Background

Physical activity is beneficial for preventing non-communicable and infectious diseases, such as pneumonia. Physical activity is also a potential protective factor for reducing coronavirus disease 2019 (COVID-19) severity. Conversely, outbreaks of respiratory viral infections are more likely to occur owing to group activities, opportunities for contact with individuals and vocalisations. Since the onset of the COVID-19 pandemic, several cases of COVID-19 outbreaks during various sports and exercise have been reported. However, the common causes underlying these outbreaks remain unclear.

Objective

The objective of this study is to identify the causes of COVID-19 outbreaks during sports and exercise using systematic review approach.

Methods

Our eligibility criteria were published articles reporting case investigation on COVID-19 outbreaks and the cause during sports and exercise. Studies such as reviews and observational studies without case investigations were excluded. PubMed, CINAHL, WHO COVID-19 Research Database and Ichushi Web were searched on 28 August 2023. The quality of included studies was rated using a quality criteria checklist adapted from a previous systematic review of influenza outbreaks. Vote counting of outbreak causes was performed by type of sports (team or individual).

Results

Twenty-one articles reporting 22 outbreaks were identified (quality: high, 9; medium, 9; and low, 3). The outbreaks were most frequently reported in fitness classes, followed by soccer. Most studies listed multiple causes of the outbreaks. The most common suspected cause of outbreaks in individual exercise, mostly from fitness classes, was poor ventilation and not wearing masks, followed by not maintaining physical distance and participation of individuals with some symptoms. In team sports, the most common cause was interaction outside the game, such as social events.

Conclusions

This systematic review found a limited number of case investigations suggesting that COVID-19 outbreaks during sports and exercise may be associated with the inhalation of aerosols in indoor settings, interactions outside of team sports games and participation of individuals with some symptoms. Prevention strategies that focus on mitigating these issues may be effective at preventing sports and exercise-associated respiratory infectious diseases outbreaks.

PROSPERO Registration Number

CRD42023443158.

中文翻译：

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运动和锻炼期间 COVID-19 爆发的原因：系统评价

 背景

身体活动有利于预防非传染性疾病和传染病，例如肺炎。身体活动也是降低 2019 冠状病毒病 （COVID-19） 严重程度的潜在保护因素。相反，由于群体活动、与个人接触的机会和发声，更容易发生呼吸道病毒感染的爆发。自 COVID-19 大流行开始以来，已报告了几例在各种运动和锻炼期间爆发 COVID-19 的病例。然而，这些疫情的常见原因尚不清楚。

 目的

本研究的目的是使用系统评价方法确定运动和锻炼期间 COVID-19 爆发的原因。

 方法

我们的纳入标准是已发表的文章，报告了 COVID-19 疫情的病例调查以及运动和锻炼期间的原因。排除了综述和没有病例调查的观察性研究等研究。于 2023 年 8 月 28 日检索了 PubMed、CINAHL、WHO COVID-19 研究数据库和 Ichushi Web。使用质量标准检查表对纳入研究的质量进行评级，该检查表改编自先前对流感暴发的系统评价。按运动类型（团队或个人）对爆发原因进行计票。

 结果

确定了 21 篇报告了 22 次疫情的文章（质量：高，9;中，9;和低，3）。疫情最常在健身课上报告，其次是足球。大多数研究列出了爆发的多种原因。个人运动中最常见的疑似爆发原因，主要来自健身课程，是通风不良和不戴口罩，其次是没有保持身体距离和有某些症状的人参与。在团队运动中，最常见的原因是游戏外的互动，例如社交活动。

 结论

本系统评价发现，数量有限的病例调查表明，运动和锻炼期间的 COVID-19 爆发可能与在室内环境中吸入气溶胶、团队运动比赛以外的互动以及有某些症状的个体参与有关。专注于缓解这些问题的预防策略可能有效预防与运动和运动相关的呼吸道传染病爆发。

PROSPERO 注册号

 CRD42023443158。