One wouldn’t know it by looking at them play, but for many elite athletes who contracted Covid-19, returning to the field and to peak performance is a long and slow process.
Some athletes, post-Covid, have developed heart abnormalities similar to the one that likely caused footballer Christian Eriksen to collapse during a game in June 2021. (Shutterstock)
In August 2021, two economists from the Dusseldorf Institute for Competition Economics collaborated with an economist from University of Reading on a fascinating study. Sorting through all the positive cases reported from Serie A (Italy’s top football league) and the Bundesliga (Germany’s top tier), they zoomed in on 233 of the 257 players who had tested positive and recovered by July 2021.
The researchers then pulled their playing statistics (a British firm called Opta Sports collects granular data on each match played in these leagues, recording every movement and every touch each player makes on the field) and compared performance parameters from before and after they contracted the disease. The findings were startling.
Even 150 days after infection, most of these players showed statistically significant reductions in performance. They played fewer minutes than before, and completed fewer passes. It was not the aim of this research to look specifically at footballers. The paper is titled “The long shadow of an infection: Covid-19 and performance at work”. But the authors found that few industries maintained data on its workers as rigorously as elite football leagues did, so they decided to use footballers as a jumping-off point.
Now, one of the big surprises in the pandemic has been the speed and success with which sports bounced back after that initial global standstill. The Bundesliga was the first major football league to restart, in May 2020. Even Italy, devastated by the virus in March and April that year, resumed Serie A in June that year.
Sports scientists and doctors were then faced with the unique challenge of figuring out how to monitor athletes who had recovered from an infection, how to make up for the loss of performance, and what a safe return to peak performance entailed.
Covid-19 affects the lungs, which became an area of major concern. The other, more difficult, issue was that studies had shown that patients with Covid-19 could develop myocarditis, an inflammation of the heart that can lead to sudden cardiac death.
In elite sport, myocarditis is always a concern. It is believed to have caused cardiac events among professional sportspeople such as Denmark’s Christian Eriksen, who was 29 when he collapsed on the field during a Euro 2020 match from unexplained cardiac arrest.
In a study conducted last year around this post-Covid concern, 26 athletes from Ohio State University who had recovered from Covid-19 were put through a series of cardiovascular tests. Nearly half showed heart abnormalities and a few met the criteria for myocarditis.
Thankfully, more extensive studies — as the economists found, elite athletes are constantly under the medical lens and provide a rich field of readily available data — have shown that risk factors for sportspeople who have recovered from Covid-19 are markedly low. All the complicating factors that can make an infection more difficult to deal with — obesity, hypertension, smoking, coronary heart disease, obstructive lung disease, etc — are rare in sportspeople.
So, return-to-play protocols for athletes who have recovered from Covid-19 now follow a simple rule, in most countries: if there are no external symptoms of lasting effects, just go out and play.
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