Anxiety, insomnia, and depression during COVID-19 lockdown in elite individual and team sport athletes

Purpose: Pandemic-induced lockdowns disrupted sport training and competition. We aimed to identify the impact on the mental health of high-level athletes and clarify whether the efects difer for team-based and individual athletes. Methods: This cross-sectional survey, stratifed by sex and sport type, collected demographic data and mental health measurements from 274 Brazilian high-performance athletes (142 from team sports and 132 from individual sports) involved with the Brazilian Olympic Committee program for the Tokyo Olympics 2021. Depression, disturbed sleep, and anxiety were assessed by the 9-Item Patient Health Questionnaire, 7-Item Insomnia Severity Index, and 7-Item Generalized Anxiety Disorder scale respectively. Responses were analyzed dichotomously according to published threshold values, characterizing the relative frequency distribution of prevalence (PCRS) or non-prevalence of clinically relevant symptoms (NPCRS). Results: Out of all participants, 47 [17.1%], Z(274) = 15.38, p = .001, 32 [11.7%], Z(274) = 17.94, p = .001, and 49 [17.9%], Z(274) = 15.04, p = .001 had PCRS of anxiety, insomnia, and depression, respectively. There were no signifcant diferences in the PCRS among genders. Compared with individual sport athletes, team sport athletes were more likely to report PCRS of insomnia (12 [37.5%] vs 20 [62.5%], Z(274) = −2.00, p = .046), and depression (18 [36.7%] vs 31 [63.3%], Z(274) = −2.63, p = .009) but not for anxiety. Conclusion: Athletes reported high levels of mental health problems during the lockdown. Team sport athletes reported worse symptoms of insomnia and depression than individual sport athletes, possibly due to the impact of unaccustomed social isolation and lack of social team activity. Therefore, it becomes relevant to consider psychological support to team sport athletes who for some reason, such as a pandemic, enduring crisis even injury rehabilitation needs to be isolated. (AU)

Covid-19 and its effect on olympic sport: the importance of studying social isolation and the harm it causes, in order to minimize it / Covid-19 e seu efeito no esporte olímpico: a importância de estudar o isolamento social e seus danos a fim de minimizá-los / Covid-19 y su efecto en el deporte olímpico: la importancia de estudiar el aislamiento social y sus daños a fin de minimizarlos

ABSTRACT In March 2020, the World Health Organization (WHO) declared the disease caused by the SARS-CoV2 virus, known as COVID-19, to be a pandemic. The sporting world, too, is suffering from the global effects of this disease, with the postponement or cancellation of competitions, including the 2020 Tokyo Olympic Games. As a proposal for containing the disease, social isolation was declared. Despite the importance of this measure, it was harmful for Olympic athletes, as they had to stay away from their training site and trainers, as well as their interdisciplinary teams. It is therefore important to study this harm caused, in order to minimize it. In general, it is believed that regular physical activity is associated with improved immune system functioning. The lack of training can therefore have significant consequences for the performance and health of the Olympic athlete. From the athlete's point of view, the impaired immune system, due to the reduced frequency of physical exercise, leaves them more vulnerable to contracting or developing infections or other diseases. The risk of harm due to the decreased performance of preventive works is also evident in this population. The reductions in training load and intensity can cause changes in the athlete's body composition and affect various aspects of cardiorespiratory fitness, as well as reducing strength levels and muscle potency. In relation to the athlete's mental health, two aspects are particularly challenging: isolation and uncertainty. Based on the possible harm caused by social isolation, the need is seen for a specific and joint work, in an attempt to minimize it. This work addresses the following topics: (I) context: transmission, symptoms, diagnosis, treatment, discharge criteria, isolation and post-pandemic consequences; (II) harm and proposals: nutritional, physiological, biomechanical and psychological. Level of evidence II; Review Article.

RESUMO Em março de 2020, a Organização Mundial da Saúde (OMS) declarou como pandemia a doença causada pelo vírus SARS-CoV2, conhecida como COVID-19. O mundo do esporte acompanha e sofre os efeitos globais dessa enfermidade, com o adiamento ou cancelamento de competições, inclusive os Jogos Olímpicos de Tóquio 2020. Como proposta para contenção da doença, foi determinado o isolamento social. Apesar de importante, esta medida traz danos aos atletas olímpicos pelo afastamento do local de treinamento e de treinadores, assim como de sua equipe interdisciplinar. Portanto, entende-se a importância de estudar esses danos a fim de minimizá-los. De forma geral, acredita-se que a atividade física regular esteja associada à melhora do funcionamento do sistema imunológico. Assim, a falta de treinamento pode levar a consequências importantes para o desempenho e a saúde do atleta olímpico. Do ponto de vista da saúde do atleta, o comprometimento do sistema imunológico pela redução da regularidade do exercício físico deixa o atleta mais vulnerável a contrair e desenvolver infecções ou outras patologias. Além disso, o risco de lesões considerando a diminuição da realização dos trabalhos preventivos é evidente nessa população. As reduções da carga e da intensidade de treino podem provocar mudanças na composição corporal do atleta e afetar diversos componentes da aptidão cardiorrespiratória, assim como reduzir níveis de força e potência muscular. Com relação à saúde mental do atleta, dois aspectos são os mais desafiadores: o isolamento e a incerteza. A partir dos possíveis danos causados pelo isolamento social, entende-se a necessidade de um trabalho específico e em conjunto, na tentativa de minimizá-los. Neste trabalho serão abordados os seguintes tópicos: (I) contexto: transmissão, sintomas, diagnóstico, tratamento, critérios de alta, isolamento e consequências pós-pandemia; (II) danos e propostas: nutricionais, fisiológicas, biomecânicas, bioquímicas e psicológicas. Nível de evidência II; Artigo de Revisão.

RESUMEN En marzo de 2020, la Organización Mundial de la Salud (OMS) declaró como pandemia a la enfermedad causada por el virus SARS-CoV2, conocida como COVID-19. El mundo del deporte acompaña y sufre los efectos globales de esa enfermedad, con la postergación o cancelación de competiciones, inclusive los Juegos Olímpicos de Tokio 2020. Como propuesta para contención de la enfermedad, se determinó el aislamiento social. A pesar de importante, esta medida trae daños a los atletas olímpicos por el alejamiento del local de entrenamiento y de entrenadores, así como de su equipo interdisciplinario. Por lo tanto, se entiende la importancia de estudiar esos daños a fin de minimizarlos. De forma general, se cree que la actividad física regular esté asociada a la mejora del funcionamiento del sistema inmunológico. Así, la falta de entrenamiento puede llevar a consecuencias importantes para el desempeño y la salud del atleta olímpico. Desde el punto de vista de la salud del atleta, el compromiso del sistema inmunológico por la reducción de la regularidad del ejercicio físico deja al atleta más vulnerable a contraer y desarrollar infecciones u otras patologías. Además, el riesgo de lesiones considerando la disminución de la realización de los trabajos preventivos es evidente en esa población. Las reducciones de la carga y de la intensidad de entrenamiento pueden provocar cambios en la composición corporal del atleta y afectar diversos componentes de la aptitud cardiorrespiratoria, así como reducir niveles de fuerza y potencia muscular. Con relación a la salud mental del atleta, dos aspectos son los más desafiantes: el aislamiento y la incertidumbre. A partir de los posibles daños causados por el aislamiento social, se entiende la necesidad de un trabajo específico y en conjunto, en la tentativa de minimizarlos. En este trabajo serán abordados los siguientes tópicos: (I) contexto: transmisión, síntomas, diagnóstico, tratamiento, criterios de alta, aislamiento y consecuencias postpandemia; (II) daños y propuestas: nutricionales, fisiológicas, biomecánicas, bioquímicas y psicológicas. Nivel de evidencia II; Artículo de Revisión.