Young Athletes in the Light of New Threats
At the end of 2019 few expected a new coronavirus – SARS-CoV-2 – whose
outbreak appeared in Wuhan, China, would significantly affect the world
population. After the World Health Organisation (WHO) announced a
pandemic in March 2020, there was concern about patients who suffer from
chronic diseases, including those with respiratory symptoms. Due to the
on-going phase of the pandemic at the time of writing, we are likely to
see many new research developments. In this section, we discuss a few
early results.
Presently there is no evidence that asthma in children is a risk factor
for infection with coronavirus disease 2019 (COVID-19). However,
symptoms of COVID-19 can mimic asthma exacerbation, including dry cough
and shortness of breath. Fever, which commonly occurs in COVID-19, could
be a differentiating factor from asthma exacerbation. Furthermore,
epidemiologic information such as travel history and possible contact
with infected persons should be considered. From the limited data from
the United States, children with symptoms of asthma should continue
therapy. This approach is supported by the statement of the Global
Initiative for Asthma (GINA), the Centers for Disease Control and
Prevention and the North American Consensus Guideline on Allergy Care.
Additional recommendations include frequent handwashing, apply the
principle of social distancing, and avoiding airborne allergens.
Special attention should be paid to athletes whose sports plans were
cancelled or postponed by this pandemic, including those with EIB and
asthma. There is currently no data available on prevalence, nature and
behavior of COVID-19 in athletes.
Consequences of isolation favor increased sedentary behaviors, lack of
communication among athletes and coaches, and an insufficient amount of
exercise. Negative lifestyle changes can lead to inappropriate nutrition
and an increase in body fat, which affects both physical and mental
health. There is a global consensus that the beneficial effect of
regular physical effort at moderate volume and intensity is associated
with decreased risk of respiratory infections. A sedentary lifestyle
poses a greater threat to athletes who depend on daily exercise. The
restrictions put in place by governments to prevent spread of COVID-19,
limit athletes’ ability to train. At the time of writing COVID-19
symptoms reported in pediatric patients are relatively mild with
recovery lasting 5-7 days. Nevertheless, a prolonged rest period for
such patients is recommended.
Jukic et al. offer strategies and solutions for athletes during the
COVID-19 pandemic. Firstly, they recommend encouraging athletes to
re-adapt their approach to isolation as an opportunity for “personal
development.” Secondly, by using the proper technology, athletes should
be supported and be in constant contact with experts, such as coaches,
nutritionists, physicians and psychologists. Adequate equipment should
be provided at the athletes’ living conditions, such as cardio equipment
(e.g. treadmill, bicycle), resistance training equipment (e.g.
dumbbells, elastic or medicine bands), and other techniques, which the
athlete can use to support exercise (e.g. mats, foam rollers).
Alternative sports skills training should be considered (e.g.
kinesthetic ball training in small space). The physician’s role is to
educate athletes about nutrition, supplementation, and hydration, and
also to encourage “preventive behaviors” (e.g. washing hands, social
distancing). Every athlete should use forms of self-assessment and
establish daily monitoring by the use of modern
technology28.
To summarize, athletes should comply with limitations and apply
strategies that will allow them to maintain an appropriate level of
physical exertion. Those, who have asthma symptoms should remain on
their current medication and introduce detailed control over the
treatment. More research will be required to help improve these
guidelines in the coming months29,30.