Evidence map›Paper›PMID 39820033›Full record

SynthesisPloS one2025

Exploring mental health symptoms in elite athletes during the COVID-19 pandemic: A systematic review and meta-analysis on sex differences.

Liang-Tseng Kuo, Sung-Huang Laurent Tsai, Udit Dave, William A Marmor, Reena Olsen, Bridget Jivanelli, Michelle E Kew, Daphne I Ling

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Liang-Tseng KuoDepartment of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan.ORCID 0000-0002-5507-8396
Sung-Huang Laurent TsaiSchool of Medicine, Chang Gung University, Taoyuan, Taiwan.
Udit DaveTulane University School of Medicine, New Orleans, Louisiana, United States of America.ORCID 0000-0002-9950-6938
William A MarmorDepartment of Orthopaedics, University of Miami, Miami, Florida, United States of America.ORCID 0000-0002-8434-2088
Reena OlsenSports Medicine Institute, Hospital for Special Surgery, New York, New York, United States of America.ORCID 0000-0002-0012-1481
Bridget JivanelliKim Barrett Memorial Library, HSS Education Institute, Hospital for Special Surgery, New York, New York, United States of America.ORCID 0000-0002-8707-4859
Michelle E KewSports Medicine Institute, Hospital for Special Surgery, New York, New York, United States of America.ORCID 0000-0001-6189-0359
Daphne I LingSports Medicine Institute, Hospital for Special Surgery, New York, New York, United States of America.ORCID 0000-0003-4415-2471

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The COVID-19 pandemic significantly affected elite athletes, leading to increased mental health issues such as stress, anxiety, and depression. Sex differences in mental health may exist among athletes during the COVID-19 crisis. This study aimed to perform a systematic review and meta-analysis to examine sex differences in mental health symptoms among elite athletes during the COVID-19 pandemic. We systematically searched the databases including Pubmed, EMBASE, and manually checked previous systematic reviews for relevant studies in March 2024. Authors were also contacted for sex-specific data. Studies were included if they compared mental health symptoms between male and female elite athletes during the COVID-19 pandemic. We used a random-effects model to summarize the rate ratio (RR) between female and male athletes across studies. Risk of bias in studies was assessed using a 9-item tool. We included 18 studies in this review. The results indicated that female athletes reported higher levels of anxiety (RR 1.24, 95% CI = 1.08 to 1.43) and depression (RR 1.36, 95% CI = 1.15 to 1.61) than male athletes during the pandemic. They also had a higher risk of stress or distress (RR 1.27, 95% CI = 0.99 to 1.63) than their male counterparts. No significant differences were found regarding alcohol use or misuse between female and male athletes (RR 1.01, 95% CI = 0.75 to 1.37). Limited evidence was available for eating disorders, gambling, substance use, and sleep problems. In conclusion, female and male athletes differed in mental health symptoms during the COVID-19 pandemic. Female athletes were more likely to report anxiety, depression, and distress. Incorporating mental health resources may be particularly important for women's sports, which have smaller financial margins and greater career uncertainty than men's sports.

Indexed as

AthletesCOVID-19Mental HealthAnxietyDepressionFemaleHumansMalePandemicsSARS-CoV-2Sex FactorsStress, Psychological

Identifiers

PMID39820033
PMCPMC11737678

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.