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

Author

Listed:
  • Alessandro Corsini

    (Italian Sport Medicine Federation (FMSI), 7000196 Rome, Italy)

  • Andrea Bisciotti

    (Kinemove Rehabilitation Center, 54027 Pontremoli, Italy)

  • Raffaele Canonico

    (Società Sportiva Calcistica Napoli, 81030 Napoli, Italy)

  • Andrea Causarano

    (Associazione Sportiva Roma, 00182 Rome, Italy)

  • Riccardo Del Vescovo

    (Hellas Verona Football Club, 37126 Verona, Italy)

  • Pierluigi Gatto

    (Genoa Cricket and Football Club, 16155 Genoa, Italy)

  • Paolo Gola

    (Spezia Calcio, 19136 La Spezia, Italy)

  • Massimo Iera

    (Football Club Crotone, 88900 Crotone, Italy)

  • Stefano Mazzoni

    (Sport Medicine Department—Milan Lab, Associazione Calcistica Milan, 20149 Milano, Italy)

  • Paolo Minafra

    (Torino Football Club, 10121 Torino, Italy)

  • Gianni Nanni

    (Bologna Football Club 1909, 40132 Bologna, Italy)

  • Giulio Pasta

    (Parma Calcio, 43123 Parma, Italy)

  • Ivo Pulcini

    (SS Lazio, 00060 Rome, Italy)

  • Stefano Salvatori

    (Benevento Calcio, 82100 Benevento, Italy)

  • Marco Scorcu

    (Cagliari Calcio, 09124 Cagliari, Italy)

  • Luca Stefanini

    (Juventus Football Club, 10151 Torino, Italy)

  • Fabio Tenore

    (Udinese Calcio, 33100 Udine, Italy)

  • Stefano Palermi

    (Public Health Department, University of Naples Federico II, 80131 Naples, Italy)

  • Maurizio Casasco

    (Italian Sport Medicine Federation (FMSI), 7000196 Rome, Italy)

  • Stefano Calza

    (Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy)

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, CI 95% 1.05; 1.77, p -value = 0.02). The injury burden demonstrated an 86% increase (ratio = 1.86, CI 95% 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, CI 95% 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%, CI 95% 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.

Suggested Citation

  • Alessandro Corsini & Andrea Bisciotti & Raffaele Canonico & Andrea Causarano & Riccardo Del Vescovo & Pierluigi Gatto & Paolo Gola & Massimo Iera & Stefano Mazzoni & Paolo Minafra & Gianni Nanni & Giu, 2023. "Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship," IJERPH, MDPI, vol. 20(6), pages 1-13, March.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:6:p:5182-:d:1098084
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    References listed on IDEAS

    as
    1. Giuseppe Annino & Vincenzo Manzi & Anas Radi Alashram & Cristian Romagnoli & Mattia Coniglio & Niloofar Lamouchideli & Marco Alfonso Perrone & Dolores Limongi & Elvira Padua, 2022. "COVID-19 as a Potential Cause of Muscle Injuries in Professional Italian Serie A Soccer Players: A Retrospective Observational Study," IJERPH, MDPI, vol. 19(17), pages 1-8, September.
    2. Antonello D’Andrea & Luigi Cante & Stefano Palermi & Andreina Carbone & Federica Ilardi & Francesco Sabatella & Fabio Crescibene & Marco Di Maio & Francesco Giallauria & Giancarlo Messalli & Vincenzo , 2022. "COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden," IJERPH, MDPI, vol. 19(10), pages 1-10, May.
    3. Antonio Maestro & David Varillas-Delgado & Esther Morencos & Jorge Gutiérrez-Hellín & Millán Aguilar-Navarro & Gonzalo Revuelta & Juan Del Coso, 2022. "Injury Incidence Increases after COVID-19 Infection: A Case Study with a Male Professional Football Team," IJERPH, MDPI, vol. 19(16), pages 1-12, August.
    4. José Manuel Prieto-Fresco & Daniel Medina-Rebollo & Jesús Fernández-Gavira & Antonio Muñoz-Llerena, 2022. "A Study on the Injury Rate of Spanish Competitive Athletes as a Consequence of the COVID-19 Pandemic Lockdown," IJERPH, MDPI, vol. 20(1), pages 1-14, December.
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