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      Respiratory complications following COVID‐19 in athletic populations: A narrative review

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          Abstract

          Athletes typically experience a mild‐to‐moderate, self‐limiting illness following infection with the novel severe acute respiratory syndrome coronavirus 2. Some athletes, however, can develop prolonged symptoms, with breathlessness, cough, and chest tightness impacting return to training and competition. In athletes with persistent cardiopulmonary symptoms following COVID‐19, focus is usually placed on the identification and characterization of cardiac complications, such as myocarditis. In this review, we focus on summarizing the literature assessing pulmonary complications and physiological consequences associated with COVID‐19 illness in athletes. The review also provides recommendations for clinical assessment of the athlete with pulmonary issues following COVID‐19 and directions for future research.

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          Most cited references43

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          Post-acute COVID-19 syndrome

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.
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            Attributes and predictors of long COVID

            Reports of long-lasting coronavirus disease 2019 (COVID-19) symptoms, the so-called 'long COVID', are rising but little is known about prevalence, risk factors or whether it is possible to predict a protracted course early in the disease. We analyzed data from 4,182 incident cases of COVID-19 in which individuals self-reported their symptoms prospectively in the COVID Symptom Study app1. A total of 558 (13.3%) participants reported symptoms lasting ≥28 days, 189 (4.5%) for ≥8 weeks and 95 (2.3%) for ≥12 weeks. Long COVID was characterized by symptoms of fatigue, headache, dyspnea and anosmia and was more likely with increasing age and body mass index and female sex. Experiencing more than five symptoms during the first week of illness was associated with long COVID (odds ratio = 3.53 (2.76-4.50)). A simple model to distinguish between short COVID and long COVID at 7 days (total sample size, n = 2,149) showed an area under the curve of the receiver operating characteristic curve of 76%, with replication in an independent sample of 2,472 individuals who were positive for severe acute respiratory syndrome coronavirus 2. This model could be used to identify individuals at risk of long COVID for trials of prevention or treatment and to plan education and rehabilitation services.
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              Lifestyle Risk Factors, Inflammatory Mechanisms, and COVID-19 Hospitalization: A Community-Based Cohort Study of 387,109 Adults in UK

              Highlights • The association between lifestyle factors and risk of COVID-19 hospitalisation is unknown. • In this large community-based sample, poorer lifestyle habit and elevated C-reactive protein was associated with greater risk of COVID-19 hospitalisation. • Unhealthy lifestyle behaviours in combination accounted for up to 51% of the population attributable fraction of severe COVID-19. • Low grade inflammation may be an important mechanism. • Adopting simple lifestyle changes could lower the risk of severe COVID-19 infection.
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                Author and article information

                Contributors
                j.hull@rbht.nhs.uk
                Journal
                Scand J Med Sci Sports
                Scand J Med Sci Sports
                10.1111/(ISSN)1600-0838
                SMS
                Scandinavian Journal of Medicine & Science in Sports
                John Wiley and Sons Inc. (Hoboken )
                0905-7188
                1600-0838
                20 December 2022
                20 December 2022
                : 10.1111/sms.14275
                Affiliations
                [ 1 ] Department of Respiratory Medicine Royal Brompton Hospital London UK
                [ 2 ] Institute of Sport, Exercise and Health (ISEH), Division of Surgery and Interventional Science University College London London UK
                Author notes
                [*] [* ] Correspondence

                James H Hull, Royal Brompton Hospital, Fulham Road, London, SW3 6NP, UK.

                Email: j.hull@ 123456rbht.nhs.uk

                Author information
                https://orcid.org/0000-0002-9336-8626
                https://orcid.org/0000-0003-4697-1526
                Article
                SMS14275 SJMSS-SI-824-22.R1
                10.1111/sms.14275
                9880648
                36539388
                7facbf76-a05f-43ea-bce3-3fb161b14173
                © 2022 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 04 November 2022
                : 26 August 2022
                : 13 November 2022
                Page count
                Figures: 1, Tables: 3, Pages: 11, Words: 5032
                Categories
                Special Issue Article
                Special Issue Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.4 mode:remove_FC converted:27.01.2023

                Sports medicine
                athlete,covid‐19,exercise test,persistent symptoms
                Sports medicine
                athlete, covid‐19, exercise test, persistent symptoms

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