A Case Series of SARS-CoV-2 Reinfection in Elite Athletes

Gábor Áron Fülöp; Bálint Lakatos; Mihály Ruppert; Attila Kovács; Vencel Juhász; Gábor Dér; András Tállay; Hajnalka Vágó; Boldizsár Kiss; Béla Merkely; Endre Zima

doi:10.3390/ijerph192113798

A Case Series of SARS-CoV-2 Reinfection in Elite Athletes

Int J Environ Res Public Health. 2022 Oct 24;19(21):13798. doi: 10.3390/ijerph192113798.

Authors

Gábor Áron Fülöp¹, Bálint Lakatos¹, Mihály Ruppert¹, Attila Kovács¹, Vencel Juhász¹, Gábor Dér¹, András Tállay², Hajnalka Vágó^{1

2}, Boldizsár Kiss¹, Béla Merkely^{1

2}, Endre Zima^{1

2}

Affiliations

¹ The Heart and Vascular Center, Semmelweis University, H-1122 Budapest, Hungary.
² Department of Sports Medicine, Semmelweis University, H-1122 Budapest, Hungary.

Abstract

Objectives: The actual frequency and the risk factors of SARS-CoV-2 reinfection is still a matter of intense scientific discussion. In this case series, we report three elite athletes who underwent COVID-19 reinfection with a short time frame.

Case presentations: As a part of contact tracing, three speed skaters (22-, 24-, and 29-year-old males) were found to be SARS-CoV-2 positive by polymerase chain reaction (PCR) tests. Later on, only one of the athletes experienced mild symptoms, such as fatigue, loss of smell and taste and subfebrility, while the other two athletes were asymptomatic. Following the quarantine period, detailed return-to-play examinations, including laboratory testing, ECG, 24-h Holter monitoring, transthoracic echocardiography and cardiac magnetic resonance imaging, revealed no apparent abnormality; therefore, the athletes restarted training. After a median of 74 days, all three athletes presented with typical symptoms of COVID-19, such as fever, marked fatigue and headache. SARS-CoV-2 PCR tests were performed again, showing recurrent positivity. Repeated return-to-play assessments were initiated, finding no relevant abnormality. Athletes were also tested for SARS-CoV-2 anti-nucleoprotein antibody titers, showing only modest increases following the second infection.

Conclusions: We report a small cluster of elite athletes who underwent a PCR-proven SARS-CoV-2 reinfection. According to these findings, athletes may be considered as a high-risk group in terms of recurrent COVID-19.

Keywords: COVID-19; SARS-CoV-2; athletes; reinfection.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Athletes
COVID-19* / diagnosis
COVID-19* / epidemiology
Fatigue / etiology
Humans
Male
Reinfection / epidemiology
SARS-CoV-2*

Grants and funding

The research was financed by the Thematic Excellence Program (2020-4.1.1.-TKP2020) of the Ministry for Innovation and Technology in Hungary, within the framework of the Therapeutic Development and Bioimaging thematic programs of the Semmelweis University and also by the New National Excellence Program of the Ministry of Human Capacities (ÚNKP-20-4-I-SE-13 to B.L. and ÚNKP-20-5 to A.K.). This project was also supported by a grant from the National Research, Development and Innovation Office (NKFIH) of Hungary (K135076 to B.M.). A.K. was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences. Project no. TKP2021-NKTA-46 has been implemented with the support provided by the Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund, financed under the TKP2021-NKTA funding scheme.