Advertisement

Nowhere to hide: The significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes

      Abstract

      Objectives

      To describe the perceptions of South African elite and semi-elite athletes on return to sport (RTS); maintenance of physical conditioning and other activities; sleep; nutrition; mental health; healthcare access; and knowledge of coronavirus disease 2019 (COVID-19).

      Design

      Cross- sectional study.

      Methods

      A Google Forms survey was distributed to athletes from 15 sports in the final phase (last week of April 2020) of the level 5 lockdown period. Descriptive statistics were used to describe player demographic data. Chi-squared tests investigated significance (p < 0.05) between observed and expected values and explored sex differences. Post hoc tests with a Bonferroni adjustment were included where applicable.

      Results

      67% of the 692 respondents were males. The majority (56%) expected RTS after 1–6 months. Most athletes trained alone (61%; p < 0.0001), daily (61%; p < 0.0001) at moderate intensity (58%; p < 0.0001) and for 30–60 min (72%). During leisure time athletes preferred sedentary above active behaviour (p < 0.0001). Sleep patterns changed significantly (79%; p < 0.0001). A significant number of athletes consumed excessive amounts of carbohydrates (76%; p < 0.0001; males 73%; females 80%). Many athletes felt depressed (52%), and required motivation to keep active (55%). Most had access to healthcare during lockdown (80%) and knew proceedings when suspecting COVID-19 (92%).

      Conclusions

      COVID-19 had physical, nutritional and psychological consequences that may impact on the safe RTS and general health of athletes. Lost opportunities and uncertain financial and sporting futures may have significant effects on athletes and the sports industry. Government and sporting federations must support athletes and develop and implement guidelines to reduce the risk in a COVID-19 environment.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Science and Medicine in Sport
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Zhou P.
        • Yang X.-L.
        • Wang X.-G.
        • et al.
        A pneumonia outbreak associated with a new coronavirus of probable bat origin.
        Nature. 2020; 579: 270-273https://doi.org/10.1038/s41586-020-2012-7
        • Rothan H.A.
        • Byrareddy S.N.
        The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak.
        J Autoimmun. 2020; : 102433https://doi.org/10.1016/j.jaut.2020.102433
        • Jiang F.
        • Deng L.
        • Zhang L.
        • et al.
        Review of the clinical characteristics of coronavirus disease 2019 (COVID-19).
        J Gen Intern Med. 2020; : 1-5
        • Richards G.
        • Mer M.
        • Schleicher G.
        • et al.
        COVID-19 and the rationale for pharmacotherapy: a South African perspective.
        Wits J Clin Med. 2020; 2: 11-18
      1. President Cyril Ramaphosa: South Africa's response to Coronavirus COVID-19 pandemic. South Africa: South Africa Government Newsroom Speeches; 2020. Available at: https://www.gov.za/speeches/president-cyril-ramaphosa-south-africas-response-coronavirus-covid-19-pandemic-23-apr-2020.

        • Qiu J.
        • Shen B.
        • Zhao M.
        • et al.
        A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations.
        Gen Psychiatry. 2020; 33https://doi.org/10.1136/gpsych-2020-100213
        • Thomas S.
        • Reading J.
        • Shephard R.J.
        Revision of the physical activity readiness questionnaire (PAR-Q).
        Can J Sport Sci. 1992; 17: 338-345
        • Segal-Isaacson C.
        • Wylie- Rosett J.
        • Gans K.M.
        Validation of a short dietary assessment questionnaire: the Rapid Eating and Activity Assessment for Participants short version (REAP-S).
        Diabetes Educ. 2004; 30: 774-781https://doi.org/10.1177/014572170403000512
        • Krueger R.F.
        • Derringer J.
        • Markon K.E.
        • et al.
        Initial construction of a maladaptive personality trait model and inventory for DSM-5.
        Psychol Med. 2012; 42: 1879-1890https://doi.org/10.1017/S0033291711002674
      2. World Health Organization. Coronavirus. Available at: https://www.who.int/health-topics/coronavirus#tab=tab_3.

      3. Guidelines for case-finding, diagnosis, management and public health response in South Africa, Centre for Respiratory Diseases and Meningitis and Outbreak Response, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS) and the National Department of Health, South African Government, South Africa, 2020. Available at: https://www.nicd.ac.za/wp-content/uploads/2020/03/NICD_DoH-COVID-19-Guidelines-10March2020_final.pdf.

        • Myer G.D.
        • Faigenbaum A.D.
        • Cherny C.E.
        • et al.
        Did the NFL lockout expose the Achilles heel of competitive sports?.
        JOSPT, Inc., JOSPT, 1033 North Fairfax Street, Suite 304, Alexandria, VA2011
        • Aicale R.
        • Tarantino D.
        • Maffulli N.
        Overuse injuries in sport: a comprehensive overview.
        J Orthop Surg Res. 2018; 13: 1-11
        • Maupin D.
        • Schram B.
        • Canetti E.
        • et al.
        The relationship between acute: chronic workload ratios and injury risk in sports: a systematic review.
        Open Access J Sports Med. 2020; 11: 51
        • Matthews C.E.
        • Ockene I.S.
        • Freedson P.S.
        • et al.
        Moderate to vigorous physical activity and risk of upper-respiratory tract infection.
        Med Sci Sports Exerc. 2002; 34: 1242-1248
        • Soligard T.
        • Steffen K.
        • Palmer D.
        • et al.
        Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: a prospective study of 11,274 athletes from 207 countries.
        Br J Sports Med. 2017; 51: 1265-1271
        • Schwellnus M.
        • Soligard T.
        • Alonso J.-M.
        • et al.
        How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness.
        Br J Sports Med. 2016; 50: 1043-1052
        • de Oliveira Neto L.
        • Elsangedy H.M.
        • de Oliveira Tavares V.D.
        • et al.
        Training in home – home-based training during COVID-19 (SARS-COV2) pandemic: physical exercise and behavior-based approach.
        Revista Brasileira de Fisiologia do Exercício. 2020; 19
        • Ogard W.K.
        Proprioception in sports medicine and athletic conditioning.
        Strength Cond J. 2011; 33: 111-118https://doi.org/10.1519/SSC.0b013e31821f3ae
        • Jukic I.
        • Calleja-González J.
        • Cos F.
        • et al.
        Strategies and solutions for team sports athletes in isolation due to COVID-19.
        Multidisciplinary Digital Publishing Institute, 2020
        • Farren G.L.
        • Zhang T.
        • Gu X.
        • et al.
        Sedentary behavior and physical activity predicting depressive symptoms in adolescents beyond attributes of health-related physical fitness.
        J Sport Health Sci. 2018; 7: 489-496
        • de Oliveira R.G
        • Guedes D.P.
        Physical activity, sedentary behavior, cardiorespiratory fitness and metabolic syndrome in adolescents: systematic review and meta-analysis of observational evidence.
        Public Library of Science, 2016
        • COVID-19 and Sporting Activity
        AIS framework for rebooting sport.
        The Australian Institute of Sport, Australia2020 (Available at: https://ais.gov.au/health-wellbeing/covid-19#ais_framework_for_rebooting_sport)
        • Sarto F.
        • Impellizzeri F.
        • Spörri J.
        • et al.
        Impact of potential physiological changes due to COVID-19 home confinement on athlete health protection in elite sports: a call for awareness in sports programming.
        2020 (Available at: https://osf.io/preprints/sportrxiv/4zb3a/)
        • Reardon C.L.
        • Hainline B.
        • Aron C.M.
        • et al.
        Mental health in elite athletes: International Olympic Committee consensus statement (2019).
        Br J Sports Med. 2019; 53: 667-699
        • Trojian T.
        Depression is under-recognised in the sport setting: time for primary care sports medicine to be proactive and screen widely for depression symptoms.
        Br J Sports Med. 2016; 50: 137-139
        • Tolentino J.C.
        • Schmidt S.L.
        DSM-5 criteria and depression severity: implications for clinical practice.
        Front Psychiatry. 2018; 9: 450https://doi.org/10.3389/fpsyt.2018.00450
        • Nédélec M.
        Recovery strategies in elite sport: focus on both quantity and quality of sleep.
        Rev Med Liege. 2020; 75: 49
        • Haspel J.A.
        • Anafi R.
        • Brown M.K.
        • et al.
        Perfect timing: circadian rhythms, sleep, and immunity – an NIH workshop summary.
        J Clin Invest Insight. 2020; 5https://doi.org/10.1172/jci.insight.131487
        • Thomas D.T.
        • Erdman K.A.
        • Burke L.M.
        Nutrition and athletic performance.
        Med Sci Sports Exerc. 2016; 48: 543-568https://doi.org/10.1249/MSS.0000000000000852
        • Maughan R.J.
        • Depiesse F.
        • Geyer H.
        The use of dietary supplements by athletes.
        J Sports Sci. 2007; 25: S103-S113https://doi.org/10.1080/02640410701607395
        • Grant W.B.
        • Lahore H.
        • McDonnell S.L.
        • et al.
        Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths.
        Nutrients. 2020; 12: 988
        • Kwinda M.A.
        Guidance on the application of telemedicine guidelines during the covid-19 pandemic.
        Health Professions Council of South Africa, South Africa2020 (Available at: https://www.hpcsa.co.za/Uploads/Events/Announcements/APPLICATION_OF_TELEMEDICINE_GUIDELINES.pdf)
        • Greenhalgh T.
        • Schmid M.B.
        • Czypionka T.
        • et al.
        Face masks for the public during the covid-19 crisis.
        BMJ. 2020; 369: m1435
      4. National Department of Health, COVID-19, online resource and news portal, South Africa, 2020. Available at: http://www.health.gov.za/index.php/component/phocadownload/category/631.

      5. COVID-19 Corona Virus South African Resource Portal, 2020. Available at: https://sacoronavirus.co.za/.

        • Lillicrap S.
        Behind closed doors: what impact can these coronavirus hit games have on players?.
        Sportsman HQ, England2020 (Available at: https://www.thesportsman.com/articles/behind-closed-doors-what-impact-can-these-coronavirus-hit-games-have-on-players)
        • Hughes D.
        • Saw R.
        • Perera N.K.P.
        • et al.
        The Australian Institute of sport framework for rebooting sport in a COVID-19 environment.
        J Sci Med Sport. 2020; (Available at: https://www.jsams.org/article/S1440-2440(20)30527-2/fulltext)
        • Varaeva Y.R.
        • Livantsova E.N.
        • Polenova N.V.
        • et al.
        Characteristics of blood lipid profiles of professional athletes: a literature review.
        Curr Pharm Des. 2020; 26: 98-102https://doi.org/10.2174/1381612825666191213115232
        • Soligard T.
        • Schwellnus M.
        • Alonso J.-M.
        • et al.
        How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury.
        Br J Sports Med. 2016; 50: 1030-1041
        • Gabbett T.J.
        The training – injury prevention paradox: should athletes be training smarter and harder?.
        Br J Sports Med. 2016; 50: 273-280
        • Carmody S.
        • Borodina M.A.
        • Gouttebarge M.
        • et al.
        When can professional sport recommence safely during the COVID-19 pandemic? Risk assessment and factors to consider.
        Br J Sports Med. 2020; (Available at: https://blogs.bmj.com/bjsm/2020/04/30/when-can-professional-sport-recommence-safely-during-the-covid-19-pandemic-risk-assessment-and-factors-to-consider/)
      6. AIS Whitepaper on load, Prescription of training load in relation to loading and unloading phases of training. Executive Summary, Version 1, 4 May 2015, 2020. Available at: http://runpure.com.au/wp- content/uploads/2016/02/AIS_White_paper_- _Loads_and_risks_following_troughs250615.pdf.

      7. Eminent Persons Group on Transformation in Sport (EPG), Sport transformation status report. A comparative & sport code specific assessment & introduction to school sport structure, Published by the Department of Sport & Recreation, South Africa, 2016/2017. Available at: https://www.srsa.gov.za/sites/default/files/Transformation %20Status%20Report%20-%202016-2017%20EPG%20-FINAL.pdf.