733 BO44 – Greater number of acute symptoms is associated with multi-organ involvement in athletes with SARS-CoV-2 infection

Background The severity of SARS-CoV-2 infection [days to return to sport (RTS)] in athletes has been associated with the total number of acute symptoms. Data on the association between acute symptoms and demographics, sport participation, co-morbidities/allergies and organ involvement are however lacking. Objective To explore if the number of acute SARS-CoV-2 symptoms in athletes is associated with organ involvement, adjusting for possible confounders: demographics, sport participation (level/type), history of co-morbidities/allergies. Design Prospective cohort study with cross-sectional analysis. Setting Medical evaluation 10–28 days after the onset of SARS-CoV-2 symptoms. Participants 95 Competitive athletes of varying levels of participation (professional/amateur) and different sport types. Assessment of risk factors Group differences were explored for demographics, sport participation, history of co-morbidities/allergies and organ involvement (defined as residual symptoms, abnormal clinical signs or selected laboratory investigations). Main outcome measurements The association between number of acute SARS-CoV-2 symptoms in 3 subgroups [by number of symptoms (1=≤5, 2=6–9, or 3=≥10)] and demographics, sport participation, history of co-morbidity/allergies and organ involvement. Results There was a significantly higher% of females (p=0.007) in subgroup 3 vs. 1 (p=0.005) or 2 (p=0.017). The% endurance athletes (p=0.022) was significantly higher in subgroups 3 vs. 1 (p=0.021) or 2 (p=0.037). The mean number of co-morbidities (p=0.003) was significantly lower in subgroup 2 vs. 1 (p=0.02) and allergies were more frequent in subgroup 3 vs. 1 (37.5% vs. 13.8%; p=0.037). After adjusting for sex and co-morbidities, number of organ systems involved was greater in subgroups 3 (2.4; p=0.0001) and 2 (2.3; p=0.0001) vs. 1(1.2). Conclusions More acute SARS-CoV-2 symptoms (>5) in athletes were associated with higher number of organ involvement, independent of sex or history of co-morbidities. Number of acute symptoms is a valuable measure of disease severity, which is the first step in clinical RTS decision making after recent SARS-CoV-2 infection.