ArticleBMJ open sport & exercise medicine2025
COVID-19 infection and return-to-play outcomes of elite athletes in Japan: a retrospective descriptive study.
Article in BMJ open sport & exercise medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To describe the characteristics of COVID-19 among elite Japanese athletes and their return-to-play (RTP) time. Methods: We retrospectively reviewed clinical records at the Japan Institute of Sports Sciences between June 2022 and May 2023. Elite athletes who underwent periodic health examinations were examined by a physician to confirm COVID-19 history, symptoms and the RTP time. Results: Of 994 athletes, 456 had a COVID-19 history (mean±SD, 23.3±4.6 years; 56% male). Most infections occurred during the sixth wave (Omicron variant), followed by the seventh and eighth waves, with 88% recorded after the fifth wave. Indoor athletes were more frequently affected than outdoor athletes (306 vs 150, p<0.05). Badminton athletes were the most commonly affected athletes (16%), followed by volleyball (10%) and handball (7%). Among those with a history of COVID-19, 89% reported symptoms, while 11% were asymptomatic. Fever was the most common symptom (80%), followed by sore throat (58%) and cough (44%). The median (IQR) RTP time was 10 (7-14) days. Overall, 472 athletes resumed play within 28 days, while 20 returned after 28 days. RTP delays were more frequent before Omicron (9/59 athletes) than after (11/433 athletes, p<0.05). Conclusion: COVID-19 was more common among indoor sports athletes, primarily during the Omicron wave, with most cases being symptomatic but resolving quickly. These findings likely reflect factors such as close-contact training, immune changes during intensive training and international travel and may help characterise COVID-19 outcomes in elite athletes.
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