Advertisement
Journal of Science and Medicine in Sport
Advanced searchSave search
Letter to the Editor|Articles in Press

Comment on “Vaccine, infection, COVID-19-related loss of training time and athletes”

Published:March 06, 2023DOI:https://doi.org/10.1016/j.jsams.2023.01.005
Comment on “Vaccine, infection, COVID-19-related loss of training time and athletes”
Previous ArticleResponse to the letter to the Editor regarding the article “Vaccine versus infection - COVID-19-related loss of training time in elite athletes”
Next ArticleDeveloping AI enabled sensors and decision support for military operators in the field
      Dear Editor,
      We would like to share ideas on the publication “Vaccine versus infection - COVID-19-related loss of training time in elite athletes.
      • Krzywański J.
      • Mikulski T.
      • Krysztofiak H.
      • et al.
      Vaccine versus infection - COVID-19-related loss of training time in elite athletes.
      J Sci Med Sport. 2022; (S1440-2440(22)00438-8. [Online ahead of print])https://doi.org/10.1016/j.jsams.2022.10.004
      ” According to Krzywanski et al., COVID-19 causes athletes to lose a large amount of training days, however vaccination against COVID-19 results in a noticeably lesser and more predictable loss.
      • Krzywański J.
      • Mikulski T.
      • Krysztofiak H.
      • et al.
      Vaccine versus infection - COVID-19-related loss of training time in elite athletes.
      J Sci Med Sport. 2022; (S1440-2440(22)00438-8. [Online ahead of print])https://doi.org/10.1016/j.jsams.2022.10.004
      This supports the inclusion of vaccination in prevention plans for athletes whenever they are accessible, according to Krzywaski et al.
      • Krzywański J.
      • Mikulski T.
      • Krysztofiak H.
      • et al.
      Vaccine versus infection - COVID-19-related loss of training time in elite athletes.
      J Sci Med Sport. 2022; (S1440-2440(22)00438-8. [Online ahead of print])https://doi.org/10.1016/j.jsams.2022.10.004
      However, there are additional factors that must be considered for a proper interpretation of their results.
      There are 4 points which should be addressed by the authors of the Krzywanski article somewhat better. The efficacy of the utilized vaccines for the acquisition of Covid-19 for given strain of SARS-CoV-2, the recipient's pre-vaccination co-morbidity (which will not, of course, be high in athletes), and their potential impact on adverse reactions and time lost due to vaccination are relevant things to consider. Also, an individual's typical response or other confounding factors could have caused the unpleasant response to the vaccination. The current study by Krzywanski et al. used a questionnaire as well as a retrospective analysis. However, it remains unclear if these data are independent from each other.
      The second point is that athletes may have previously had COVID-19 without experiencing any symptoms (which may have an effect on the vaccination side effects and time loss). Prior asymptomatic COVID-19 and the absence of clinical symptoms after vaccination may be linked.
      • Gao Z.
      • Xu Y.
      • Sun C.
      • et al.
      A systematic review of asymptomatic infections with COVID-19.
      J Microbiol Immunol Infect. 2021; 54: 12-16
      For athletes, a chance of prior asymptomatic COVID-19 exists. In a recent study from China, 30.6% of the infected athletes were asymptomatic.
      • You M.
      • Liu H.
      • Wu Z.
      The spread of COVID-19 in athletes.
      Sci Sports. 2022; 37: 123-130
      An earlier asymptomatic infection can result in altered symptoms of COVID-19 or a different response to COVID-19 vaccine. Therefore, an asymptomatic previous COVID-19 must be checked out. Krzywanski et al. used no laboratory tests to rule out a previous asymptomatic COVID-19. As a result, such a confounding effect may exist in this case and may have affected their observation. This would potentially cause more variability.
      The third problem that needs to be addressed is “cross contamination” with COVID-19, or the presence of an unidentified COVID-19 at the time of vaccination (with potential side effects and impacts on time loss). A breakthrough COVID-19 is still possible after immunization. According to a recent report, the COVID-19 breakthrough can occur as early as the first day after immunization, implying an unfortunate timepoint of vaccination.
      • Bouton T.C.
      • Lodi S.
      • Turcinovic J.
      • et al.
      COVID-19 Vaccine Impact on Rates of SARS-CoV-2 Cases and Post Vaccination Strain Sequences Among Healthcare Workers at an Urban Academic Medical Center: A Prospective Cohort Study.
      2021https://doi.org/10.1101/2021.03.30.21254655
      Again, no examination has been conducted in the Krzywanski et al. study to rule out the likelihood of cross contamination as a confounding factor.
      The fourth and last factor to be considered is the genetic background, which may also affect how an individual responds to immunization. Čiučiulkaitė et al.
      • Čiučiulkaitė I.
      • Möhlendick B.
      • Thümmler L.
      • et al.
      GNB3 c.825c>T polymorphism influences T-cell but not antibody response following vaccination with the mRNA-1273 vaccine.
      Front Genet. 2022; 13932043
      investigated the idea that inherited genetic variability influences vaccination recipients' immunological response. The GNB3 gene c.825C>T polymorphism has been observed to be related with a response to the COVID-19 vaccine.
      • Čiučiulkaitė I.
      • Möhlendick B.
      • Thümmler L.
      • et al.
      GNB3 c.825c>T polymorphism influences T-cell but not antibody response following vaccination with the mRNA-1273 vaccine.
      Front Genet. 2022; 13932043
      If future clinical trials are planned that address vaccine efficacy and side effects, the impacts of the genetic polymorphism background should be taken into account. Gülyaşar et al. reported that similar healthy athletes had diverse backgrounds of the GNB3 gene c.825C>T polymorphism, which is connected with physical fitness.
      • Gülyaşar T.
      • Oztürk L.
      • Sipahi T.
      • et al.
      GNB3 gene c.825C>T polymorphism and performance parameters in professional basketball players.
      Acta Physiol Hung. 2014; 101: 176-184
      Unfortunately, there is no assessment of the genetic background in Krzywanski et al.'s.
      The mentioned confounders may have influenced the results and induced more variability. If there is a confounder, there might be a variable low or high clinical efficacy of the vaccine. The observed outcomes might be incorrectly interpreted. To measure the COVID-19-related loss of training time in elite athletes, a robust approach should be in place to rule out confounding effects such as prior COVID-19 infection, cross contamination, and co-morbidity. In addition, the participants must be divided into groups depending on the utilized vaccine type, vaccination delivery technique, and dosage. If additional research is conducted with a plan to manage these points, it may provide more important data for future planning to manage the COVID-19 problem and post-COVID-19 consequences among athletes.

      Conflict of interest

      None.

      References

        • Krzywański J.
        • Mikulski T.
        • Krysztofiak H.
        • et al.
        Vaccine versus infection - COVID-19-related loss of training time in elite athletes.
        J Sci Med Sport. 2022; (S1440-2440(22)00438-8. [Online ahead of print])https://doi.org/10.1016/j.jsams.2022.10.004
        View in Article
        • Gao Z.
        • Xu Y.
        • Sun C.
        • et al.
        A systematic review of asymptomatic infections with COVID-19.
        J Microbiol Immunol Infect. 2021; 54: 12-16
        View in Article
        • You M.
        • Liu H.
        • Wu Z.
        The spread of COVID-19 in athletes.
        Sci Sports. 2022; 37: 123-130
        View in Article
        • Bouton T.C.
        • Lodi S.
        • Turcinovic J.
        • et al.
        COVID-19 Vaccine Impact on Rates of SARS-CoV-2 Cases and Post Vaccination Strain Sequences Among Healthcare Workers at an Urban Academic Medical Center: A Prospective Cohort Study.
        (medRxiv)2021https://doi.org/10.1101/2021.03.30.21254655 ([2021.03.30.21254655])
        View in Article
        • Čiučiulkaitė I.
        • Möhlendick B.
        • Thümmler L.
        • et al.
        GNB3 c.825c>T polymorphism influences T-cell but not antibody response following vaccination with the mRNA-1273 vaccine.
        Front Genet. 2022; 13932043
        View in Article
        • Gülyaşar T.
        • Oztürk L.
        • Sipahi T.
        • et al.
        GNB3 gene c.825C>T polymorphism and performance parameters in professional basketball players.
        Acta Physiol Hung. 2014; 101: 176-184
        View in Article

      Article info

      Publication history

      Published online: March 06, 2023
      Accepted: January 7, 2023
      Received in revised form: January 5, 2023
      Received: October 20, 2022

      Publication stage

      In Press Journal Pre-Proof

      Identification

      DOI: https://doi.org/10.1016/j.jsams.2023.01.005

      Copyright

      © 2023 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      Linked Article

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX