{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:17:12Z","timestamp":1784099832302,"version":"3.55.0"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2021,7,17]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To report COVID-19 illness pattern, symptom duration and time loss in UK elite athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Observational, clinical and database review of athletes with symptomatic COVID-19 illness managed within the UK Sports Institutes. Athletes were classified as confirmed (positive SARS-CoV-2 PCR or antibody tests) or probable (consistent clinical features) COVID-19. Clinical presentation was characterised by the predominant symptom focus (eg, upper or lower respiratory illness). Time loss was defined as days unavailable for full sport participation and comparison was made with a 2016\u20132019 respiratory illness dataset from the same surveillance system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 24 February 2020 and 18 January 2021, 147 athletes (25 Paralympic (17%)) with mean (SD) age 24.7 (5.2) years, 37% female, were diagnosed with COVID-19 (76 probable, 71 confirmed). Fatigue was the most prevalent symptom (57%), followed by dry cough (50%) and headache (46%). The median (IQR) symptom duration was 10 (6\u201317) days but 14% reported symptoms &gt;28 days. Median time loss was 18 (12\u201330) days, with 27% not fully available &gt;28 days from initial date of infection. This was greater than our historical non-COVID respiratory illness comparator; 6 days, 0\u20137 days (p&lt;0.001) and 4% unavailable at 28 days. A lower respiratory phenotype (ie, including dyspnoea\u00b1chest pain\u00b1cough\u00b1fever) was present in 18% and associated with a higher relative risk of prolonged symptoms risk ratio 3.0 (95% CI: 1.4 to 6.5) and time loss 2.1 (95% CI: 1.2 to 3.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort, COVID-19 largely resulted in a mild, self-limiting illness. The presence of lower respiratory tract features was associated with prolonged illness and a delayed return to sport.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2021-104392","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T13:28:30Z","timestamp":1627910910000},"page":"4-11","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Clinical patterns, recovery time and prolonged impact of COVID-19 illness in international athletes: the UK experience"],"prefix":"10.1136","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4697-1526","authenticated-orcid":false,"given":"James H","family":"Hull","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK"},{"name":"English Institute of Sport, Manchester, UK"},{"name":"Sports Respiratory Service, Institute of Sport, Exercise and Health (ISEH), UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Wootten","sequence":"additional","affiliation":[{"name":"UK Sport, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moiz","family":"Moghal","sequence":"additional","affiliation":[{"name":"English Institute of Sport, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4123-9806","authenticated-orcid":false,"given":"Neil","family":"Heron","sequence":"additional","affiliation":[{"name":"Sport Institute Northern Ireland, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhodri","family":"Martin","sequence":"additional","affiliation":[{"name":"Sports Medicine, Sport Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil S","family":"Walsted","sequence":"additional","affiliation":[{"name":"Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Biswas","sequence":"additional","affiliation":[{"name":"Sports Medicine, English Institute of Sport, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4855-0744","authenticated-orcid":false,"given":"Mike","family":"Loosemore","sequence":"additional","affiliation":[{"name":"English Institute of Sport, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5394-975X","authenticated-orcid":false,"given":"Niall","family":"Elliott","sequence":"additional","affiliation":[{"name":"Sports Medicine, Sport Scotland Institute of Sport, Stirling, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3783-0505","authenticated-orcid":false,"given":"Craig","family":"Ranson","sequence":"additional","affiliation":[{"name":"English Institute of Sport, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,2]]},"reference":[{"key":"2025080112172528000_56.1.4.1","unstructured":"Public-Health-England . 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