, 79–87. [Google Scholar] [CrossRef]
- Vecchiato, M.; Zanardo, E.; Battista, F.; Quinto, G.; Bergia, C.; Palermi, S.; Duregon, F.; Ermolao, A.; Neunhaeuserer, D. The Effect of Exercise Training on Irisin Secretion in Patients with Type 2 Diabetes: A Systematic Review. J. Clin. Med. 2023, 12, 62. [Google Scholar] [CrossRef]
- Armstrong, R.B.; Warren, G.L.; Warren, J.A. Mechanisms of Exercise-Induced Muscle Fibre Injury. Sports Med. 1991, 12, 184–207. [Google Scholar] [CrossRef] [PubMed]
- Armstrong, R.B. Initial Events in Exercise-Induced Muscular Injury. Med. Sci. Sports Exerc. 1990, 22, 429–435. [Google Scholar] [PubMed]
- Watson, A.; Brindle, J.; Brickson, S.; Allee, T.; Sanfilippo, J. Preseason Aerobic Capacity Is an Independent Predictor of In-Season Injury in Collegiate Soccer Players. Clin. J. Sport Med. 2017, 27, 302–307. [Google Scholar] [CrossRef] [PubMed]
- Bisciotti, G.N.; Eirale, C.; Corsini, A.; Baudot, C.; Saillant, G.; Chalabi, H. Return to Football Training and Competition after Lockdown Caused by the COVID-19 Pandemic: Medical Recommendations. Biol. Sport 2020, 37, 313–319. [Google Scholar] [CrossRef]
- D’Andrea, A.; Cante, L.; Palermi, S.; Carbone, A.; Ilardi, F.; Sabatella, F.; Crescibene, F.; Di Maio, M.; Giallauria, F.; Messalli, G.; et al. COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden. Int. J. Environ. Res. Public Health 2022, 19, 5898. [Google Scholar] [CrossRef] [PubMed]
- Sarto, F.; Impellizzeri, F.M.; Spörri, J.; Porcelli, S.; Olmo, J.; Requena, B.; Suarez-Arrones, L.; Arundale, A.; Bilsborough, J.; Buchheit, M.; et al. Impact of Potential Physiological Changes due to COVID-19 Home Confinement on Athlete Health Protection in Elite Sports: A Call for Awareness in Sports Programming. Sports Med. 2020, 50, 1417–1419. [Google Scholar] [CrossRef] [PubMed]
- de Boer, M.D.; Maganaris, C.N.; Seynnes, O.R.; Rennie, M.J.; Narici, M.V. Time Course of Muscular, Neural and Tendinous Adaptations to 23 Day Unilateral Lower-Limb Suspension in Young Men. J. Physiol. 2007, 583, 1079–1091. [Google Scholar] [CrossRef]
- Curzi, D.; Lattanzi, D.; Ciuffoli, S.; Burattini, S.; Grindeland, R.E.; Edgerton, V.R.; Roy, R.R.; Tidball, J.G.; Falcieri, E. Growth Hormone plus Resistance Exercise Attenuate Structural Changes in Rat Myotendinous Junctions Resulting from Chronic Unloading. Eur. J. Histochem. 2013, 57, e37. [Google Scholar] [CrossRef] [Green Version]
- Zamora, A.J.; Carnino, A.; Roffino, S.; Marini, J.F. Respective Effects of Hindlimb Suspension, Confinement and Spaceflight on Myotendinous Junction Ultrastructure. Acta Astronaut. 1995, 36, 693–706. [Google Scholar] [CrossRef]
- Tidball, J.G.; Quan, D.M. Reduction in Myotendinous Junction Surface Area of Rats Subjected to 4-Day Spaceflight. J. Appl. Physiol. 1992, 73, 59–64. [Google Scholar] [CrossRef]
- de Palma, L.; Marinelli, M.; Pavan, M.; Bertoni-Freddari, C. Involvement of the Muscle-Tendon Junction in Skeletal Muscle Atrophy: An Ultrastructural Study. ROM J. Morphol. Embryol. 2011, 52, 105–109. [Google Scholar] [PubMed]
- Wilson, M.G.; Hull, J.H.; Rogers, J.; Pollock, N.; Dodd, M.; Haines, J.; Harris, S.; Loosemore, M.; Malhotra, A.; Pieles, G.; et al. Cardiorespiratory Considerations for Return-to-Play in Elite Athletes after COVID-19 Infection: A Practical Guide for Sport and Exercise Medicine Physicians. Br. J. Sports Med. 2020, 54, 1157–1161. [Google Scholar] [CrossRef]
- Zaborova, V.; Gurevich, K.; Chigirintseva, O.; Gavrilov, V.; Rybakov, V. Pandemical Influence on Athletic Events and Communications in Sport. Front. Sports Act. Living 2021, 3, 653291. [Google Scholar] [CrossRef]
- Prieto-Fresco, J.M.; Medina-Rebollo, D.; Fernández-Gavira, J.; Muñoz-Llerena, A. A Study on the Injury Rate of Spanish Competitive Athletes as a Consequence of the COVID-19 Pandemic Lockdown. Int. J. Environ. Res. Public Health 2022, 20, 420. [Google Scholar] [CrossRef] [PubMed]
- Ramagole, D.A.; Janse van Rensburg, D.C.; Pillay, L.; Viviers, P.; Zondi, P.; Patricios, J. Implications of COVID-19 for resumption of sport in South Africa: A South African Sports Medicine Association (SASMA) position statement—Part 2. S. Afr. J. Sports Med. 2020, 32, v32i1a8986. [Google Scholar] [CrossRef]
- Ferrandi, P.J.; Alway, S.E.; Mohamed, J.S. The Interaction between SARS-CoV-2 and ACE2 May Have Consequences for Skeletal Muscle Viral Susceptibility and Myopathies. J. Appl. Physiol. 2020, 129, 864–867. [Google Scholar] [CrossRef]
- Elliott, N.; Martin, R.; Heron, N.; Elliott, J.; Grimstead, D.; Biswas, A. Infographic. Graduated Return to Play Guidance Following COVID-19 Infection. Br. J. Sports Med. 2020, 54, 1174–1175. [Google Scholar] [CrossRef] [PubMed]
COVID-19 Severity Level | Type of Patients | |
---|---|---|
I | Asymptomatic or Presymptomatic Infection: | Individuals who test positive for SARS-CoV-2 using a virologic test (i.e., a nucleic acid amplification test or an antigen test) but who have no symptoms that are consistent with COVID-19. |
II | Mild Illness | Individuals who have any of the various signs and symptoms of COVID-19 (e.g., fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell) but who do not have shortness of breath, dyspnea, or abnormal chest imaging. |
III | Moderate Illness | Individuals who show evidence of lower respiratory disease during clinical assessment or imaging and who have a saturation of oxygen (SpO2) ≥ 94% on room air at sea level. |
IV | Severe Illness | Individuals who have a SpO2 < 94% on room air at sea level, a ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) < 300 mmHg, respiratory frequency > 30 breaths per minute, or lung infiltrates > 50%. |
V | Critical Illness | Individuals who have respiratory failure, septic shock, and/or multiple organ dysfunction. |
COVID-19 | HR (95% CI) | p-Value |
---|---|---|
Yes vs. No | 1.36 (1.05, 1.77) | 0.020 |
COVID-19 Level | Incidence Rate (95% CI) | Comparisons | Relative Risk (95% CI) | p-Value |
---|---|---|---|---|
No COVID-19 | 2.87 (2.33; 3.52) | I/No COVID-19 | 0.94 (0.61; 1.46) | 0.80 |
I | 2.71 (1.77; 4.15) | (II–III)/No COVID-19 | 1.69 (1.21; 2.38) | 0.002 |
II–III | 4.86 (3.53; 6.70) |
COVID-19 Level | Injury Burden (95% CI) | Comparisons | Ratio (95% CI) | p-Value |
---|---|---|---|---|
No COVID-19 | 55.10 (39.78; 76.32) | I/No COVID-19 | 0.92 (0.54; 1.58) | 0.77 |
I | 50.75 (98.06; 88.64) | (II–III)/No COVID-19 | 1.86 (1.21; 2.86) | 0.005 |
II–III | 102.57 (66.48; 158.26) |
COVID-19 | Anatomical Location | Injury Probability (CI 95%) |
---|---|---|
No | Muscle–tendon junction | 27.1% (21.3%; 32.9%) |
Muscle belly | 72.9% (67.1%; 78.7%) | |
I | Muscle–tendon junction | 35.3% (19.2%; 51.4%) |
Muscle belly | 64.7% (48.6%; 80.8%) | |
II–III | Muscle–tendon junction | 40.6% (28.6%; 52.7%) |
Muscle belly | 59.4% (47.3%; 71.4%) |
COVID-19 Level | Average Time (95% CI) | Difference (95% CI) | p-Value |
---|---|---|---|
I | 16.18 (14.7; 17.6) | −0.02 (−1.16; 1.11) | 0.97 |
II–III | 16.16 (14.6; 17.7) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Corsini, A.; Bisciotti, A.; Canonico, R.; Causarano, A.; Del Vescovo, R.; Gatto, P.; Gola, P.; Iera, M.; Mazzoni, S.; Minafra, P.; et al. Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship. Int. J. Environ. Res. Public Health 2023, 20, 5182. https://doi.org/10.3390/ijerph20065182
Corsini A, Bisciotti A, Canonico R, Causarano A, Del Vescovo R, Gatto P, Gola P, Iera M, Mazzoni S, Minafra P, et al. Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship. International Journal of Environmental Research and Public Health. 2023; 20(6):5182. https://doi.org/10.3390/ijerph20065182
Chicago/Turabian StyleCorsini, Alessandro, Andrea Bisciotti, Raffaele Canonico, Andrea Causarano, Riccardo Del Vescovo, Pierluigi Gatto, Paolo Gola, Massimo Iera, Stefano Mazzoni, Paolo Minafra, and et al. 2023. "Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship" International Journal of Environmental Research and Public Health 20, no. 6: 5182. https://doi.org/10.3390/ijerph20065182
APA StyleCorsini, A., Bisciotti, A., Canonico, R., Causarano, A., Del Vescovo, R., Gatto, P., Gola, P., Iera, M., Mazzoni, S., Minafra, P., Nanni, G., Pasta, G., Pulcini, I., Salvatori, S., Scorcu, M., Stefanini, L., Tenore, F., Palermi, S., Casasco, M., & Calza, S. (2023). Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship. International Journal of Environmental Research and Public Health, 20(6), 5182. https://doi.org/10.3390/ijerph20065182