Key result
The risk of subsequent musculoskeletal injury following COVID-19 was similar to the risk following general infection among high school athletes (rate ratio 1.2; 95% CI 0.7-2.4).
Why the study?
The study was designed to describe illness and COVID-19-specific illness in high school athletes across two academic years, and to assess subsequent musculoskeletal injury risk following general infection versus COVID-19.
Does COVID-19 infection increase the risk of subsequent musculoskeletal injury compared to general infection in high school athletes?
Observational (n=171,008)
Yes
Does COVID-19 infection increase the risk of subsequent musculoskeletal injury compared to general infection in high school athletes?
Relative Risk: 1.2 (95% CI 0.7–2.4)
Subsequent musculoskeletal injury incidence following moderate and severe infections in high school athletes was similar between general infections and COVID-19.
Similar post-infection injury risk after COVID-19 and general illness may support equivalent return-to-play guidance in high school athletes; leaves open confirmation in prospective studies.
Objectives To describe overall illness and COVID-19- specific illness in high school athletes in the 2019–2020 and 2020–2021 academic school years, and to describe and assess the risk of musculoskeletal injury following general infection and after COVID-19. Design Ecological study. Methods High schools (6 states; 176 high schools) were matched between the 2019–2020 and 2020–2021 academic school years, based on 2020–2021 high school sport participation. Illness and injury data were collected from the high school athletic trainers. Illness was stratified by overall illness, general infection, and COVID-19. Injuries following moderate or severe infections or COVID-19 were recorded. Illness and injury incidence rate per 100 athletes per year, with 95% confidence intervals (95% CIs), were calculated. Negative binomial models comparing injury following general infections and COVID-19 infections were calculated. Results A total of 98 487 and 72 521 athletes participated in the 2019–2020 and 2020–2021 years. Illness incidence rate was less in the 2019–2020 academic school year [0.30 (95% CI: 0.27, 0.34)] than the 2020–2021 academic school year [1.1 (1.0–1.2)], resulting in a difference of 0.8 (95% CI: 0.7, 0.9). COVID-19 incidence rate was 0.52 (0.47–0.58) in the 2020–2021 year. Injury following general infection incidence rate was 27.9 injuries (21.4–34.5) per 100 athletes in 2019–2020, and 22.5 injuries (19.3–25.7) per 100 athletes in 2020–2021. There was no difference in injury risk following general infection and COVID-19 [rate ratio: 1.2 (95% CI: 0.7, 2.4)]. Conclusions The incidence rate for all illnesses in high school athletes was slightly (0.8) greater in the 2020–2021 academic compared to the 2019–2020 year. Most of the incidence increase was due to infections and COVID-19. Subsequent injury incidence following moderate and severe infections were similar between years and between general infections and COVID-19. J Orthop Sports Phys Ther 2022;52(8):546–553. Epub: 19 June 2022. doi:10.2519/jospt.2022.11200
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Shanley et al. (2022) conducted an observational in COVID-19 and general infection (n=171,008). COVID-19 infection vs. General infection was evaluated on Musculoskeletal injury following infection (rate ratio 1.2, 95% CI 0.7-2.4). The risk of subsequent musculoskeletal injury following COVID-19 was similar to the risk following general infection among high school athletes (rate ratio 1.2; 95% CI 0.7-2.4).
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