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Article

Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship

by
Alessandro Corsini
1,*,
Andrea Bisciotti
2,
Raffaele Canonico
3,
Andrea Causarano
4,
Riccardo Del Vescovo
5,
Pierluigi Gatto
6,
Paolo Gola
7,
Massimo Iera
8,
Stefano Mazzoni
9,
Paolo Minafra
10,
Gianni Nanni
11,
Giulio Pasta
12,
Ivo Pulcini
13,
Stefano Salvatori
14,
Marco Scorcu
15,
Luca Stefanini
16,
Fabio Tenore
17,
Stefano Palermi
18,
Maurizio Casasco
1 and
Stefano Calza
19
1
Italian Sport Medicine Federation (FMSI), 7000196 Rome, Italy
2
Kinemove Rehabilitation Center, 54027 Pontremoli, Italy
3
Società Sportiva Calcistica Napoli, 81030 Napoli, Italy
4
Associazione Sportiva Roma, 00182 Rome, Italy
5
Hellas Verona Football Club, 37126 Verona, Italy
6
Genoa Cricket and Football Club, 16155 Genoa, Italy
7
Spezia Calcio, 19136 La Spezia, Italy
8
Football Club Crotone, 88900 Crotone, Italy
9
Sport Medicine Department—Milan Lab, Associazione Calcistica Milan, 20149 Milano, Italy
10
Torino Football Club, 10121 Torino, Italy
11
Bologna Football Club 1909, 40132 Bologna, Italy
12
Parma Calcio, 43123 Parma, Italy
13
SS Lazio, 00060 Rome, Italy
14
Benevento Calcio, 82100 Benevento, Italy
15
Cagliari Calcio, 09124 Cagliari, Italy
16
Juventus Football Club, 10151 Torino, Italy
17
Udinese Calcio, 33100 Udine, Italy
18
Public Health Department, University of Naples Federico II, 80131 Naples, Italy
19
Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
 
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*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(6), 5182; https://doi.org/10.3390/ijerph20065182
Submission received: 30 January 2023 / Revised: 6 March 2023 / Accepted: 8 March 2023 / Published: 15 March 2023
Review Reports Versions Notes

Abstract

Introduction: Football was the first sport to resume competitions after the coronavirus disease 2019 (COVID-19) lockdown and promptly the hypothesis was raised of a potential relationship between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and musculoskeletal injuries in athletes. This study aimed to confirm the association between SARS-CoV-2 infection and muscle strain injury in a large population of elite football players and to investigate if the COVID-19 severity level could affect the risk of injury. Methods: A retrospective cohort study involving 15 Italian professional male football teams was performed during the Italian Serie A 2020–2021 season. Injuries and SARS-CoV-2 positivity data were collected by team doctors through an online database. Results: Of the 433 included players, we observed 173 SARS-CoV-2 infections and 332 indirect muscle strains. COVID-19 episodes mostly belonged to severity level I and II. The injury risk significantly increased after a COVID-19 event, by 36% (HR = 1.36, CI95% 1.05; 1.77, p-value = 0.02). The injury burden demonstrated an 86% increase (ratio = 1.86, CI95% 1.21; 2.86, p-value = 0.005) in the COVID-19 severity level II/III versus players without a previous SARS-CoV-2 infection, while level I (asymptomatic) patients showed a similar average burden (ratio = 0.92, CI95% 0.54; 1.58, p-value = 0.77). A significantly higher proportion of muscle–tendon junction injuries (40.6% vs. 27.1%, difference = 13.5%, CI95% 0.002%; 26.9%, p-value = 0.047) was found when comparing level II/III versus Non-COVID-19. Conclusions: This study confirms the correlation between SARS-CoV-2 infection and indirect muscle injuries and highlights how the severity of the infection would represent an additional risk factor.
Keywords: COVID-19; football; muscle injury; risk factor; epidemiology COVID-19; football; muscle injury; risk factor; epidemiology

Share and Cite

MDPI and ACS Style

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

AMA Style

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 Style

Corsini, 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 Style

Corsini, 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

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